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Herzog K, Schepper F, Kamm-Thonwart R, Herrmann J, Budich M, Weiler-Wichtl L, Pletschko T, Suttorp M, Christiansen H, Martini J. Trajectories of illness perceptions in paediatric cancer patients and their parents and associations with health-related quality of life: Results of a prospective-longitudinal study. Psychooncology 2024; 33:e6332. [PMID: 38520473 DOI: 10.1002/pon.6332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/16/2024] [Accepted: 03/12/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVE In paediatric oncology, little is known about trajectories of illness perceptions and their longitudinal associations with health-related quality of life (HRQoL). Therefore, the aim of this study was to investigate changes in illness perceptions in children and parents over a one-year-period and to investigate predictive value of child's and parent's illness perceptions during acute treatment for child's HRQoL 1 year later. METHODS N = 65 child-parent-dyads participated in a longitudinal study (retention rate: 80.2%). Children were 4-18 years of age and underwent acute cancer treatment at baseline. Children and parents reported on their own illness perceptions (Illness-Perception-Questionnaire-Revised), as well as on the child's HRQoL (KINDL-R) at baseline and one-year-follow-up. Paired-samples t-tests were calculated to investigate changes over time. A hierarchical multiple regression analysis was performed to investigate predictive value of child's and parent's illness perceptions for child's HRQoL. RESULTS Child's HRQoL t(63) = -6.73, p < 0.001, their perceptions of coherence (i.e. understanding; t(54) = -2.36, p = 0.022) and consequences of their illness (t(54) = 2.86, p = 0.006), and parent's perception of cyclical trajectory (t(61) = 2.06, p = 0.044) improved from baseline to 1-year-follow-up. All other illness perceptions remained stable. Exploratory post-hoc analyses showed differences in the pattern of change in age-, gender-, and diagnosis-specific subgroups. After controlling for baseline levels of HRQoL, child's perceptions of symptoms and consequences were independent predictors of their HRQoL 1 year later (R2 = 0.396, F(2,52) = 10.782, p < 0.001), whereas no parent's illness perceptions added predictive value. CONCLUSION In paediatrics, child's and parent's illness perceptions should be assessed. Our findings highlight the importance of illness perceptions as potential modifiable variables in interventions to improve child's HRQoL.
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Affiliation(s)
- Kristina Herzog
- Department of Psychiatry and Psychotherapy, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
- Elternhilfe für krebskranke Kinder e.V. Leipzig, Leipzig, Germany
| | - Florian Schepper
- Department of Paediatric Oncology, Haematology and Haemostaseology, Leipzig University, Leipzig, Germany
- Department of Paediatric Psychiatry, Psychotherapy and Psychosomatics, Leipzig University, Leipzig, Germany
| | - Remo Kamm-Thonwart
- Sonnenstrahl e.V. Dresden-Förderkreis für krebskranke Kinder und Jugendliche, Dresden, Germany
| | - Jessy Herrmann
- Elternhilfe für krebskranke Kinder e.V. Leipzig, Leipzig, Germany
| | - Mihaela Budich
- Department of Paediatrics, Paediatric Haematology and Oncology, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Liesa Weiler-Wichtl
- Department of Paediatric and Adolescent Medicine, Medical University Vienna, Vienna, Austria
| | - Thomas Pletschko
- Department of Paediatric and Adolescent Medicine, Medical University Vienna, Vienna, Austria
| | - Meinolf Suttorp
- Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Holger Christiansen
- Department of Paediatric Oncology, Haematology and Haemostaseology, Leipzig University, Leipzig, Germany
| | - Julia Martini
- Department of Psychiatry and Psychotherapy, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
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Herzog K, Schepper F, Herrmann J, Martini J. The puppet interview to measure illness perceptions in paediatric oncology: development and psychometric properties in acute treatment and follow-up care. BMC Pediatr 2024; 24:112. [PMID: 38350877 PMCID: PMC10863186 DOI: 10.1186/s12887-024-04586-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/22/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Illness perceptions comprise assumptions about symptoms, timeline, consequences, controllability, and emotional responses to an illness. Recent evidence shows that illness perceptions are associated with coping and well-being. So far, assessment in paediatric care was based on parental report only, since no instrument for the direct assessment of young children was available. We aim to describe the development (incl. indication and contraindication) of an innovative puppet interview to assess illness perceptions in children with cancer from the age of four years. Moreover, we investigate longitudinal trajectories and examine psychometric properties. METHODS The puppet interview was developed based on the Illness-Perception-Questionnaire-Revised and the Berkeley-Puppet-Interview. Longitudinal trajectories and psychometric properties were examined in a sample of patient-parent dyads (N = 75) in a prospective longitudinal study in acute treatment with a 1-year follow-up (study 1: nT1 = 41, nT2 = 27) and in a cross-sectional study in follow-up care (study 2, n = 34). RESULTS The puppet interview is comprehensible and well-received by children in acute treatment and follow-up care. There were significant differences in perceptions of a chronic timeline (U = 301.00, p = .008), consequences (U = 251.00, p = .008), and emotional representations (U = 244.50, p = .020) between children in acute treatment and children in follow-up care. Over the course of one year, children in acute treatment perceived more symptoms as part of their illness (MT1 = 3.6, SDT1 = 2.9, MT2 = 4.5, SDT2 = 3.1, n = 27, Z = -2.603, p = .009). We found expected intercorrelations between illness perception dimensions, e.g. between perception of consequences and emotional representations (rτ = .27, p = .033), and between perception of a chronic timeline and consequences (rτ = .38, p = .001). Moreover, we found confirming results regarding construct validity, as child's perceptions of symptoms correlated with their self-rated HRQoL (rτ = -.32, padj. = .014). Also parent-rated subscale on illness-specific aspects of child's HRQoL correlated with child's perception of symptoms (rτ = -.26, padj. = .016), cyclicity (rτ = -.28, padj. = .016), and consequences (rτ = -.34, padj. = .014). Acceptable internal consistency was shown for the dimensions timeline-acute/chronic and personal control. CONCLUSIONS Parental report can now be complemented by a self-report of illness perceptions in children aged four years and older. This will allow for the further adaptation of medical and psychosocial care during and after acute cancer treatment. TRIAL REGISTRATION The study has been pre-registered at the German Clinical Trials Register (registered 30/06/2020; DRK-S00022034) and at the Open Science Foundation ( https://osf.io/7xr6z ).
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Affiliation(s)
- Kristina Herzog
- Department of Psychiatry and Psychotherapy, Faculty of Medicine of the Technische Universität Dresden, Fetscherstr. 74, Dresden, 01307, Germany.
- Elternhilfe Für krebskranke Kinder Leipzig e.V., Leipzig, Germany.
| | - Florian Schepper
- Department of Paediatric Oncology, Haematology, and Haemostaseology, Leipzig University, Leipzig, Germany.
- Department of Paediatric Psychiatry, Psychotherapy, and Psychosomatics, Leipzig University, Leipzig, Dresden, Germany.
| | - Jessy Herrmann
- Elternhilfe Für krebskranke Kinder Leipzig e.V., Leipzig, Germany
| | - Julia Martini
- Department of Psychiatry and Psychotherapy, Faculty of Medicine of the Technische Universität Dresden, Fetscherstr. 74, Dresden, 01307, Germany
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Langford L, Latchford G, Mulvey M. Can illness representations be used to understand pain experienced in breast cancer survivorship-a cross-sectional study. J Cancer Surviv 2024:10.1007/s11764-024-01533-2. [PMID: 38285112 DOI: 10.1007/s11764-024-01533-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/08/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Chronic pain is a recognised long-term consequence associated with breast cancer and its treatment; however, it is often underdiagnosed and undertreated. This study aims to explore the associations between illness representations, chronic cancer pain, and HRQoL in women who have survived breast cancer. DESIGN AND METHODS A cross-sectional online survey design was used. Data from 182 women who participated in the survey were analysed. RESULTS Chronic cancer pain was reported by 66% of respondents. Using the BPI-SF (score 0-10), participants were categorised into one of four pain categories: no chronic pain (BPI score 0; 34.1%), mild pain (BPI score 1-3; 35.7%), moderate pain (BPI score 4-6; 25.3%), and severe pain (BPI score 7 + ; 4.9%). The main findings were that having a strong illness identity (IPQ-R subscale which assesses the number of symptoms an individual attributes to their illness) was found to be a significant predictor of pain severity (OR 1.21 (95% CI 1.07-1.37), p = 0.003). Furthermore, HRQoL was significantly associated and predictive of pain severity (OR 0.97 (95% CI 0.95-0.99), p < 0.001). An additional finding was that not being in paid work was strongly associated with being in a higher pain category (OR 5.92 (95% CI 1.84-19.05), p = 0.003). CONCLUSIONS The findings of this study highlight the high prevalence of chronic cancer pain experienced by this population. Results show that dimensions of illness representations are associated with chronic cancer pain experienced by breast cancer survivors. Furthermore, having a strong illness identity and HRQoL were found to be independent, significant predictors of pain severity. IMPLICATIONS FOR CANCER SURVIVORS These findings demonstrate that chronic pain is an unmet clinical need experienced by breast cancer survivors, which is associated with reduced overall HRQoL. Therefore, consideration is needed regarding the assessment and management of chronic pain experienced by this population.
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Affiliation(s)
- Lewis Langford
- Clinical Neuropsychology, Salford Royal Hospital, Salford, M6 8HD, UK.
- Institute of Health Sciences, University of Leeds, Leeds, UK.
| | - Gary Latchford
- Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Matt Mulvey
- Institute of Health Sciences, University of Leeds, Leeds, UK
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Halemani K, Issac A, Mishra P, Dhiraaj S, Mandelia A, Mathias E. Effectiveness of Preoperative Therapeutic Play on Anxiety Among Children Undergoing Invasive Procedure: a Systematic Review and Meta-analysis. Indian J Surg Oncol 2022; 13:858-867. [PMID: 36687245 PMCID: PMC9845488 DOI: 10.1007/s13193-022-01571-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 06/25/2022] [Indexed: 01/25/2023] Open
Abstract
Play is an indispensable part of growing up and by using play to distract children while undergoing invasive procedures can have a positive impact. Play can help children to cope with painful procedures and long-term treatment. The aim of the review was to evaluate the evidence concerning the effect of play on anxiety among children undergoing invasive procedures. This is a systematic review and meta-analysis. Data sources: PubMed, The MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Clinical Key, Cochrane Library, and Google Scholar were searched between 2012 and 2020. Review methods: randomized controlled trials (RCTs) that evaluated the effectiveness of play on anxiety among children undergoing invasive procedures were included. Meta-analysis was done using Revman v5.3 software. A total of 451 participants from 5 trials were involved in the systemic review and meta-analysis. Self-reported anxiety, parents reported anxiety, and self-reported pain were found significant in intervention [χ2 = 7.57, df = 2 at P < 0.02]. When compared with control group, the review result revealed that experimental group reduced the anxiety and pain (P < 0.05).
