Illness cognitions and the associated socio-demographic and clinical factors in Chinese women with breast cancer

Illness cognition, illness perception and related factors in patients with lymphangioleiomyomatosis

PURPOSE

To explore the self-perceived illness cognition and perception status, as well as the relevant factors among lymphangioleiomyomatosis (LAM) patients.

METHODS

A web-based questionnaire survey was conducted in September 2023. A total of 121 LAM patients participated (including 16 patients with TSC-LAM), and the survey collected general demographic information, responses to a disease cognition questionnaire, and a simplified disease perception questionnaire.

RESULTS

LAM patients have a higher level of negative illness cognition and a lower level of positive illness cognition, specifically characterized by helplessness (15.74 ± 4.68 points), acceptance (16.00 ± 3.28 points), and perceived benefits (16.92 ± 3.86 points). Single-factor analysis of variance found significant correlations between cultural level, age, family average monthly income, use of rapamycin, use of home oxygen therapy, hospitalization frequency, disease duration, severity of respiratory distress, activity limitation, and the helplessness score of LAM patients (p ≤ 0.05); the number of children was significantly associated with acceptance scores of LAM patients (p ≤ 0.05); and whether surgery had been performed was significantly associated with acceptance and perceived benefits scores of LAM patients (p ≤ 0.05). Disease duration and activity limitation entered the regression equation for helplessness dimension, while whether surgery had been performed entered the regression equation for perceived benefits dimension, but no factor entered the regression equation for acceptance dimension. Applying the same analysis to disease perception, we found that the average score of the Illness Perception Questionnaire was 45.43 ± 8.97, with lower scores in the reverse-scored items of individual control, treatment, and understanding.

CONCLUSIONS

LAM patients exhibit higher levels of helplessness, particularly among those with longer disease duration and greater activity limitations, leading to a more negative perception of the disease. Additionally, patients who have undergone surgical procedures tend to perceive fewer benefits. Furthermore, there is a significant correlation between illness perception and factors such as rapamycin usage, home oxygen therapy, disease duration and activity limitations caused by LAM. This indicates that clinical healthcare providers should pay more attention to LAM patients and their associated groups, providing both informational and psychological support.

Illness cognition and associated socio-demographic and clinical factors in parents of children with leukemia

PURPOSE

Illness cognition is an important mediator between psychological and behavioral adjustment and the quality of life for patients and their caregivers. Evidence related to illness cognition among parents of children with leukemia is limited. The purpose of this study is to explore the illness cognition status and associated factors in parents of children with leukemia.

METHODS

A cross-sectional survey was conducted with the parents of 335 children with leukemia from three general children's hospitals in China from January to December 2022. A parents' version of the illness cognition questionnaire was used to collect data. This included three subscales: helplessness, acceptance, and perceived benefits.

RESULTS

The mean scores of helplessness, acceptance and perceived benefits of parents regarding their children's disease were 15.56 (4.60), 16.25 (4.41), and 19.96 (3.69) respectively. The multiple regression model indicated seven factors associated with the parents' illness cognition (adjusted R [2] ranged from 0.182 to 0.134): four socio-demographic factors (parent's age, role, education level, and family income) and three clinical factors (length of time spent each day caring for the child, the child's age at diagnosis, and the duration of the disease).

CONCLUSION

This study reports on different levels of illness cognition and associated factors among parents of children with leukemia. The results may help pediatric oncology medical staff identify risk factors for poor psychological adjustment to children's diseases. Parents may benefit from psychological support aimed at improving positive illness cognition.

Effect of Training for an Athletic Challenge on Illness Cognition in Individuals with Chronic Disability: A Prospective Cohort Study

