Table 4.

Themes and Sub-Themes, Definition, and Supportive Quotes for Coping Strategies Described by Retinoblastoma Survivors

S. No.	Themes and Sub-Themes	Definition of Theme/Sub-Theme (n)*	Supporting Quotes
1.	Active coping	Utilization of psychological or behavioral efforts to deal with the problem (n = 49)
1a.	To become stronger	Patient became more resilient and developed acceptance (21)	“but that shaped my personality to be stronger and to have a better outlook on life and to appreciate it more, "what doesn't kill you, makes you stronger"” (ID #50001060) “but it did make (me) determined to do the best I could at whatever I tried” (ID #50002520)
1b.	Had to learn compensatory skills/alternative methods	Patient uses alternative methods generally, and more specifically such as adjusting seating to manage seing the other person, walking on right side of people so patient doesn’t run into them (17)	“had to learn all the compensatory skills that I wouldn’t have otherwise” (ID #50001300) “it has forced me to use alternative methods for most life skills, everything from access to print/information to personal independence, to a great extent social interaction, and romance possibility.” (ID #50006580) “Does it stop me from doing other things? NO! Find other ways around it!” (ID #50008260)
1c.	To become more resourceful and creative problem solver	Patient has learned to be more creative in finding a solution to his/her problems and thinking outside the box (7)	“I have had to learn to be more resourceful, more of a creative problem solver, definitely learned that there is more than one way to do something” (ID #50001120) “You pretty much always have to do something from a different angle” (ID #50001980)
1d.	To become extra cautious and careful	Patient has to be deliberate and more careful in doing things (7)	“have to be cautious and careful b/c can't see anything coming” (ID #50000110) “Extra caution for sports, driving, etc.” (ID #50000660)
1e.	Wear patch, sunglasses etc.	Patient wears a patch or sunglasses for protection (4)	“I removed it when I was 19 and I wear an eye patch currently” (ID #50001540) “Prefer to wear sunglasses as much as possible” (ID #50001170)
1f.	To learn specific tasks	Patient describes learning specific tasks such as spatial relationships, learn braille, learn to adapt sporting ability (4)	“Work on learning spatial relationships.” (ID #50008580) “learning things like braille…” (ID #50009720) “having to adapt sports ability” (ID #50009720)
1g.	To focus more on appearance	Patient described spending more time with appearance to appear nice and to refocus people’s attention away from eye problems (2)	“take more time with appearance so people see beyond eye problems - try to distract people” (ID #50000040) “It has always affected how I style my hair” (ID #50004650) “I wear my hair over that eye to cover it” (ID #50005800)
2.	Avoidant coping	Efforts to avoid dealing with the stressor (n = 12)
2a.	Avoid thoughts, people and/or situations	Patient’s strategy is to avoid by either not thinking about it, looking down and avoiding eye contact, avoid being in certain situations, etc. (6)	“I tend to look down and avoid eye contact” (ID #50000920) “I don't go around thinking about it” (ID #50005330)
2b.	Don’t talk about it	Patient doesn’t talk much about his eye problems (5)	“For this reason, I use the don't ask, don't tell policy because I feel that I am not handicapped.” (ID #50006120) “As a result I may be somewhat more reserved in social situations or in my career than normal.” (ID #50007040)
2c.	To engage in harmful behaviors	Specific examples of strategies patient uses such as becomes aggressive (1), or overeats (1)	“…and responded by punching kids in face” (ID #50004040) “think I also over-eat as a way of coping, I am overweight.” (ID #50007320)
3.	Spiritual coping	Patient has increased reliance on faith (2)	“put life in God's hands” (ID #50007520) “Read Psalm 139-God created me just how he wanted to create me.” (ID #50006540)

^*(n) is for the number of participants whose response fit the theme/sub-theme.

NOTE: Themes and sub-themes are not mutually exclusive.