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Affiliation(s)
- Kurvatteppa Halemani
- College of Nursing, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh India
| | - Alwin Issac
- College of Nursing, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha India
| | - Prabhaker Mishra
- Dept. of Biostatistics & Health Informatics, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh India
| | - Sanjay Dhiraaj
- Dept. of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh India
| | - Ankur Mandelia
- Dept.of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh India
| | - Edline Mathias
- Manipal College of Nursing, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
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Tian X, Tang L, Yi LJ, Qin XP, Chen GH, Jiménez-Herrera MF. Mindfulness Affects the Level of Psychological Distress in Patients With Lung Cancer via Illness Perception and Perceived Stress: A Cross-Sectional Survey Study. Front Psychol 2022; 13:857659. [PMID: 35465528 PMCID: PMC9022206 DOI: 10.3389/fpsyg.2022.857659] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/03/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose The aims of the study were first to investigate the association between illness perception and psychological distress and second to determine whether mindfulness affects psychological distress via illness perception and perceived stress in patients with lung cancer. Methods Among 300 patients with lung cancer who participated in this cross-sectional study, 295 patients made valid responses to distress thermometer (DT), the Five Facet Mindfulness Questionnaire (FFMQ), the Brief Illness Perception Questionnaire (B-IPQ), and the Perceived Stress Scale (PSS) between January and July 2021. The possible pathways of mindfulness affecting psychological distress were analyzed based on the structural equation modeling analysis. Results A total of 24.4% patients with lung cancer had DT > 4. Illness perception (β = 0.17, p = 0.002) and perceived stress (β = 0.23, p < 0.001) had a direct effect on psychological distress. Mindfulness had a direct effect on illness perception (β = -0.16, p = 0.006) and mindfulness indirectly influenced psychological distress (β = -0.04, p = 0.009) through affecting illness perception alone or simultaneously affecting both the illness perception and perceived stress in patients with lung cancer. Conclusion Lung cancer suffered from varying levels of psychological distress. Mindfulness may alleviate psychological distress by reducing the level of illness perception and perceived stress. We suggest developing a comprehensive factor model to clarify potential mechanisms of mindfulness on psychological distress due to the very low effect of mindfulness on psychological distress via illness perception and perceived stress.
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Affiliation(s)
- Xu Tian
- Department of Nursing, Universitat Rovira i Virgili, Tarragona, Spain
| | - Ling Tang
- Chongqing University Cancer Hospital, Chongqing, China
| | - Li-Juan Yi
- Department of Nursing, Universitat Rovira i Virgili, Tarragona, Spain
| | - Xiao-Pei Qin
- Department of Rehabilitation Medicine, Jiaozuo People’s Hospital, Jiaozuo, China
| | - Gui-Hua Chen
- Department of Nursing, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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The impact of illness perception on functionality, pain, stiffness, and activity of daily living after total hip replacement surgery. J Psychosom Res 2022; 155:110749. [PMID: 35150982 DOI: 10.1016/j.jpsychores.2022.110749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/30/2022] [Accepted: 01/30/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE According to the Common Sense Model (CSM), cognitive and emotional representations influence recovery. We used groups of individuals grouping multiple cognitive representations (schemas) to predict the recovery process after total hip arthroplasty (THR). METHODS The aim of this prospective cohort study with three collection time points was to examine the significance of these schemas for functionality three and six months after THR. We assessed illness perception with the Illness Perception Questionnaire-Revised and the functionality with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Data were collected four weeks before (n = 317), three (n = 268), and six months after (n = 292) primary THR. Groups of individuals with the same schemas were identified using a two-step cluster analysis across cognitive representations. Controlling for WOMAC variables (functionality, stiffness, pain, and activities of daily living) before THR, we calculated the regression of schemas and emotional representations before THR on WOMAC variables after THR. RESULTS Before THR, two cognitive schemes were found: Schema One: medium identity, long duration, many consequences, low personal and treatment control, and low coherence; Schema Two: low identity, short timeline, low consequences, and high personal and treatment control. Patients with Schema Two had better functionality and lower pain and stiffness three months after surgery compared to those with Schema One. After three months, the influence of cognitive schemas was stronger on functionality than that of emotional representation (f2: 0.04 /0.02). CONCLUSION Further study is needed to determine whether a psychological intervention can change Schema One.
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Różycka J. How I see is how I feel. Identification of illness perception schema and its association with adaptation outcomes in multiple sclerosis - a 5-year prospective study. PLoS One 2021; 16:e0258740. [PMID: 34710124 PMCID: PMC8553031 DOI: 10.1371/journal.pone.0258740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 10/04/2021] [Indexed: 11/18/2022] Open
Abstract
The aim of the study was to assess the role of illness perception in adaptation to chronic disease among patients with relapsing-remitting multiple sclerosis (RRMS). The differences between the obtained configurations of the illness perception components during four measurements and the model of predictions of the values of adaptation indicators, i.e. depression, anxiety and quality of life during subsequent measurements, were analyzed. Illness representation was assessed at baseline via the Illness Representation Questionnaire–Revised. The adaptation indicators–anxiety, depression (measured by HADS) and quality of life (measured by MSIS-29) were measured at baseline and three more times over a five-year period. The k-means cluster analysis (with two-way and repeated measures ANOVA) was conducted in a group of 90 patients (48.89% women and 51.11% men). Subsequently, the mean values of depression, anxiety, physical and psychological quality of life were compared between the clusters using the Kruskall-Wallis test. Finally, a cross-lagged panel modeled for HADS and MSIS-29 subscales in each measurement occasion (T1-T4). Three different illness perception clusters (Anxious, Realistic and Fatalistic Illness Perception named AIP, RIP and FIP) were composed which differentiated the depression, anxiety, quality of life level and age. FIP showed the lowest adaptation outcomes with small differences between AIP and RIP. It was also significantly characterized by the highest age. The positive adaptation indicators were related to the RIP cluster. The model presented rather satisfactory fit (χ2(48) = 81.05; CFI = .968; TLI = .925; SRMR = .050) with slightly inflated RMSEA = .087 (90%CI .053-.120). Based on initial measurements of individual characteristics, it was possible to predict the functioning of patients after several years. For patients with AIP, the covariance of anxiety and depression was significant, for patients with RIP–depression and anxiety, and for patients with FIP–depression. In addition, each of the variables was a predictor of subsequent measurements in particular time intervals, illustrating the dynamics of changes. Results highlight that illness perceptions formed at the beginning of RRMS are important for the process of adaptation to the disease. Moreover, they showed the differences between the adaptation outcomes supporting the idea that a cognitive representation might be important for the level of psychological functioning.
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Bockholt M, Mehnert-Theuerkauf A, Vehling S. [Association of Illness Perceptions with Demoralization and Psychological Distress in Cancer: a Longitudinal Study]. Psychother Psychosom Med Psychol 2021; 71:464-472. [PMID: 34265855 DOI: 10.1055/a-1522-8500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Zusammenfassung
Hintergrund Diese Längsschnittstudie untersucht den Einfluss
der Ausprägung subjektiver Krankheitstheorien auf den zeitlichen
Verlauf von Demoralisierung, Depression und Angst bei Patienten mit einer
Krebserkrankung.
Methode Wir untersuchten n=307 Patienten mit gemischten
Tumordiagnosen und Erkrankungsstadien zu drei Messzeitpunkten:
während der ambulanten bzw. stationären Behandlung, nach 6
Monaten (n=213, 69%) sowie nach 12 Monaten (n=153,
50%). Subjektive Krankheitstheorien wurden anhand der Subskalen
Konsequenzen, Kontrolle, Behandlungskontrolle und Kohärenz des
Illness Perception Questionnaire (IPQ-R) erfasst. Psychische Belastung wurde
anhand der Demoralisierungsskala (DS) sowie der Module Depression und Angst
des Gesundheitsfragebogens für Patienten (PHQ-9 und GAD-7) erfasst.
Längsschnittliche Analysen erfolgten anhand von Varianzanalysen mit
Messwiederholung (MANOVA).
Ergebnisse Zu Studienbeginn nahmen 20% der Teilnehmer die
Erkrankung als mit einschneidenden Konsequenzen verbunden wahr
(12-Monats-Follow-up: 16%); 25% nahmen sie als
persönlich kontrollierbar (12-Monats-Follow-up: 17%),
42% als durch die medizinische Behandlung kontrollierbar
(12-Monats-Follow-up: 26%) und 24% als
kohärent/verstehbar wahr (12-Monats-Follow-up: 30%).
Zu Studienbeginn war die Wahrnehmung einschneidender Konsequenzen mit einer
signifikant höheren psychischen Belastung verbunden, von
Kontrollierbarkeit und Kohärenz mit einer signifikant geringeren
psychischen Belastung. Die Größe dieses Zusammenhangs war
jeweils am höchsten für Demoralisierung (Konsequenzen:
r=0,45, p<0,001, Kontrolle:
r=− 0,25, p<0,001, Behandlungskontrolle:
r=− 0,31, p<0,001, Kohärenz:
r=− 0,27, p<0,001). Keine der Subskalen
hatte einen signifikanten Einfluss auf die zeitliche Veränderung der
psychischen Belastung über den Verlauf von 12 Monaten
(d≤0,29, p≥0,09).
Diskussion Die subjektive Wahrnehmung einschneidender Konsequenzen,
geringer Kontrollierbarkeit sowie Verstehbarkeit der Erkrankung kann eine
wichtige Quelle für aktuell erlebte hohe Belastungen bei
Krebspatienten sein. Sie geht jedoch nicht zwangsläufig mit einem
weiteren Anstieg oder Abfall der psychischen Belastung einher. Ein
möglicher Grund könnte in den begrenzten
Möglichkeiten des eingesetzten IPQ-R liegen, adaptiv-angemessene von
maladaptiv-verzerrten Krankheitswahrnehmungen zu differenzieren.