Illness cognitions (IC) influence how a patient adapts to a chronic disease. The aim was (1) to determine if training for a handcycling mountain time trial (HandbikeBattle) improves IC and (2) to identify factors associated with IC change scores. Persons with a chronic disability (N = 220; including N = 151 with spinal cord disorder) trained 5 months and participated in the time trial. The IC Questionnaire measured helplessness, acceptance, perceived benefits and was assessed before training (T1), after training (T2), and four months after the event (T3). Age, sex, body mass index (BMI), time since injury (TSI), disability characteristics, self-efficacy, mental health (MH) and musculoskeletal pain were obtained at T1. Multilevel regression analyses showed that helplessness decreased (from 11.96 to 11.28, p < 0.01) and perceived benefits increased (from 16.91 to 17.58, p < 0.01) from T1 to T2. For helplessness this decrease persisted during follow-up (11.16 at T3). Changes in helplessness were associated with self-efficacy (p = 0.02), MH (p = 0.02) and lesion completeness (p = 0.02), and were independent of disability type (p = 0.66), lesion level (p = 0.30) and demographics such as sex (p = 0.29) and age (p = 0.67). Training with peers may improve helplessness and perceived benefits in individuals with a chronic disability. Especially individuals with MH problems might benefit from training for an athletic challenge with peers to improve illness cognitions, and ultimately, quality of life.

Development of an evidence‑based, theory‑driven, and culturally appropriate character strengths-based intervention for breast cancer patients, following the Medical Research Council Framework

PURPOSE

To design and develop a complex, evidence‑based, theory‑driven, and culturally appropriate character strengths-based intervention (CSI) for breast cancer patients, following the Medical Research Council (MRC) framework.

METHODS

From 2018 September to 2020 November, a complex intervention perspective was adopted. The rationale, methods, and processes employed in carrying out the study were reported. The acceptability and feasibility of intervention program were evaluated as a part of subsequent pilot study. Based on piloting, a refined and optimized definitive intervention was obtained. The development of the intervention is an iterative process involving input from three key stakeholders: experts, medical staff, and patient representatives.

RESULTS

The systematic review revealed CSIs were effective and the selected theory served as a guide and indicated theory-inspired modifications. A representative team of breast cancer patients and oncology nurses collaboratively developed and tailored the intervention content and format with attention to the acceptability and feasibility. Five main strategies, including peripheral, evidential, linguistic, constituent-involving, and sociocultural strategies, were used to achieve and strengthen the cultural appropriateness. After the pilot phase, several refinements were made on the CSI program, such as editorial changes in the booklet or alternative suggestions for difficult strengths-based activities (e.g., outdoor activities). All participants not only expressed satisfaction with the program in process evaluation, but also reported perceived benefits such as enjoyable and sociable experience, better well-being, and increased confidence.

CONCLUSION

Consideration of the MRC framework, theory guidance, and suggestions from stakeholders during intervention development can optimize uptake and sustainability in the clinical setting. It is recommended that randomized controlled trial be used in future studies to assess the intervention, the process and the mechanisms of the intervention. Our approach may offer implications for the design and implementation of similar initiatives to support cancer patients.

TRIAL REGISTRATION

ClinicalTrials.gov Register Identifier: NCT04219267, 07/01/2020, retrospectively registered.

Illness perception and perceived benefits of illness among persons with type 1 diabetes

BACKGROUND

Illness perception is assigned an increasing role in the control of chronic disease. This study examines illness perception and perceived benefits related to illness in persons with type 1 diabetes mellitus. We used quantitative and qualitative methods for a more in-depth analysis.

PARTICIPANTS AND PROCEDURE

The participants (N = 110; mean age: 31.52 years; 80.9% women) completed online questionnaires: the Brief Illness Perception Questionnaire (B-IPQ), the perceived benefits subscale of the Illness Cognition Questionnaire (ICQ) and the Hospital Anxiety and Depression Scale (HADS). Interpretative phenomenological analysis (IPA) was used to analyze patients' responses to an open-ended question regarding perceived benefits.

RESULTS

Perceived benefits score was positively correlated with personal (ρ = .20) and treatment control: life-style (ρ = .25) and coherence (ρ = .22). Negative correlations were noted between B-IPQ total score (ρ = -.30), concern (ρ = -.30), depression (ρ = -.35), anxiety (ρ = -.32) and irritability (ρ = -.19). 52.7% of participants reported at least one benefit of having type 1 diabetes. Patients who reported at least one benefit had statistically significantly higher scores in the perceived benefits subscale (p < .001), personal control (p = .005) and treatment control (p = .030) and lower scores in consequences (p = .023), identity (p = .045), concern (p < .001), emotional response (p < .001), and illness perception total score (p < .001) than those who did not report any benefit. IPA revealed four main themes: personal benefits, health-related benefits, social contacts and economic benefits.

