Illness perceptions as predictors of psychological distress among head and neck cancer survivors: a longitudinal study

Abstract

Background Leventhal's commonsense model implies illness perceptions influence illness outcomes. This study examined illness perceptions among head and neck cancer survivors, and whether these predicted subsequent psychological distress. Methods A total of 124 survivors of head and neck cancer (87% nasopharyngeal carcinoma; NPC) completed measures of psychological distress (Hospital Anxiety and Depression Scale; HADS), illness perceptions (Brief Illness Perception Questionnaire; B‐IPQ), dispositional optimism (revised Chinese version of the Life Orientation Test; C‐LOT‐R), and clinical and demographic data approximately12.9 months after diagnosis (T1). Six months later (T2) psychological distress (HADS) was again measured. Adjusted multivariate analyses tested whether illness perceptions predicted T2 HADS scores. Results Illness perception dimensions were significantly intercorrelated (0.01‐0.68), explaining 8.0% of anxiety and 4.8% of depression symptom variability at T2. After adjustment for T1 distress, illness identity (β = 0.270, P < .01) and sex identification as a woman (β = 0.275, P < .01) predicted T2 anxiety symptoms while illness identity (β = 0.195, P < .05), unemployment (β = 0.195, P < .05), and pessimism (β = –0.227, P < .01) predicted T2 depression symptoms. Conclusion Perceived illness identity predicted psychological distress, accounting for modest levels of distress variance. Unresolved symptoms may exacerbate distress.

Mindfulness Affects the Level of Psychological Distress in Patients With Lung Cancer via Illness Perception and Perceived Stress: A Cross-Sectional Survey Study

“…The individual will concurrently construct or elaborate both cognitive and emotional representations of their symptoms and illness to relieve the adverse impacts resulting from the symptom or an illness ( Dempster et al, 2011 ). Some studies have revealed the association between illness perception and psychological distress among different populations ( Zhang et al, 2017 , 2018 , 2020b ). In this study, we first investigated the association between illness perception and psychological distress among patients with lung cancer and determined that illness perception was positively related to psychological distress.…”

“…In a prospective, longitudinal, and observational study, illness perceptions were demonstrated as a potential predictor of psychological distress in patients with non-muscle-invasive bladder cancer ( Zhang et al, 2020b ). Meanwhile, illness perception has been found to predict psychological distress in head and neck cancer survivors ( Zhang et al, 2018 ), esophageal cancer survivors ( Dempster et al, 2011 ), and breast cancer survivors ( Zhang et al, 2017 ). However, it is not yet known whether the same association holds for patients with lung cancer.…”

Psychological Distress and Illness Perceptions in Thyroid Cancer Survivors: Does Age Matter?

“…As expected, higher scores on the following illness perception subscales (experiencing more consequences of illness, a stronger sense of continued duration of illness, experiencing more symptoms of the illness, being more concerned about the illness, and being more emotionally affected by the illness) were associated with more psychological distress in all age groups, which is in line with other studies. [38][39][40] This information can be used to inform therapeutic approaches to working with cancer-related distress. Higher scores on two illness perception subscales (i.e., thinking your treatment can help your illness more and understanding your illness better) were associated with younger age, while higher scores on a third one (a stronger sense of continued duration of illness) was associated with higher age.…”

Quality of life and its associations with illness perceptions over a 3‑month follow‑up period in patients with non‑small cell lung cancer: A prospective longitudinal study

“…Additionally, the global QOL differed significantly between the two groups in illness perception for the identity item, and a higher global QOL was observed over the 3-month follow-up period in the strong perception group. A previous study on head and neck cancer survivors described that the illness identity captured patients' perceptions of symptom load (27). In the present study, the patients in the strong identity perception group may have exhibited a higher global QOL over the 3-month period as the patients captured their perceptions of symptom load prior to treatment.…”