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Affiliation(s)
- Malin Bockholt
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Anja Mehnert-Theuerkauf
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Sigrun Vehling
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.,II. Medizinische Klinik und Poliklinik (Onkologie, Hämatologie und Knochenmarktransplantation mit Abteilung für Pneumologie), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
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Schoormans D, Jansen M, Mols F, Oerlemans S. Negative illness perceptions are related to more fatigue among haematological cancer survivors: a PROFILES study. Acta Oncol 2020; 59:959-966. [PMID: 32412348 DOI: 10.1080/0284186x.2020.1759823] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: The common sense model provides a theoretical framework for understanding substantial fatigue among (haematological) cancer survivors based on their illness perceptions. We therefore examined the associations between modifiable illness perceptions and substantial fatigue while controlling for sociodemographic, clinical, and psychological factors (symptoms of depression and anxiety) among haematological cancer survivors.Methods: Data from the population-based PROFILES registry were used. Survivors diagnosed between 1999 and 2013 with Hodgkin lymphoma (N = 164), non-Hodgkin lymphoma (N = 655) and chronic lymphocytic leukaemia (N = 174) were included. Survivors completed the Brief Illness Perception Questionnaire (B-IPQ), the Fatigue Assessment Scale (FAS), and Hospital Anxiety and Depression Scale (HADS). Multivariable logistic regressions analyses were performed for the total group and three haematological cancers separately relating illness perceptions to substantial fatigue (>21 FAS).Results: Haematological cancer survivors with illness perceptions that represent more negative consequences (consequences, OR = 1.27; 95%CI = 1.13-1.42); attribute more symptoms to their illness (identity, OR = 1.29; 95%CI = 1.17-1.43); and have a poorer illness understanding (coherence, 1.13; 1.04-1.22) were more often substantially fatigued. For the remaining five illness perceptions, no significant association was found. Non-Hodgkin lymphoma survivors who reported a poor illness understanding (coherence, OR = 1.35; 95% CI = 1.06-1.72) and chronic lymphocytic leukaemia survivors who reported that treatment can control (OR = 1.25; 95%CI = 1.01-1.55) the illness experienced more often substantial fatigue.Conclusion: Those who experience more consequences of their disease, attribute more symptoms to their illness, and have a poorer illness understanding, have a higher risk to experience substantial levels of fatigue even years after diagnosis. Psychological interventions changing these illness perceptions may be beneficial in reducing fatigue among haematological cancer survivors.
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Affiliation(s)
- Dounya Schoormans
- CoRPS - Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Mandy Jansen
- CoRPS - Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Floortje Mols
- CoRPS - Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Simone Oerlemans
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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Schoormans D, Wijnberg L, Haak H, Husson O, Mols F. Negative illness perceptions are related to poorer health-related quality of life among thyroid cancer survivors: Results from the PROFILES registry. Head Neck 2020; 42:2533-2541. [PMID: 32488948 PMCID: PMC7496500 DOI: 10.1002/hed.26290] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/15/2020] [Accepted: 05/12/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Differentiated thyroid cancer (DTC) reports a poorer health-related quality of life (HRQoL) than a norm population. Patients' illness perceptions are modifiable and known associates of HRQoL in other cancers. The aim was to examine the relationship between illness perceptions and HRQoL among DTC survivors. METHODS DTC survivors registered in the Netherlands Cancer Registry diagnosed between 1990 and 2008, received a survey on illness perceptions (Brief-Illness Perception Questionnaire; B-IPQ) and HRQoL (European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire-Core 30; EORTC QLQ-C30). Multiple regression analyses were conducted investigating the relation between illness perceptions and HRQoL, while controlling for sociodemographic and clinical characteristics. RESULTS Two hundred and eighty-four DTC survivors were included. DTC survivors who believed their illness had many negative consequences; who perceived their illness as controllable by treatment; who had strong beliefs symptoms could be attributed to their illness; and who had strong beliefs their illness causes negative emotions, reported a poorer HRQoL. CONCLUSIONS Stronger negative illness perceptions are related to a poorer HRQoL among DTC survivors.
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Affiliation(s)
- Dounya Schoormans
- CoRPS-Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Laura Wijnberg
- CoRPS-Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Harm Haak
- Department of Internal Medicine, Maxima Medical Centre, Eindhoven, The Netherlands
| | - Olga Husson
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK.,Department of Psychosocial Research, Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Floortje Mols
- CoRPS-Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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11
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Turkington C, Dempster M, Maguire J. Adjustment to hand injury: Cross-sectional survey exploring adjustment in relation to illness perceptions and coping strategies. J Hand Ther 2019; 31:502-510. [PMID: 28684197 DOI: 10.1016/j.jht.2017.05.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 05/26/2017] [Accepted: 05/26/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Cross-sectional descriptive. INTRODUCTION Hand injuries are highly prevalent, and the impact they have on physical, emotional, and functional adjustment is well recognized. Increasingly, adjustment to health conditions including hand injuries is being understood in terms of psychological variables. PURPOSE OF THE STUDY To examine the role of illness beliefs and coping strategies in adjustment to hand injury. Adjustment was considered from a complete perspective including quality of life (QOL) and functional ability as well as mood and trauma symptoms. METHODS Cross-sectional survey whereby consecutive patients (n = 65) attending the regional plastic surgery service with hand injuries were invited to complete a questionnaire assessing illness perceptions, coping strategies, QOL, hand functioning, depression, and trauma symptoms. Data were analyzed in SPSS (IBM Corporation, Armonk, NY) by correlation and then hierarchical regression analysis. RESULTS Illness perceptions and coping strategies were significantly related to the adjustment outcomes (hand functioning, QOL, depression, and trauma symptoms). Specifically, poorer adjustment was associated with more negative illness beliefs (r = 0.31-0.47), greater use of denial (r = 0.24-0.53), and avoidance-based (r = 0.41-0.64) coping strategies. DISCUSSION Illness beliefs and coping play an important role in adjustment after hand injury. Adjustment is multifaceted with a need to consider physical and emotional functioning. More optimistic beliefs and adaptive coping styles are associated with improved adjustment. CONCLUSION The role of psychological variables in optimizing adjustment is an important consideration for the design of psychological interventions, but because this study was cross sectional and cannot assume directional effects, future longitudinal studies are needed. LEVEL OF EVIDENCE N/A.
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Affiliation(s)
| | - Martin Dempster
- School of Psychology, Queens University Belfast, Belfast, Northern Ireland.
| | - Jennifer Maguire
- Department of Clinical Health Psychology, Ulster Hospital, Dundonald, Northern Ireland
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12
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Westbrook TD, Morrison EJ, Maddocks KJ, Awan FT, Jones JA, Woyach JA, Johnson AJ, Byrd JC, Andersen BL. Illness Perceptions in Chronic Lymphocytic Leukemia: Testing Leventhal's Self-regulatory Model. Ann Behav Med 2019; 53:839-848. [PMID: 30590383 DOI: 10.1093/abm/kay093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Leventhal's Self-regulatory Model proposes that somatic characteristics of a health threat (e.g., symptom severity), and prior experience with the threat (e.g., unsuccessful treatment), are determinants of illness perceptions. Chronic lymphocytic leukemia (CLL) is appropriate for test of these postulates, having three phases differing in symptom severity and prior treatment experiences: indolent disease requiring no treatment (active surveillance; AS), symptomatic disease requiring a first treatment (FT), and highly symptomatic disease in those who have relapsed and/or failed to respond to prior treatments (relapsed/refractory; RR). PURPOSE To test symptom severity and prior treatment experiences as determinants of illness perceptions, illness perceptions were characterized and contrasted between CLL groups. METHODS Three hundred and thirty CLL patients (AS, n = 100; FT, n = 78; RR, n = 152) provided illness perception data on one occasion during a surveillance visit (AS) or prior to beginning treatment (FT, RR). RESULTS Analysis of variance with planned comparisons revealed that consequences, identity, and concern were least favorable among RR patients, followed by FT, then AS (ps < .01). AS patients endorsed the lowest levels of coherence (ps < .01), and the most chronic illness timeline (ps < .01). FT patients endorsed the highest levels of personal and treatment control (ps < .01). CONCLUSIONS Data provide preliminary empirical support for Self-regulatory Model postulates that symptom severity and prior disease experiences influence illness perceptions. Unique knowledge needs for AS patients and elevated psychological/physical symptoms for later-stage CLL patients may warrant clinical attention.
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Affiliation(s)
| | | | - Kami J Maddocks
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Farrukh T Awan
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Jeffrey A Jones
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Jennifer A Woyach
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Amy J Johnson
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - John C Byrd
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
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13
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Milrad SF, Hall DL, Jutagir DR, Lattie EG, Czaja SJ, Perdomo DM, Ironson G, Doss BD, Mendez A, Fletcher MA, Klimas N, Antoni MH. Relationship satisfaction, communication self-efficacy, and chronic fatigue syndrome-related fatigue. Soc Sci Med 2019; 237:112392. [PMID: 31377502 DOI: 10.1016/j.socscimed.2019.112392] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 05/21/2019] [Accepted: 06/29/2019] [Indexed: 10/26/2022]
Abstract
RATIONALE Relationship dissatisfaction has been linked with worse health outcomes in many patient populations, though the mechanism(s) underlying this effect are unclear. Among patients with chronic fatigue syndrome (CFS) and their partners, there is evidence for a bi-directional association between poorer relationship satisfaction and the severity of CFS-related fatigue. OBJECTIVE Here, we hypothesized that relationship dissatisfaction negatively impacts fatigue severity through greater depression and less patient satisfaction about communication about symptoms to partners. METHOD Baseline data were drawn from diagnosed CFS patients (N = 150) participating in a trial testing the efficacy of a stress management intervention. Data derived from fatigue severity (Fatigue Symptom Index, FSI), depression (Center for Epidemiologic Survey-Depression, CES-D), relationship quality (Dyadic Adjustment Scale, DAS) and communication satisfaction (Patient Symptom Disclosure Satisfaction, PSDS) questionnaires were used for bootstrapped indirect effect analyses using parallel mediation structural equation modeling in Mplus (v8). Age and BMI were entered as covariates. RESULTS Greater relationship satisfaction predicted greater communication satisfaction (p < 0.01) and lower CES-D scores (p < 0.01), which in turn were each significantly related to greater fatigue severity (p < 0.05). Tests of the indirect paths indicated that relationship satisfaction had a significant effect on fatigue severity through both constructs, but primarily via depression. There was no direct association between relationship satisfaction and fatigue severity after the intermediate variables (depression, communication satisfaction) were included in the model. CONCLUSION Results highlight the importance of considering depression and communication-related factors when examining the effects of relationship satisfaction on CFS symptoms such as fatigue. Further mechanism-based, longitudinal research might identify relationship-related mediating variables that can be targeted therapeutically.
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Affiliation(s)
| | - Daniel L Hall
- Department of Psychiatry, Massachusetts General Hospital/ Harvard Medical School, USA
| | - Devika R Jutagir
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, USA
| | - Emily G Lattie
- Department of Medical Social Sciences, Northwestern University, Chicago IL, USA
| | - Sara J Czaja
- Department of Psychiatry and Behavioral Sciences, University of Miami, USA
| | - Dolores M Perdomo
- Department of Psychiatry and Behavioral Sciences, University of Miami, USA
| | - Gail Ironson
- Department of Psychology, University of Miami, USA
| | - Brian D Doss
- Department of Psychology, University of Miami, USA
| | | | - Mary Ann Fletcher
- Institute for Neuro Immune Medicine, Nova Southeastern University, USA
| | - Nancy Klimas
- Institute for Neuro Immune Medicine, Nova Southeastern University, USA
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14
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Durazo A, Cameron LD. Representations of cancer recurrence risk, recurrence worry, and health-protective behaviours: an elaborated, systematic review. Health Psychol Rev 2019; 13:447-476. [PMID: 31117924 DOI: 10.1080/17437199.2019.1618725] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
An expanded Common-Sense Model (CSM) contextualised to the self-regulation of cancer recurrence risk identifies risk representational attributes and recurrence worry as primary processes motivating protective behaviours in cancer survivors. A systematic review examined evidence for CSM hypotheses regarding how these processes influence diet and physical activity (PA) among survivors. A research agenda is outlined and used to evaluate the evidence base. Common databases were searched for eligible, peer-reviewed, English language reports, yielding 18 studies quantitatively testing hypothesised relationships among representations of prior cancer, recurrence risk representations, recurrence worry, and diet and PA. The findings provide promising, but mixed and limited evidence for some of the hypothesised associations of specific risk recurrence attributes with recurrence worry, and risk recurrence attributes and recurrence worry with diet and PA. Findings support the distinction of recurrence risk representations and illness representations of the prior cancer, with each showing different relationships with recurrence worry and behaviours. We discuss the status of the evidence base in relation to assessment, design, and analysis priorities and propose strategies that can yield more sensitive, rigorous tests of the CSM for cancer recurrence risk as applied to diet and PA.