CONCLUSIONS

The study revealed that in patients with type 1 diabetes perceived disease benefits are closely related to more positive illness perception and lower levels of depression, anxiety and irritability. The findings suggest that addressing potential benefits related to illness may influence the emotional state.

The influence of socio-demographics and clinical characteristics on coping strategies in cancer patients: a systematic review

OBJECTIVES

Cancer is a frequent illness and a traumatic experience for both patients and their families. This systematic review aims to analyse studies that examine socio-demographic and clinical characteristics that predict the coping strategies in cancer patients.

METHODS

From January 2000 to March 2021, the database searches were conducted in 7 different databases, using relevant keywords. According to PRISMA Statements, full-text, peer-reviewed articles in English which used socio-demographics as independent variables and coping as dependent variables were included.

RESULTS

Of 1101 abstracts and titles, 30 full-text papers were included. Overall results showed a great influence of socio-demographic characteristics (such as women, younger, in a relationship, with high educational level, with active work status, and high income) on positive coping strategies adopted by cancer patients. Regarding clinical characteristics, no-metastatic patients who have recently been diagnosed, especially in the early stage of cancer, and who know the characteristics of their illness and treatments, more frequently used adaptive coping strategies.

CONCLUSIONS

Both socio-demographics and clinical characteristics showed considerable influence on the coping strategies adopted by patients in most of the investigations. These results supported the assessment of basic patients' information (sociodemographic and clinical characteristics) as fundamental to quickly outline an efficient, supportive, and holistic taking-over, before all the essential and in-depth considerations.

TRIAL REGISTRATION

This systematic review was recorded in PROSPERO with the registration number: CRD42021254776.

Awareness and cognition of illness in Saudi Arabian patients with Crohn's disease

BACKGROUND

Crohn's disease (CD) is a progressive illness associated with high morbidity owing to the complications associated with the condition. Patients' awareness and cognition of such complications may carry significant psychological impact. The aim of this study is to assess the illness cognition of Saudi patients diagnosed with CD and to identify clinical associations.

METHODS

Adult patients with CD were asked to complete an illness cognition questionnaire (ICQ) between January and December of 2019. Additional data was extracted from the medical records. The ICQ composed of three domains: Helplessness (6 items), acceptance (6 items), and perceived benefits (6 items). Descriptive statistics were used to summarize patient characteristics and a linear regression analysis was used to identify associations with the ICQ score.

RESULTS

A total of 88 patients were included, of which 55.8% were females, 18% were smokers, and 11.5% had undergone CD-related surgery. The mean age was 26.9 ± 7.7 years and the mean duration of disease was 54.7 ± 60.5 months. The mean score was 17.4 ± 3.6 for the helplessness domain, 13.4 ± 3.6 for the acceptance domain, and 13.5 ± 3.5 for the perceived benefits domain. We found associations between abdominal pain and acceptance (P = 0.048), extra intestinal manifestations and perceived benefit (P = 0.001), and treatment with mesalamine and helplessness (P = 0.03). In a linear regression analysis, albumin level was the only factor associated with helplessness (coef = 0.18, P = 0.048).

CONCLUSIONS

A considerable proportion of Saudi patients diagnosed with CD generally reported a negative perception of their disease. Albumin level was associated with helplessness.

Do COVID-19-Related Treatment Changes Influence Fear of Cancer Recurrence, Anxiety, and Depression in Breast Cancer Patients?

BACKGROUND

The worldwide spread of the coronavirus disease 2019 (COVID-19) has impacted the treatment of cancer patients. Treatment changes can negatively affect patients' prognosis and may be psychologically burdensome.

OBJECTIVE

The aim of this study was to explore whether COVID-19-related treatment changes (delays, cancellations, changes) influenced fear of cancer recurrence, anxiety, and depression in breast cancer patients.

METHODS

A convenience sample (n = 154) of patients who were diagnosed with breast cancer no longer than 2 years ago was obtained from an online community and social network site. The survey content included COVID-19-related treatment experiences and psychological status. The data were analyzed using descriptive statistics, χ2 test, independent t test, and analysis of variance.

RESULTS

Twenty-nine patients (18.8%) had experienced COVID-19-related treatment changes, and changes of the treatment plan had a significant correlation with depression (t = 2.000, P = .047). Fear of cancer recurrence was high (mean score, 84.31 ± 24.23). Fifteen percent had moderate to severe levels of anxiety, and 24.7% had moderate to severe levels of depression. Narrative reports also identified COVID-19-related unforeseen costs.

