This study was done to identify predictors of the fighting spirit or helplessness/hopelessness in the patients' mental adjustment to cancer. Cancer patients' characteristics like performance status, metastasis and duration of diagnosis with demographic factors, spiritual support and social support were used as predictors of a fighting spirit or helplessness/hopelessness.

total of 124 ambulatory cancer patients completed the Mental Adjustment to Cancer (MAC) scale and responded in a structured instrument about their characteristics, spiritual and social support.

The results of multiple regression analysis revealed that confidence in the supporter (R²=.114, p=.000), duration of cancer diagnosis (R²=.041, p=.000) and faith (R²=.030, p=.000) were predictive of a fighting spirit (R²=.185, p=.000); whereas, education (R²= .074, p=.001), performance status (R²=.055, p=.000), satisfaction with social support (R²=.046, p=.000), and metastasis (R²=.037, p=.000) were predictive of helplessness/hopelessness (R²=.202, p=.000).

Social support, spiritual support and disease related factors like metastasis, performance status, and duration of cancer diagnosis need to be considered in a psychosocial nursing intervention for a fighting spirit or helplessness/hopelessness.