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Affiliation(s)
- Arturo Durazo
- Psychological Sciences, School of Social Sciences, Humanities and Arts (SSHA), University of California, Merced, San Francisco, CA, USA
| | - Linda D Cameron
- Psychological Sciences, School of Social Sciences, Humanities and Arts (SSHA), University of California, Merced, San Francisco, CA, USA
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15
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Graham-Wisener L, Collins L, Hanna J, Dempster M. The need for enhanced psychological support in esophageal cancer-an exploratory study of the perception of HCPs, patients, and carers. Dis Esophagus 2019; 32:5075410. [PMID: 30124801 DOI: 10.1093/dote/doy076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Esophageal cancer patients and carers report significant levels of psychological distress. Despite this, only a small number of patients and carers engage with existing psychological services. This study aims to explore the perception of esophageal cancer patients, carers, and healthcare professionals (HCPs) of psychological distress and current provision of support, the need for and format of tailored support and barriers to patient/carer engagement. Semistructured interviews were undertaken with n = 14 esophageal cancer patients, carers, and HCPs. Directed content analysis was utilized to code the transcripts according to the preconceived categories as defined by study aim. Participants reported key periods for heightened distress around diagnosis and postsurgery on discharge from hospital. Provision of existing support was not felt to be adequate. A number of patient/carer barriers to engaging with support were identified in addition to HCP barriers. Participants perceived enhanced psychological support as a priority supportive care need with a number of recommendations for tailoring existing support services more adequately to the clinical population. With reports of heightened psychological morbidity yet with few esophageal cancer patients engaging with psychological services, there is an impetus to develop detailed care pathways to facilitate meeting this prioritized support need.
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Affiliation(s)
- L Graham-Wisener
- Marie Curie Hospice Belfast, Marie Curie.,School of Psychology, Queen's University Belfast
| | - L Collins
- Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - J Hanna
- Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - M Dempster
- School of Psychology, Queen's University Belfast
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16
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Nelson AM, Juckett MB, Coe CL, Costanzo ES. Illness perceptions predict health practices and mental health following hematopoietic stem cell transplantation. Psychooncology 2019; 28:1252-1260. [PMID: 30942921 DOI: 10.1002/pon.5075] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 03/19/2019] [Accepted: 03/23/2019] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Beliefs about illness have been shown to shape health practices and coping efforts. The present study investigated illness perceptions among patients undergoing hematopoietic stem cell transplant (HSCT). We also examined the extent to which perceptions predicted health practices and mental health following transplant. METHODS Participants (N = 332) completed measures of illness perceptions (beliefs about cancer consequences and course, personal and treatment control over cancer, and understanding of one's cancer) prior to HSCT. Health practices (diet, physical activity, and alcohol use) and mental health (depression, anxiety, and psychological well-being) were assessed pre transplant and at 1, 3, 6, and 12 months post transplant. RESULTS On average, HSCT recipients felt they understood their cancer, viewed their cancer to be a chronic condition with severe consequences, and believed they had moderate personal control over their cancer but that medical treatment provided more control. Perceptions varied by transplant type. Mixed-effects linear regression models revealed that HSCT recipients who perceived the consequences of their cancer to be more serious experienced more depression and anxiety, less well-being, and ate a healthier diet, but were less physically active during the year following transplant. Those with greater personal and treatment control ate a healthier diet and reported greater well-being. Patients with a better understanding of their cancer also ate a healthier diet and reported less depression, less anxiety, and greater well-being. CONCLUSIONS Perceptions of cancer shape HSCT recipients' health practices and psychological well-being during the critical first year of recovery after transplant.
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Affiliation(s)
- Ashley M Nelson
- Department of Psychology, University of South Florida, Tampa, Florida.,Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
| | - Mark B Juckett
- Department of Medicine, Hematology/Oncology Division, University of Wisconsin-Madison, Madison, Wisconsin.,Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin
| | - Christopher L Coe
- Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Erin S Costanzo
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin
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17
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Graham-Wisener L, Hanna J, Collins L, Dempster M. Psychological adjustment in patients post-curative treatment for oesophageal cancer: a longitudinal interview study. Psychol Health 2019; 34:901-921. [PMID: 30939933 DOI: 10.1080/08870446.2019.1579910] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: Oesophageal cancer is an increasingly prevalent disease with a demanding post-curative treatment recovery period and sustained longer-term effects. Although post-curative treatment is a key transitionary period, the process of psychological adjustment for the individual is under-researched which limits the evidence base to inform supportive care. The aim of this study was to understand the process of adjustment for oesophageal cancer patients post-curative treatment, in particular the beliefs participants hold regarding their condition and how these are appraised against their experience. Design: Serial interviews were undertaken with six oesophageal cancer patients who have recently completed curative treatment, at baseline and at 6-month follow-up using interpretative phenomenological analysis. Results: The findings demonstrate an effortful process of adjustment, including recognising and accepting a changed self, fostering control beliefs over the course of the illness and physical sequelae, searching for meaning, developing illness coherence and moving away from self-blame. Conclusions: This study is the first to utilise a longitudinal qualitative design in oesophageal cancer, and provides an understanding of post-treatment adjustment over time for this clinical population through which to inform clinical practice and service development.
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Affiliation(s)
- Lisa Graham-Wisener
- a School of Psychology, Queen's University Belfast , Belfast , Northern Ireland
| | - Julie Hanna
- b Belfast Health and Social Care Trust , Belfast City Hospital , Belfast , Northern Ireland
| | - Louise Collins
- b Belfast Health and Social Care Trust , Belfast City Hospital , Belfast , Northern Ireland
| | - Martin Dempster
- a School of Psychology, Queen's University Belfast , Belfast , Northern Ireland
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18
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Groeneveld IF, van der Pas SL, Meesters JJL, Schuurman JM, van Meijeren-Pont W, Jagersma E, Goossens PH, Kaptein AA, Vliet Vlieland TPM. Illness perceptions of stroke survivors: Predictors and changes over time - A 1 year follow-up study. J Psychosom Res 2019; 116:54-61. [PMID: 30654994 DOI: 10.1016/j.jpsychores.2018.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/11/2018] [Accepted: 10/31/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To describe the illness perceptions (IP) of stroke patients in the first year post stroke; to identify patient clusters with comparable IP trajectories and determine their associations with health. METHODS This prospective study included consecutive stroke patients after medical rehabilitation. Three and 12 months post stroke they completed the Brief Illness Perception Questionnaire (B-IPQ) and questionnaires on physical and mental health. All eight IP and their changes over time were described. Clusters of patients with comparable IP trajectories were constructed by k-means clustering, with subsequent comparison of patient characteristics. Multivariable logistic regression analyses were conducted to determine the association between IP clusters and 12-month mental health. RESULTS Hundred-and-eighty-four patients were included (men n = 107 [58.2%]; mean age 61.1 [SD 12.7] years). At 3 months, the scores of the IP coherence (mean 3.0, SD 2.3) and treatment control (mean 3.2, SD 2.5) were lowest (best), and consequences (mean 6.1, SD 2.8) and anticipated timeline (mean 6.0, SD 2.7) were highest (worst). At 12 months, the timeline and treatment control scores had significantly worsened. Three clusters of the trajectories of IP were identified, and designated as 'favourable', 'average', and 'unfavourable'. The unfavourable cluster was significantly associated with worse physical and mental health at 3 months (unadjusted) and depressive symptoms at 12 months. CONCLUSION Stroke patients' IP partly changed between 3 and 12 months post stroke. Patients with an unfavourable IP trajectory had a higher chance of depressive symptoms at 12 months. Illness perceptions could be considered as an additional target of treatment.
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Affiliation(s)
- I F Groeneveld
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands.
| | - S L van der Pas
- Medical Statistics, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands; Mathematical Institute, Leiden University, the Netherlands
| | - J J L Meesters
- Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | | | - W van Meijeren-Pont
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | - E Jagersma
- Sophia Rehabilitation, The Hague, the Netherlands
| | - P H Goossens
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | - A A Kaptein
- Department of Medical Psychology, Leiden University Medical Center, Leiden, the Netherlands
| | - T P M Vliet Vlieland
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
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19
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Glattacker M, Heyduck K, Meffert C, Jakob T. Illness Beliefs, Treatment Beliefs and Information Needs as Starting Points for Patient Information: The Evaluation of an Intervention for Patients with Depression. J Clin Psychol Med Settings 2018; 25:316-333. [PMID: 29453506 DOI: 10.1007/s10880-018-9551-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Patients with depression are often dissatisfied with disease- and therapy-related information. The objective of this study was to evaluate an intervention that applied the Common Sense Model to the provision of information during inpatient rehabilitation for patients with depression. The intervention was evaluated in a sequential control group design. Analyses of covariance were used to assess differences between the control and intervention groups. Changes with respect to illness and treatment beliefs (personal control, treatment control, coherence and concerns about medicines), satisfaction with information about medicines, illness and rehabilitation, and depressive burden were selected as primary outcome measures. We observed significant between-group differences indicating the intervention group's superiority in terms of satisfaction with information regarding medicines. However, the two groups' changes during rehabilitation did not differ in terms of the other outcomes. The intervention resulted in patients judging that their medication information needs had been more thoroughly fulfilled than those patients who received care-as-usual information. However, the intervention did not prove to be effective when the other outcome variables are considered. Taken together and bearing in mind the limitations of our study-particularly the non-randomised design-our results should be replicated in a randomised controlled trial.