CONCLUSION

In the midst of the COVID-19 pandemic, breast cancer patients experienced treatment changes, and changes in treatment plans were significantly associated with depression. Fear of recurrence, anxiety, and depression were found at high levels.

IMPLICATIONS FOR PRACTICE

Oncology nurses should assess the psychological status of cancer patients in the early survivorship phase who appear to be especially vulnerable during the COVID-19 pandemic. Oncology nurses can also monitor whether patients are receiving timely supportive care to alleviate fears and anxiety and assess financial needs for COVID-19-related costs.

Associations between illness cognitions and health-related quality of life in the first year after diagnosis of amyotrophic lateral sclerosis

OBJECTIVE

To describe illness cognitions among patients with amyotrophic lateral sclerosis (ALS), to study cross-sectional associations between illness cognitions and health-related quality of life (HRQoL) and to study the predictive value of illness cognitions measured shortly after the diagnosis for HRQoL at follow-up.

METHODS

Prospective longitudinal design. We administered Self-report questionnaires at study onset (n = 72) and follow-up (n = 48). Median follow-up period was 10.0 months. At baseline median ALS Functional Rating Scale-Revised was 43, median time since onset of symptoms was 13.6 months, 79% of patients presented with spinal onset. Illness cognitions Helplessness, Acceptance and Disease Benefits were measured with the Illness Cognitions Questionnaire (ICQ) and HRQoL with the ALS Assessment Questionnaire (ALSAQ-40). Correlational and regression analyses were used.

RESULTS

Patients experienced more Helplessness at follow-up. We found no significant changes in Acceptance or Disease Benefits at follow-up. In cross-sectional analyses, Helplessness was independently related to worse HRQoL at baseline (β = 0.44; p = .001) and Acceptance and Disease Benefits were independently related to worse HRQoL at follow-up (β = -0.17, p = .045) and (β = -0.186, p = .03 respectively). Longitudinal analyses showed that, adjusted for disease severity at baseline, Helplessness at baseline was a predictor of worse HRQoL at follow-up (β = 0.43; p = .006). None of the illness cognitions were a significant predictor of HRQoL with adjustment for baseline HRQoL.

CONCLUSION

Helplessness was independently associated with HRQoL in the cross-sectional and longitudinal analyses. These results can help us identify patients shortly after diagnosis who might benefit from psychological interventions.

Reliability and Validity of the Turkish Version of Illness Cognition Questionnaire

Background: This study aimed to determine the validity and reliability characteristics of the Illness Cognition Questionnaire (ICQ). Methods: A total of 205 patients who had pain related to chronic musculoskeletal diseases were referred to the study. In order to test the validity, Short Disease Perception Scale (SDPS), Hospital Anxiety and Depression Scale (HADS) were administered together with the ICQ. Confirmatory factor analysis was used to measure the construct validity of the ICQ, and convergent and divergent validities were evaluated using Pearson correlation analysis. In order to achieve the test-retest reliability of the questionnaire, 81 patients re-applied the questionnaire after two days. Cronbach's alpha internal consistency and test-retest reliability coefficients were calculated to determine the reliability level of the questionnaire. Results: The factor loadings of the ICQ helplessness subscale ranged from 0.784 to 0.853, the acceptance subscale ranged from 0.583 to 0.855, and the perceived benefits subscale ranged from 0.733 to 0.794. Internal consistency coefficients of the ICQ were found α = 0.929 for the helplessness subscale, α = 0.868 for the acceptance subscale, and α = 0.896 for perceived benefits subscale. The results of the analysis showed that there was a statistically significant positive correlation between the initial measurement of helplessness sub-scale and the retest helplessness subscale at 0.697 level (p < .05). A statistically significant positive correlation was determined between the test and the retest of acceptance sub-scale at 0.465 level (p < .05). A statistically significant positive correlation was found between the first test of the perceived benefits sub-scale and the retest test at the 0.661 level. Conclusion: The Turkish version of the ICQ was found to be valid and reliable. It is a measurement tool that could be used easily in clinics because of its short application time and easy to understand. We think that ICQ which provides a new awareness in the perception of disease in Turkish society should be examined in different diseases and age groups.