Untangling the relationship between negative illness perceptions and worse quality of life in patients with advanced cancer—a study from the population-based PROFILES registry

Abstract

Purpose Quality of life (QoL) is an important yet complex outcome of care in patients with advanced cancer. QoL is associated with physical and psychosocial symptoms and with patients’ illness perceptions (IPs). IPs are modifiable cognitive constructs developed to make sense of one’s illness. It is unclear how IPs influence patients’ QoL. A better understanding of this relationship can inform and direct high quality care aimed at improving patients’ QoL. We therefore investigated the mediating role of anxiety and depression in the association of IPs with QoL. Methods Data from 377 patients with advanced cancer were used from the PROFILES registry. Patients completed measures on IPs (BIPQ), QoL (EORTC QLQ-C30), and symptoms of anxiety and depression (HADS). Mediation analyses were conducted to decompose the total effect of IPs on QoL into a direct effect and indirect effect. Results All IPs but one (“Comprehensibility”) were negatively associated with QoL (p<0.001); patients with more negative IPs tended to have worse QoL. The effect was strongest for patients who felt that their illness affected their life more severely (“Consequences”), patients who were more concerned about their illness (“Concern”), and patients who thought that their illness strongly affected them emotionally (“Emotions”). Anxiety mediated 41–87% and depression mediated 39–69% of the total effect of patients’ IPs on QoL. Conclusion Negative IPs are associated with worse QoL. Anxiety and depression mediate this association. Targeting symptoms of anxiety and depression, through the modification of IPs, has the potential to improve QoL of patients with advanced cancer.

Improving the self-care behavior of type 2 diabetes mellitus clients by combining the basic conditioning factors and self-care agency

“…24 Negative perception of the illness, on the other hand, worsens the health status and well-being of patients. 25,26 Sociocultural background significantly influences the lifespan of an individual, including the ways people perceive and treat health and diseases, including their health-seeking. 27 The social dimension refers to the standard of living, behavior, and economic conditions, while the cultural aspect of health care refers to the perception and the ways health.…”

The impact of frailty and illness perceptions on quality of life among people living with HIV in Greece: A network analysis

“…IP is a construct which refers to how people perceive their disease (cognitive representation) and react to it emotionally (emotional representation), influencing the ways they cope, but also their adherence to therapy and, to an extent, their illness outcomes [24]. Additionally, it has been found to be associated with QoL [25][26][27]. As an example, people's perceptions of HIV having severe consequences and related symptoms have been linked with dysfunctional coping [28], while feeling in control of the disease and perceiving that HIV has mild consequences have been associated with healthy coping mechanisms and a positive psychological adjustment [29].…”

“…Negative IP of HIV, for example perceptions that one does not have personal control over the situation, were associated with experienced symptoms [30] and were negatively related to QoL [31]. Moreover, negative IP have been found to predict psychological distress, anxiety and depression in people living with cancer [32,33], which in turn can result in a lower QoL [25].…”

Translation, cross-cultural adaptation, and psychometric evaluation of the brief illness perception questionnaire into Yoruba language among persons with chronic low back pain

“…Illness perceptions as a psychosocial construct may constitute a confounding factor in patient assessment and management [9]. In light of these, assessment of illness perceptions is recommended among healthcare professionals including physiotherapy [10] as a way to ensure best treatment outcomes, as well as achieve good communication with patients [11].…”