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Affiliation(s)
- Manuela Glattacker
- Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany.
| | - Katja Heyduck
- Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany
| | - Cornelia Meffert
- Department of Palliative Care, University Medical Center Freiburg, Freiburg, Germany
| | - Teresa Jakob
- Rehabilitation Center Glotterbad, Glottertal, Germany
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20
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Saritas SC, Özdemir A. Identification of the correlation between illness perception and anxiety level in cancer patients. Perspect Psychiatr Care 2018; 54:380-385. [PMID: 29465775 DOI: 10.1111/ppc.12265] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 01/10/2018] [Accepted: 01/15/2018] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To investıgate the relationship between the perception of the disease and level of anxiety in patients with cancer. DESIGN AND METHODS A correlation and descriptive study from a convenience sample of 318 oncological patients aged 18 years and older was done. Subjects were measured with a Patient's Information Form, the Revised Illness Perception Questionnare, and the Strait-Trait Anxiety Inventory. FINDINGS When evaluated together with most of its subscales, illness perception was found to affect anxiety. PRACTICE IMPLICATIONS Nurses should evaluate the anxiety levels of the cancer patients in every stage and should educate the patients and their relatives on coping with anxiety. Appropriate treatment and care depending on the illness perception of the cancer patients should be planned by nurses.
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Affiliation(s)
- Seyhan Citlik Saritas
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Inonu University, Malatya, Turkey
| | - Aysel Özdemir
- Department of Psychiatry Nursing, Faculty of Health Sciences, Inonu University, Malatya, Turkey
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21
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A Self-Regulatory Intervention for Patients with Head and Neck Cancer: Pilot Randomized Trial. Ann Behav Med 2018; 51:629-641. [PMID: 28244003 DOI: 10.1007/s12160-017-9885-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Research is yet to investigate whether psychological interventions delivered early after diagnosis can benefit patients with head and neck cancer (HNC). PURPOSE The aim of this study was to investigate the effectiveness of a brief self-regulatory intervention (targeting illness perceptions and coping) at improving HNC patient health-related quality of life (HRQL). METHODS A pilot randomized controlled trial was conducted, in which 64 patients were assigned to receive three sessions with a health psychologist in addition to standard care or standard care alone. Participants completed questionnaires assessing HRQL, general distress, and illness perceptions at baseline and again 3 and 6 months later. RESULTS Compared to the control group, patients who received the intervention had increased treatment control perceptions at 3 months (p = .01), and increased social quality of life at 6 months (p = .01). The intervention was particularly helpful for patients exhibiting distress at baseline. CONCLUSION A brief psychological intervention following HNC diagnosis can improve patient perceptions of treatment and social quality of life over time. Such interventions could be targeted to patients who are distressed in order to confer the greatest benefit. TRIAL REGISTRATION NUMBER 12614000813684.
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22
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Graham-Wisener L, Dempster M. Peer advice giving from posttreatment to newly diagnosed esophageal cancer patients. Dis Esophagus 2017; 30:1-7. [PMID: 28859397 DOI: 10.1093/dote/dox089] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/13/2017] [Indexed: 12/11/2022]
Abstract
The benefits of peer support in cancer care include the sharing of information and experience, supporting adjustment by providing an illness trajectory which cancer patients can use to prepare for their own cancer journey. Information from peers is prioritized by esophageal cancer patients, yet the content of this experiential information is not well understood. The purpose of this study is to understand the content of peer advice giving from posttreatment to newly diagnosed esophageal cancer patients. Esophageal cancer survivors (n = 23) at median 67-months postdiagnosis completed a single open-ended survey item which asked for advice they would give to individuals newly diagnosed with esophageal cancer on how to cope emotionally with the cancer journey (including adjusting to life after treatment). Transcripts were assessed using qualitative content analysis, with five categories of advice identified: social support, psychological approach, realistic expectations, support from healthcare professionals and self-care. The categories of advice reported were distinct from information needs prioritized by clinicians. This study demonstrates that experiential information is accessible and has the potential to identify neglected information and supportive care needs, and may have a potential use in delivery of psychological support to newly diagnosed patients.
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Affiliation(s)
- L Graham-Wisener
- Marie Curie Hospice Belfast, Marie Curie Cancer Care.,School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - M Dempster
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK
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23
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Do Cancer-Related Beliefs Influence the Severity, Incidence, and Persistence of Psychological Symptoms? Cancer Nurs 2017; 40:E50-E58. [DOI: 10.1097/ncc.0000000000000412] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Nehir S, Tavşanli NG, Özdemir Ç, Akyol T. A Determination of Hopelessness and the Perception of Illness in Cancer. OMEGA-JOURNAL OF DEATH AND DYING 2017; 79:115-131. [DOI: 10.1177/0030222817704336] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
This study was performed with the objective of determining hopelessness and perception of illness in cancer patients. This was a descriptive and regressional study. The study was performed between January and June 2014 on 105 outpatients at the oncology clinic of Manisa Government Hospital in Turkey’s western. A patient information form, the Beck Hopelessness Scale, and the illness perception questionnaire were used to collect data, and data analysis was performed using the program Statistical Package for Social Sciences 15.0. Percentages, t test, Kruskal–Wallis, one-way analysis of variance, and Pearson correlation were used in the evaluation of research data. The hopelessness levels of cancer patients participating in the study were at a medium level. As patients’ scores on the hopelessness scale and its subscales increase, so their illness perception scores also increase. The hopelessness levels of patients whose illness perception was good were lower; that is, as patients’ hopelessness levels fell, their illness perceptions and view of their illness were affected in a positive way.
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Affiliation(s)
- Sevgi Nehir
- Psychiatry Nursing, Nursing Department, School of Health, Celal Bayar University, Manisa, Turkey
| | - Nurgül Güngör Tavşanli
- Internal Medicine Nursing, Midwifery Department, School of Health, Celal Bayar University, Manisa, Turkey
| | - Çiğdem Özdemir
- Celal Bayar University Hafsa Sultan Hospital, Manisa, Turkey
| | - Tuğba Akyol
- Celal Bayar University Hafsa Sultan Hospital, Manisa, Turkey
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Graham L, Wikman A. Toward improved survivorship: supportive care needs of esophageal cancer patients, a literature review. Dis Esophagus 2016; 29:1081-1089. [PMID: 26455727 DOI: 10.1111/dote.12424] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The growing prevalence of esophageal cancer survivors represent a population typified by an extensive treatment regime, significant postsurgical long-term effects, and a dismal prognosis. Despite this, little is known of the supportive care needs of this patient group and the extent to which these are being met in practice. This review provides a synthesis of the research evidence to date; emphasizing opportunities for clinical application and setting a future agenda with research priorities. A literature search was performed using Medline/Embase, PsycINFO, and Web of Science. Search headings used included; [esophagus] or [esopohageal] or [upper gastrointestinal] or [upper GI] AND [cancer] or [carcinoma] or [squamous cell] AND [supportive care] or [survivorship] or [psychological] or [emotional] or [information] or [social] or [communication] or [spiritual] or [health-related-quality-of-life] or [HRQL] or [qualitative] or [patient narrative] or [clinical nurse specialist] or [CNS]. Related articles in English were reviewed, with additional articles harvested from reference sections. Esophageal cancer survivors report significant late-term effects posttreatment, encompassing sustained impairment in most areas of health-related quality of life. With a necessitated change in eating behavior, survivors find it particularly challenging to adjust to a new social identity and as a cancer population report high levels of psychological morbidity. Although the determinants of psychological morbidity are largely unknown, illness representations may be a key contributor. Several multidisciplinary supportive care interventions have been developed with promising results. The research summarized in this paper provides valuable insight into the psychosocial well-being of the esophageal cancer survivor. However, knowledge gaps remain, alongside a dearth of applied examples in meeting supportive care need.
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Affiliation(s)
- L Graham
- School of Psychology, Queen's University Belfast, Belfast, UK.,Marie Curie Cancer Care, Marie Curie Hospice Belfast, Belfast, UK
| | - A Wikman
- Surgical Care Science, Department of Molecular medicine and Surgery, Karolinska Institute, Stockholm, Sweden
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Richardson EM, Schüz N, Sanderson K, Scott JL, Schüz B. Illness representations, coping, and illness outcomes in people with cancer: a systematic review and meta-analysis. Psychooncology 2016; 26:724-737. [PMID: 27412423 DOI: 10.1002/pon.4213] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 06/27/2016] [Accepted: 07/07/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Cancer is associated with negative health and emotional outcomes in those affected by it, suggesting the need to better understand the psychosocial determinants of illness outcomes and coping. The common sense model is the leading psychological model of self-regulation in the face of illness and assumes that subjective illness representations explain how people attempt to cope with illness. This systematic review and meta-analysis examines the associations of the common sense model's illness representation dimensions with health and coping outcomes in people with cancer. METHODS A systematic literature search located 54 studies fulfilling the inclusion criteria, with 38 providing sufficient data for meta-analysis. A narrative review of the remaining studies was also conducted. RESULTS Random-effects models revealed small to moderate effect sizes (Fisher Z) for the relations between illness representations and coping behaviors (in particular between control perceptions, problem-focused coping, and cognitive reappraisal) and moderate to large effect sizes between illness representations and illness outcomes (in particular between identity, consequences, emotional representations, and psychological distress). The narrative review of studies with insufficient data provided similar results. CONCLUSIONS The results indicate how illness representations relate to illness outcomes in people with cancer. However, more high-quality studies are needed to examine causal effects of illness representations on coping and outcomes. High heterogeneity indicates potential moderators of the relationships between illness representations and health and coping outcomes, including diagnostic, prognostic, and treatment-related variables. This review can inform the design of interventions to improve coping strategies and mental health outcomes in people with cancer.
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Affiliation(s)
- Emma M Richardson
- Division of Psychology, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Natalie Schüz
- School of Health Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Kristy Sanderson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Jennifer L Scott
- Division of Psychology, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Benjamin Schüz
- Division of Psychology, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Westbrook TD, Maddocks K, Andersen BL. The relation of illness perceptions to stress, depression, and fatigue in patients with chronic lymphocytic leukaemia. Psychol Health 2016; 31:891-902. [PMID: 26982998 DOI: 10.1080/08870446.2016.1158259] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Chronic lymphocytic leukaemia (CLL) is the most prevalent adult leukaemia and is incurable. The course and treatment of CLL is unique and characterised by repeated cycles of treatment, stable disease and relapse. Utilising a Self-Regulatory Model framework, we examined the relationship between patients' illness perceptions and cancer-specific stress, depressive symptoms and fatigue. Our aim was to test illness perceptions as predictors of these outcomes when variance due to disease and treatment variables was controlled. DESIGN Data were collected on 147 patients with relapsed/refractory CLL as they entered a phase II clinical trial of an investigational medication at a university affiliated, National Cancer Institute designated comprehensive cancer center. MAIN OUTCOME MEASURES Cancer-specific stress, depressive symptoms and fatigue interference. RESULT . Hierarchical multiple regression was used. Consequences and emotional representation were related to all outcomes (ps < .01). Illness concern was related to cancer-specific stress (p < .01), and identity was related to fatigue interference (p < .01). All relationships were observed while controlling for number of previous CLL therapies received. CONCLUSION Illness perceptions are related to cancer-specific stress, depressive symptoms and fatigue interference in relapsed/refractory CLL. Interventions targeted at restructuring maladaptive illness perceptions may have clinical benefit in this population.
