Optimism and adaptation to chronic disease: The role of optimism in relation to self‐care options of type 1 diabetes mellitus, rheumatoid arthritis and multiple sclerosis

Abstract

Objectives: To determine the role of optimistic beliefs in adaptation processes of three chronic diseases different in controllability by self‐care. It was expected that optimism towards the future would relate to adaptation independently of the controllability of disease. Optimism regarding one's coping ability should be beneficial in controllable diseases. Unrealistic optimism was expected to be beneficial in uncontrollable disease. Design: The cross‐sectional design involved 104 patients with type 1 diabetes, 95 patients with rheumatoid arthritis and 98 patients with multiple sclerosis, recruited via their physician at the out‐patient department of five hospitals. Method: Confirmatory Factor Analysis (LISREL) was employed to confirm a three‐dimensional approach of optimism: outcome expectancies, efficacy expectancies and unrealistic thinking. Multi‐sample analysis by path modelling was used to examine whether the relationship of the three optimistic beliefs with coping (CISS‐21), depression and anxiety (HADS), and physical functioning (SF‐36) differs with the controllability based on the self‐care options of chronic disease. Results: These show that when chronic disease must be controlled by self‐care, physical health depends more strongly on positive efficacy expectancies. In contrast, when self‐care options for controlling chronic disease are limited, physical health depends more strongly on positive unrealistic thinking and relates negatively to positive efficacy expectancies. The impact of the three optimistic beliefs on mental health is independent of the controllability by self‐care. Conclusion: Optimistic beliefs are differently beneficial for physical health dependent on the controllability of chronic disease. Unrealistic beliefs are helpful when patients are confronted with moderately to largely uncontrollable disease where self‐care options are limited, in contrast to positive efficacy expectancies that are helpful when patients deal with largely controllable disease where self‐care is required.

Is Optimism Sensitive to the Stressors of Chronic Disease? The Impact of Type 1 Diabetes Mellitus and Multiple Sclerosis on Optimistic Beliefs

“…Earlier research showed that there are at least three different concepts, namely positive outcome expectancies, positive efficacy expectancies, and optimistic bias (Schwarzer, 1994;Fournier et al, 1999Fournier et al, , 2002. In the present study, it is expected that the three types of optimistic beliefs will react differently to chronic disease, depending on their differential sensitivity to disease-related stressors.…”

“…In the regression analyses both samples will be analyzed together, controlling for perceived control of illness indicated by a dummy variable of the Chance LOC (with 1 indicating IDDM and 0 indicating MS). The Chance LOC was preferred as an indicator of perceived controllability of illness as it is primarily determined by environmental factors in contrast to both other scales which tend to be dispositional variables depending on genetic factors (Johansson et al, 2001;Fournier et al, 2002).…”

Estilo de afrontamiento, optimismo disposicional, depresión, imagen corporal, imc, y riesgo de tca como predictores de calidad de vida relacionada con la salud

“…Desde la visión positiva de la salud se ha estudiado y definido el optimismo como la preferencia de una persona a ser motivada por la creencia que los resultados deseados son fácilmente alcanzables y a su vez se ha relacionado con efectos positivos sobre la salud psicológica y física (Brannon & Feist, 2001); así mismo el optimismo ha sido identificado como factor determinante de la calidad de vida tanto en personas enfermas como personas sanas (Fournier, Ridder, & Bensing, 2002;Gordon, Feldman, Crase, & Schoen, 2002). La importancia y relación existente entre optimismo y salud es estrecha, se considera que las personas optimistas son menos vulnerables a adquirir enfermedades físicas, tienen mejor funcionamiento del sistema inmunológico y menor tasa de mortalidad (Remor, Amorós, & Carrobles, 2006).…”

Optimism, pain coping strategies and pain intensity among women with rheumatoid arthritis

“…Chronic pain in RA is considered as an uncontrollable stressor [1], which implies low ability to determine its course and outcomes by self-care options [9]. Therefore emotion-focused coping rather than problem-focused coping might be more effective and beneficial for this group of patients [1].…”

“…Patients with positive outcome expectancies are more engaged in taking up health-oriented behaviours, even if this involves dealing with obstacles and challenges [9]. The significance of optimism in the experience of pain is due to its influence on coping strategies.…”