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Affiliation(s)
- Travis D Westbrook
- a Department of Psychology , The Ohio State University , Columbus , OH , USA
| | - Kami Maddocks
- b Division of Hematology , The Ohio State University Wexner Medical Center , Columbus , OH , USA
| | - Barbara L Andersen
- a Department of Psychology , The Ohio State University , Columbus , OH , USA
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Li WHC, Chung JOK, Ho KY, Kwok BMC. Play interventions to reduce anxiety and negative emotions in hospitalized children. BMC Pediatr 2016; 16:36. [PMID: 26969158 PMCID: PMC4787017 DOI: 10.1186/s12887-016-0570-5] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 03/05/2016] [Indexed: 12/21/2022] Open
Abstract
Background Hospitalization is a stressful and threatening experience, which can be emotionally devastating to children. Hospital play interventions have been widely used to prepare children for invasive medical procedures and hospitalization. Nevertheless, there is an imperative need for rigorous empirical scrutiny of the effectiveness of hospital play interventions, in particular, using play activities to ease the psychological burden of hospitalized children. This study tested the effectiveness of play interventions to reduce anxiety and negative emotions in hospitalized children. Methods A non-equivalent control group pre-test and post-test, between subjects design was conducted in the two largest acute-care public hospitals in Hong Kong. A total of 304 Chinese children (ages 3-12) admitted for treatments in these two hospitals were invited to participate in the study. Of the 304 paediatric patients, 154 received hospital play interventions and 150 received usual care. Results Children who received the hospital play interventions exhibited fewer negative emotions and experienced lower levels of anxiety than those children who received usual care. Conclusion This study addressed a gap in the literature by providing empirical evidence to support the effectiveness of play interventions in reducing anxiety and negative emotions in hospitalized children. Findings from this study emphasize the significance of incorporating hospital play interventions to provide holistic and quality care to ease the psychological burden of hospitalized children. Trial registration ClinicalTrials.gov NCT02665403. Registered 22 January 2016.
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Affiliation(s)
- William H C Li
- School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China.
| | - Joyce Oi Kwan Chung
- School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Ka Yan Ho
- School of Nursing, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
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Dempster M, Howell D, McCorry NK. Illness perceptions and coping in physical health conditions: A meta-analysis. J Psychosom Res 2015; 79:506-13. [PMID: 26541550 DOI: 10.1016/j.jpsychores.2015.10.006] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 09/28/2015] [Accepted: 10/19/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE There is a considerable body of research linking elements of Leventhal's Common Sense Model (CSM) to emotional well-being/distress outcomes among people with physical illness. The present study aims to consolidate this literature and examine the evidence for the role of coping strategies within this literature. METHODS A systematic review was conducted where the outcomes of interest were: depression, anxiety and quality of life. A total of 1050 articles were identified and 31 articles were considered eligible to be included in the review. RESULTS Across a range of illnesses, perceptions of consequences of the illness and emotional representations were consistently the illness perceptions with the strongest relationship with the outcomes. Coping variables tend to be stronger predictors of outcomes than the illness perception variables. The evidence for the mediating effect of coping was inconsistent. CONCLUSIONS Illness perceptions and coping have an important role to play in the explanation of distress outcomes across a range of physical health conditions. However, some clarity about the theoretical position of coping in relation to illness perceptions, and further longitudinal work is needed if we are to apply this information to the design of interventions for the improvement of psychological health among people with physical health conditions.
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Affiliation(s)
- Martin Dempster
- School of Psychology, Queen's University Belfast, Northern Ireland, UK.
| | - Doris Howell
- Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Noleen K McCorry
- Marie Curie Cancer Care, Marie Curie Hospice Belfast, Northern Ireland, UK
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Richardson AE, Morton R, Broadbent E. Caregivers' Illness Perceptions Contribute to Quality of Life in Head and Neck Cancer Patients at Diagnosis. J Psychosoc Oncol 2015; 33:414-32. [PMID: 25996835 DOI: 10.1080/07347332.2015.1046011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study investigated the contribution of patient and caregiver illness perceptions to the quality of life of head and neck cancer (HNC) patients. Ninety-eight patients and their caregivers (n = 80) completed questionnaires at diagnosis. Caregivers' illness perceptions were significantly more negative than patients with respect to consequences, timeline, treatment, concern, and the emotional impact of HNC. The interaction between some patient and caregiver illness perceptions explained additional variance in patient quality of life, above and beyond patients' own illness perceptions. These findings suggest that caregivers should be included in psychological interventions to improve HNC patient quality of life.
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Affiliation(s)
- Amy E Richardson
- a Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland , Auckland , New Zealand
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31
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Graham L, Dempster M, McCorry NK, Donnelly M, Johnston BT. Change in psychological distress in longer‐term oesophageal cancer carers: are clusters of illness perception change a useful determinant? Psychooncology 2015; 25:663-9. [DOI: 10.1002/pon.3993] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/24/2015] [Accepted: 08/25/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Lisa Graham
- School of PsychologyQueen's University Belfast Belfast UK
| | | | | | - Michael Donnelly
- Centre of Excellence for Public HealthQueen's University Belfast Belfast UK
| | - Brian T. Johnston
- Department of GastroenterologyRoyal Victoria Hospital Belfast Belfast UK
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Olsen IB, Øverland S, Reme SE, Løvvik C. Exploring Work-Related Causal Attributions of Common Mental Disorders. JOURNAL OF OCCUPATIONAL REHABILITATION 2015; 25:493-505. [PMID: 25451074 PMCID: PMC4540770 DOI: 10.1007/s10926-014-9556-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
PURPOSE Common mental disorders (CMDs) are major causes of sickness absence and disability. Prevention requires knowledge of how individuals perceive causal mechanisms, and in this study we sought to examine work-related factors as causal attribution of CMDs. METHODS A trial sample of n = 1,193, recruited because they struggled with work participation due to CMDs, answered an open-ended questionnaire item about what they believed were the most important causes of their CMDs. The population included participants at risk of sickness absence, and participants with reduced work participation due to sickness absence, disability or unemployment. We used thematic content analysis and categorized responses from 487 participants who reported work-related factors as causal attributions of their CMDs. Gender differences in work-related causal attributions were also examined. RESULTS The participants attributed their CMDs to the following work-related factors; work stress, leadership, reduced work participation, job dissatisfaction, work conflict, social work environment, job insecurity and change, workplace bullying, and physical strain. Women tended to attribute CMDs to social factors at work. CONCLUSION Findings from this study suggest several work-related risk factors for CMDs. Both factors at the workplace, and reduced work participation, were perceived by study participants as contributing causes of CMDs. Thus, there is a need to promote work participation whilst at the same time targeting aversive workplace factors. Further, our findings indicate that work-related factors may affect women and men differently. This illustrates that the association between work participation and CMDs is complex, and needs to be explored further.
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Affiliation(s)
- Ingrid Blø Olsen
- Uni Research Health, Uni Research, POB 7810, 5020, Bergen, Norway,
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Band R, Wearden A, Barrowclough C. Patient Outcomes in Association With Significant Other Responses to Chronic Fatigue Syndrome: A Systematic Review of the Literature. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2015; 22:29-46. [PMID: 26617440 PMCID: PMC4654336 DOI: 10.1111/cpsp.12093] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 04/06/2014] [Accepted: 05/15/2014] [Indexed: 01/08/2023]
Abstract
Social processes have been suggested as important in the maintenance of chronic fatigue syndrome (also known as myalgic encephalomyelitis; CFS/ME), but the specific role of close interpersonal relationships remains unclear. We reviewed 14 articles investigating significant other responses to close others with CFS/ME and the relationships between these responses and patient outcomes. Significant other beliefs attributing patient responsibility for the onset and ongoing symptoms of CFS/ME were associated with increased patient distress. Increased symptom severity, disability, and distress were also associated with both solicitous and negative significant other responses. Specific aspects of dyadic relationship quality, including high Expressed Emotion, were identified as important. We propose extending current theoretical models of CFS/ME to include two potential perpetuating interpersonal processes; the evidence reviewed suggests that the development of significant other-focused interventions may also be beneficial.
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Affiliation(s)
- Rebecca Band
- School of Psychological Sciences & Manchester Centre for Health Psychology, University of Manchester
| | - Alison Wearden
- School of Psychological Sciences & Manchester Centre for Health Psychology, University of Manchester
| | - Christine Barrowclough
- School of Psychological Sciences & Manchester Centre for Health Psychology, University of Manchester
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Wikman A, Ljung R, Johar A, Hellstadius Y, Lagergren J, Lagergren P. Psychiatric morbidity and survival after surgery for esophageal cancer: a population-based cohort study. J Clin Oncol 2014; 33:448-54. [PMID: 25547500 DOI: 10.1200/jco.2014.57.1893] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE To determine the cumulative incidence of and risk factors for psychiatric morbidity and establish the impact on survival among surgically treated patients with esophageal cancer. PATIENTS AND METHODS A nationwide Swedish cohort of 1,615 patients who underwent surgery for esophageal cancer between 1987 and 2010 with follow-up until 2012 was linked to national health registries for information on psychiatric morbidity (inferred from mental health care use). Multivariable logistic regressions were used to determine potential risk factors for postoperative psychiatric morbidity. A multivariable-adjusted Cox proportional hazard model was used to analyze overall survival. RESULTS In patients without a history of psychiatric morbidity, the 2-year cumulative incidence for treatment in psychiatric in-patient care was 2.5%, for psychiatric out-patient care was 4.2%, and for treatment with psychotropic drugs was 32.3%. Married patients were less likely to be treated postoperatively in psychiatric in-patient care (odds ratio [OR], 0.42; 95% CI, 0.22 to 0.80) or out-patient care (OR, 0.41; 95% CI, 0.17 to 1.02), whereas patients with higher tumor stage were more likely to be treated in psychiatric out-patient care (OR, 4.99; 95% CI, 1.16 to 21.38) or with psychotropic drugs (OR, 2.78; 95% CI, 1.10 to 7.01). Bearing in mind possible residual confounding, new-onset psychiatric morbidity was associated with mortality (hazard ratio [HR], 1.65 [95% CI, 1.17 to 2.33] for treatment in psychiatric in-patient care; HR, 1.93 [95% CI, 1.18 to 3.16] for treatment in psychiatric out-patient care; and HR, 2.77 [95% CI, 1.72 to 4.44] for treatment with psychotropic drugs). CONCLUSION These results highlight the importance of recognizing and addressing psychiatric morbidity in surgically treated patients with esophageal cancer.
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Affiliation(s)
- Anna Wikman
- All authors, Karolinska Institutet, Stockholm, Sweden; and Jesper Lagergren, King's College London, London, United Kingdom.
| | - Rickard Ljung
- All authors, Karolinska Institutet, Stockholm, Sweden; and Jesper Lagergren, King's College London, London, United Kingdom
| | - Asif Johar
- All authors, Karolinska Institutet, Stockholm, Sweden; and Jesper Lagergren, King's College London, London, United Kingdom
| | - Ylva Hellstadius
- All authors, Karolinska Institutet, Stockholm, Sweden; and Jesper Lagergren, King's College London, London, United Kingdom
| | - Jesper Lagergren
- All authors, Karolinska Institutet, Stockholm, Sweden; and Jesper Lagergren, King's College London, London, United Kingdom
| | - Pernilla Lagergren
- All authors, Karolinska Institutet, Stockholm, Sweden; and Jesper Lagergren, King's College London, London, United Kingdom
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Morgan K, Villiers-Tuthill A, Barker M, McGee H. The contribution of illness perception to psychological distress in heart failure patients. BMC Psychol 2014; 2:50. [PMID: 25520809 PMCID: PMC4266484 DOI: 10.1186/s40359-014-0050-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 09/11/2014] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND The influences on the psychological well-being of heart failure (HF) patients have received limited attention. Illness perceptions are a specific set of cognitive representations that have been shown to predict health-related outcomes in other patient groups. This study sought to explore the role of illness perceptions in the psychological well-being of HF patients by creating a profile of illness perceptions in HF and examining their relations with anxiety and depression. METHODS Participants were 95 consecutive outpatients. Indices of psychological well-being were depression and anxiety, measured using the Hospital Anxiety and Depression Scale (HADS). Illness perceptions were measured using the Illness Perception Questionnaire - Revised (IPQ-R). Functional status was also determined using the New York Heart Association (NYHA) classification. RESULTS Illness perceptions were associated with indices of psychological well-being. Regression analyses showed that illness perceptions accounted for a significant proportion of the variance in both depression and anxiety. The contribution of illness perceptions was greater than that made by traditional covariates (socio-demographic variables and functional status). CONCLUSIONS Results highlight dynamic interrelations between perceptions of illness and mental health indices. They also suggest that in considering the role of illness perceptions in psychological well-being, the primary focus should be on the overall dynamic of an individual's illness experience rather than on specific illness dimensions. Findings highlight the potential role of illness perceptions in depression and anxiety in HF. This has implications for interventions to maximise psychological well-being in this patient group.
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Affiliation(s)
- Karen Morgan
- Department of Psychology, Division of Population Health Science, Royal College of Surgeons in Ireland, Dublin 2, Ireland ; Perdana University, PU-RCSI School of Medicine, Block B & D Aras 1, MAEPS Building, MARDI Complex, Jalan MAEPS Perdana, 43400 Serdang Darul Ehsan, Malaysia
| | - Amanda Villiers-Tuthill
- Department of Psychology, Division of Population Health Science, Royal College of Surgeons in Ireland, Dublin 2, Ireland ; Perdana University, PU-RCSI School of Medicine, Block B & D Aras 1, MAEPS Building, MARDI Complex, Jalan MAEPS Perdana, 43400 Serdang Darul Ehsan, Malaysia
| | - Maja Barker
- Department of Psychology, Division of Population Health Science, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Hannah McGee
- Department of Psychology, Division of Population Health Science, Royal College of Surgeons in Ireland, Dublin 2, Ireland
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Tiggelman D, van de Ven MOM, van Schayck OCP, Kleinjan M, Engels RCME. The Common Sense Model in early adolescents with asthma: longitudinal relations between illness perceptions, asthma control and emotional problems mediated by coping. J Psychosom Res 2014; 77:309-15. [PMID: 25280828 DOI: 10.1016/j.jpsychores.2014.07.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 07/08/2014] [Accepted: 07/09/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The present study examined the longitudinal relations between illness perceptions and asthma control and emotional problems (i.e., anxiety, depression, stress), respectively, in adolescents with asthma. Furthermore, the mediating effects of asthma-specific coping strategies on these relations were examined, as specified in the Common Sense Model (CSM). METHODS In 2011, 2012, and 2013, adolescents (aged 10-15) with asthma were visited at home (N=253) and completed questionnaires about their illness perceptions, asthma-specific coping strategies, asthma control, symptoms of anxiety and depression, and perceived stress. Path analyses were used to examine the direct relations of illness perceptions with asthma control and emotional problems and the mediating effects of coping strategies cross-sectionally and longitudinally. RESULTS Perceptions of less perceived control and attributing more complaints to asthma were associated with better asthma control. Perceptions of more concern, less coherence, and increased influence of asthma on emotional well-being were associated with more emotional problems. Longitudinally, perceptions of more treatment control and fewer concerns predicted less emotional problems over time. More worrying mediated the cross-sectional relation between perceiving more concern about asthma and less asthma control and the longitudinal relation between perceiving more concern about asthma and more emotional problems. CONCLUSION Illness perceptions were associated with asthma control and emotional problems; however, over time, illness perceptions only predicted changes in emotional problems. Most coping strategies did not mediate the relation between illness perceptions and outcomes. Interventions aimed to change illness perceptions in adolescents with asthma could decrease emotional problems.
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Affiliation(s)
- Dana Tiggelman
- Behavioural Science Institute (BSI), Faculty of Social Sciences, Radboud University Nijmegen, Nijmegen, The Netherlands.
| | - Monique O M van de Ven
- Behavioural Science Institute (BSI), Faculty of Social Sciences, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Onno C P van Schayck
- Care and Public Health Research (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Marloes Kleinjan
- Behavioural Science Institute (BSI), Faculty of Social Sciences, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Rutger C M E Engels
- Behavioural Science Institute (BSI), Faculty of Social Sciences, Radboud University Nijmegen, Nijmegen, The Netherlands
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Hopman P, Rijken M. Illness perceptions of cancer patients: relationships with illness characteristics and coping. Psychooncology 2014; 24:11-8. [PMID: 24891136 DOI: 10.1002/pon.3591] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 05/07/2014] [Accepted: 05/13/2014] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Illness perceptions have proven to be predictive of coping and adjustment in many chronically ill patients. However, insights into illness perceptions of cancer patients are scarce. The purpose of the present study was to explore how a heterogeneous sample of cancer patients perceive their illness. We also examined the relationships between cancer patients' illness perceptions, their illness characteristics, and their coping strategies. METHODS Participants were 325 cancer patients of a generic nationwide longitudinal panel study among cancer patients in the Netherlands. They completed the revised Illness Perception Questionnaire (Winter 2011/2012) and the Mental Adjustment to Cancer Scale (Spring 2012). Analyses of variance and linear regression analyses were conducted. RESULTS Patients' views on the chronicity of cancer vary, but many believe their illness to be long-lasting. Furthermore, they strongly believe the cancer treatment to be effective. People with skin cancer experience relatively little negative consequences (p < 0.01). Recently treated patients experience more negative consequences (p < 0.001) and perceive their illness as more chronic (p < 0.01). Surprisingly, neither perceptions of treatment control nor perceptions of personal control are related to specific ways of coping. However, more passive ways of coping were more often found in patients who perceived their illness as long-lasting, more emotionally burdening, and having more negative consequences. CONCLUSIONS Our findings suggest that cancer patients might benefit more from support to alleviate the perceived severity and threat of their illness rather than from (further) strengthening their control beliefs.
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Affiliation(s)
- Petra Hopman
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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Hellstadius Y, Lagergren P, Lagergren J, Johar A, Hultman CM, Wikman A. Aspects of emotional functioning following oesophageal cancer surgery in a population-based cohort study. Psychooncology 2014; 24:47-53. [PMID: 24895142 DOI: 10.1002/pon.3583] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/31/2014] [Accepted: 05/04/2014] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this study was to establish the proportion of patients reporting emotional problems following oesophagectomy for cancer and identify the risk characteristics for emotional problems. METHODS A Swedish population-based cohort study of patients with surgically treated oesophageal cancer was used. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 was used to assess tension, worry, irritation and depressed mood at 6 months and 5 years after surgery. Potential risk characteristics were retrieved from medical notes and data linkages to Swedish health registries. Multivariable logistic regression analyses were performed to examine risk characteristics for poor emotional recovery. RESULTS Of 401 patients included at 6 months, 49% reported problems with tension, 61% worry, 62% irritation and 63% depressed mood. Of the 140 (35%) patients who completed the 5-year follow-up, 39% reported problems with tension and about half of the patients reported problems with worry, irritation, and depressed mood (49, 45 and 52%, respectively). Squamous cell carcinoma was identified as a risk characteristic for tension (OR 2.15, 95% CI 1.30-3.55), worry (OR 2.02, 95% CI 1.19-3.40) and depressed mood (OR 1.71, 95% CI 1.01-2.90) at 6 months compared with adenocarcinoma. Compared with higher education, lower education was associated with tension (upper secondary schooling: OR 1.97, 95% CI 1.02-3.79 and 9-year compulsory: OR 2.46, 95% CI 1.28-4.74), while non-cohabitating patients were less likely to report problems with worry at 6 months (OR 0.53, 95% CI 0.34-0.84) compared with cohabitating patients. CONCLUSIONS A substantial proportion of patients reports emotional problems following oesophagectomy, and risk characteristics include squamous cell carcinoma histology and low educational level.
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Affiliation(s)
- Ylva Hellstadius
- Surgical Care Science, Department of Molecular medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Wiborg JF, Löwe B. Illness perceptions in patients with somatoform disorders: Examining the role of comorbidity. J Health Psychol 2013; 20:1166-74. [DOI: 10.1177/1359105313509843] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We examined the role of comorbidity in models that use the illness perceptions of patients with somatoform disorders to explain their outcomes. A total of 138 primary care patients with somatoform disorders completed the Patient Health Questionnaire and Brief Illness Perception Questionnaire and rated their general health status. Medical comorbidity was rated by the general practitioner. Patients’ illness perceptions were consistently related to their outcomes independent of medical and psychological comorbidity in our models. At the same time, inclusion of comorbidity enhanced our models, revealing differences in the relevance of the specific comorbidity depending on the outcome measure.
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Affiliation(s)
- Jan F Wiborg
- University Medical Centre Hamburg-Eppendorf and Schön Klinik Hamburg-Eilbek, Germany
| | - Bernd Löwe
- University Medical Centre Hamburg-Eppendorf and Schön Klinik Hamburg-Eilbek, Germany
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Wikman A, Smedfors G, Lagergren P. Emotional distress -- a neglected topic among surgically treated oesophageal cancer patients. Acta Oncol 2013; 52:1783-5. [PMID: 23448288 DOI: 10.3109/0284186x.2013.771820] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Anna Wikman
- Department of Molecular Medicine and Surgery, Unit of Upper Gastrointestinal Research, Karolinska Institutet , Stockholm , Sweden
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Hurt CS, Julien CL, Brown RG. Measuring Illness beliefs in neurodegenerative disease: Why we need to be specific. J Health Psychol 2013; 20:69-79. [DOI: 10.1177/1359105313498627] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Positive perceptions of illness are typically associated with good health outcomes. However, this may not be true for all domains of illness perception in neurodegenerative diseases because of their progressive incurable nature. The appropriateness of current measures of illness belief in these conditions is not known. The validity and reliability of the Illness Perception Questionnaire–Revised was evaluated in 215 participants with Parkinson’s disease. A confirmatory factor analysis supported the structure of the Illness Perception Questionnaire–Revised with the exception of the treatment control domain. It is important to consider the nature of neurodegenerative diseases and limits of symptom control when planning interventions.
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Simpson J, Lekwuwa G, Crawford T. Illness beliefs and psychological outcome in people with Parkinson's disease. Chronic Illn 2013; 9:165-76. [PMID: 23585631 DOI: 10.1177/1742395313478219] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Illness beliefs are important predictors of psychological outcome in people with chronic illness and evidence suggests these could also be significant in furthering our understanding of psychological functioning in people with Parkinson's disease. Illness beliefs are specific, dynamic representations of an illness and cover dimensions such as cause, identity, consequences and controllability. Eighty-one people with Parkinson's disease completed a series of questionnaires to provide demographic, clinical and psychosocial data, which were then used to assess the relative impact of illness beliefs on their psychological functioning. Psychological functioning was assessed by measuring levels of depression, anxiety, stress, positive affect and emotional well-being. Hierarchical block regression indicated that illness beliefs were important independent predictors across some but not all outcomes and the results emphasised the importance of testing new predictors against more established predictors of outcome such as physical functioning and self-esteem. The illness beliefs most important in psychological outcome in people with PD were causal beliefs (particularly in psychosocial causes) and illness coherence (the level of understanding of the illness). The therapeutic potential of psychosocial variables was discussed given that these can be modified during therapy and this change can positively influence psychological outcome.
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Affiliation(s)
- Jane Simpson
- Clinical Psychology, Lancaster University, Lancaster, UK.
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Vilchinsky N, Dekel R, Asher Z, Leibowitz M, Mosseri M. The role of illness perceptions in the attachment-related process of affect regulation. ANXIETY STRESS AND COPING 2013; 26:314-29. [DOI: 10.1080/10615806.2012.682649] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Graham CD, Rose MR, Hankins M, Chalder T, Weinman J. Separating emotions from consequences in muscle disease: comparing beneficial and unhelpful illness schemata to inform intervention development. J Psychosom Res 2013; 74:320-6. [PMID: 23497834 DOI: 10.1016/j.jpsychores.2012.09.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 09/17/2012] [Accepted: 09/19/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Muscle diseases are currently untreatable and people with muscle disease experience reduced quality of life (QoL) and low mood. Patient's illness perceptions explain large proportions of the variance in QoL and mood, even after considering the impact of disease severity. Therefore a psychological intervention which helps patients modify their illness perceptions may improve QoL and mood even as the disease progresses. However, it is unknown which profile of illness perceptions (illness schema) an intervention should seek to promote. We aimed to fully describe and compare the illness schemata of clusters associated with better and worse outcomes. METHOD Following a cluster analysis of 217 people with muscle disease, a between-cluster comparison of QoL and mood identified the clusters associated with better and worse outcomes. Functional impairment was compared between-clusters to indicate if this could account for observed differences. Inter-correlations between the illness perceptions held within each cluster were examined across the clusters. RESULTS Three stable clusters holding distinct illness schemata emerged. One cluster was characterised by greater functional impairment, worse QoL and mood than the other two clusters. The other two clusters did not differ in functional impairment but differed significantly in QoL and mood. The cluster associated with better outcomes was characterised by realistic views of timeline, greater coherence, reduced emotional representation and identity, and a lack of association between emotional representation and consequences. CONCLUSION Detailed comparison of beneficial and unhelpful illness schemata, taking into account disease-specific concerns, can help inform both the content and composition of an intervention.
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Affiliation(s)
- Christopher D Graham
- Department of Health Psychology, Institute of Psychiatry, King's College London, 5th Floor Bermondsey Wing, Guy's Hospital, London, UK.
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Negative and positive illness representations of rheumatoid arthritis: a latent profile analysis. J Behav Med 2013; 37:524-32. [PMID: 23543315 DOI: 10.1007/s10865-013-9506-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 03/23/2013] [Indexed: 01/31/2023]
Abstract
This study extends previous work to consider whether individuals with rheumatoid arthritis (RA) can be categorised into groups with similar illness representations. Data from 227 RA patients attending outpatient clinics were collected prospectively at two time points, 6 months apart. The optimal number of illness representation groups at the baseline assessment was identified using latent profile analysis. Two groups of individuals sharing similar illness perception profiles were identified. The smaller group (43%), characterised by a negative representation of their illness, attributed more symptoms to their condition and reported stronger perceptions of the consequences, chronicity and cyclicality of their condition, and lower control compared to the positive representation group (57%). Cross-sectionally, membership of the negative representation group was associated with higher levels of pain and functional disability and, longitudinally, with increases in levels of pain, functional disability and distress. These data highlight the central role of illness perceptions in RA and suggest that individuals with RA can be categorised into groups with similar illness representations.
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Schoormans D, Mulder BJM, van Melle JP, Pieper PG, van Dijk APJ, Sieswerda GT, Hulsbergen-Zwarts MS, Plokker THWM, Brunninkhuis LGH, Vliegen HW, Sprangers MAG. Illness perceptions of adults with congenital heart disease and their predictive value for quality of life two years later. Eur J Cardiovasc Nurs 2013; 13:86-94. [PMID: 23524630 DOI: 10.1177/1474515113481908] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND To improve patients' quality of life (QoL) we need to identify modifiable determinants, such as illness perceptions. Patients' illness perceptions are known to regulate emotional responses and health-behaviour. Illness perceptions comprise several components: consequences, control, coherence, changeability and emotional representations. AIMS To examine (a) the relation between patient characteristics and illness perceptions, and (b) the independent predictive value of illness perceptions for future QoL. METHODS A longitudinal study in 845 patients with congenital heart disease was conducted. Patients completed three questionnaires: the IPQ-R (illness perceptions) and two years later the SF-36 and TAAQOL-CHD (QoL). Linear regression analyses were performed relating illness perceptions to patient characteristics (sex, age, disease complexity and functional status) and QoL. RESULTS Patients with a complex defect or poor functional status reported poor illness perceptions. Independent of patient characteristics, poor illness perceptions (i.e. a strong belief that the illness has severe consequences; a weak belief that you have a coherent illness understanding and that the illness can be controlled by treatment; and a strong belief that the illness is changeable and causes negative emotions) were predictive of future QoL. CONCLUSION Illness perceptions independently predict QoL, suggesting that QoL may be improved by altering patients' beliefs about their illness. For example, increasing patients' knowledge regarding their disease and informing them about treatment opportunities may enhance their QoL.
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Affiliation(s)
- Dounya Schoormans
- 1Department of Medical Psychology, Academic Medical Centre, Amsterdam, The Netherlands
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Orive M, Quintana JM, Vrotsou K, Las Hayas C, Bilbao A, Barrio I, Matellanes B, Padierna JA. Applying a coping with stress questionnaire for cancer patients to patients with non-cancer chronic illnesses. J Health Psychol 2012; 18:737-49. [PMID: 23221615 DOI: 10.1177/1359105312464673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
One of the few instruments to evaluate coping skills among patients with chronic illnesses is the Cuestionario de Afrontamiento al Estrés para Pacientes Oncológicos (CAEPO), created initially for cancer patients. We evaluate how well CAEPO applies to patients with non-cancer chronic illnesses. A total of 344 patients (115 with chronic hepatitis C, 120 with inflammatory bowel disease and 109 with recurrent vertigo) completed the CAEPO. Exploratory factor analysis and Cronbach's alpha provide only partial support for the seven factors suggested by the original CAEPO. A streamlined version with fewer dimensions and items may be a better solution for identifying coping strategies among these patients.
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Affiliation(s)
- Miren Orive
- Health Services Research on Chronic Patients Network (REDISSEC), Hospital Galdakao-Usansolo, Spain.
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Fischer MJ, Wiesenhaan ME, Does-den Heijer A, Kleijn WC, Nortier JWR, Kaptein AA. From despair to hope: a longitudinal study of illness perceptions and coping in a psycho-educational group intervention for women with breast cancer. Br J Health Psychol 2012; 18:526-45. [PMID: 23006141 DOI: 10.1111/j.2044-8287.2012.02100.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 08/06/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study examined the cross-sectional and longitudinal relationships of illness perceptions, coping, and distress in women with breast cancer. Illness perceptions and coping at baseline and changes in these variables over time served as possible predictors of distress at two follow-up points. DESIGN AND METHODS Fifty-seven women with breast cancer who participated in a psychosocial aftercare programme completed a questionnaire before the start of the intervention, directly after the end of the intervention, and 1 year after the start of the intervention. Study variables were assessed with the Illness Perception Questionnaire-Revised (illness perceptions), the COPE (coping), and the Hopkins Symptom Check List (distress). RESULTS Results showed that 43% of variance in distress at baseline was explained by participants' illness perceptions. Cyclical timeline perceptions were the strongest predictor of distress at baseline. Longitudinal data revealed that after the end of the intervention, the intensity of general distress and breast cancer-related emotions had decreased significantly. Partial correlations showed that baseline illness perceptions were unrelated to distress at follow-up. However, changes in illness perceptions (perceptions about the cyclical and chronic timeline and symptoms associated with breast cancer) showed significant associations with distress at both follow-up assessments. Associations of follow-up distress with coping styles were less consistent. CONCLUSIONS Our results suggest that changes in illness perceptions are related to an improvement or worsening of patients' emotional well-being over time. These findings hold promise for the development of interventions that specifically target patients' representations of their illness.
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Affiliation(s)
- Maarten J Fischer
- Department of Clinical Oncology, Leiden University Medical Center, The Netherlands.
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Howren MB, Christensen AJ, Karnell LH, Funk GF. Psychological factors associated with head and neck cancer treatment and survivorship: evidence and opportunities for behavioral medicine. J Consult Clin Psychol 2012; 81:299-317. [PMID: 22963591 DOI: 10.1037/a0029940] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Individuals diagnosed with head and neck cancer (HNC) not only face a potentially life-threatening diagnosis but must endure treatment that often results in significant, highly visible disfigurement and disruptions of essential functioning, such as deficits or complications in eating, swallowing, breathing, and speech. Each year, approximately 650,000 new cases are diagnosed, making HNC the 6th most common type of cancer in the world. Despite this, however, HNC remains understudied in behavioral medicine. In this article, the authors review available evidence regarding several important psychosocial and behavioral factors associated with HNC diagnosis, treatment, and recovery, as well as various psychosocial interventions conducted in this patient population, before concluding with opportunities for behavioral medicine research and practice.
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Affiliation(s)
- M Bryant Howren
- Veterans Affairs Iowa City Healthcare System, Iowa City, Iowa 52242, USA.
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Distinct Depression Symptom Trajectories over the First Year of Dialysis: Associations with Illness Perceptions. Ann Behav Med 2012; 45:78-88. [DOI: 10.1007/s12160-012-9410-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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