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Perceived Risk, Trust and Health-related Quality of Life Among Cancer Survivors

  • Rapid Communication
  • Published:
Annals of Behavioral Medicine

Abstract

Background

To design effective interventions that improve cancer survivors’ health-related quality of life (HRQoL), it is necessary to understand how HRQoL is related to cancer cognitions and interpersonal/social factors.

Purpose

This study investigated whether perceived risk of recurrence is associated with HRQoL and whether trust in the follow–up care physician moderates the perceived risk/HRQoL relationship.

Method

A cross-sectional survey of cancer survivors (N = 408).

Results

Higher perceived risk was associated with worse mental and physical HRQoL. Higher trust was associated with better mental (but not physical) HRQoL. The inverse association between perceived risk and mental HRQoL was eliminated among those with high trust in their physicians. Trust did not moderate the perceived risk/physical HRQoL relationship.

Conclusions

Addressing survivors’ perceived risk of recurrence and improving the provider-patient relationship may enhance interventions to improve mental HRQoL among cancer survivors. However, the causal relationships among the constructs should be explicated.

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Notes

  1. To alleviate concerns about dichotomizing continuous variables, we reanalyzed the data after transforming perceived risk, worry, and trust to reduce their skews. The most effective transformation varied by construct (i.e., square root for worry and inverse for perceived risk and trust). Only one of the ten main effects and interactions described in the results section differed based on whether the variables were dichotomized or transformed. Worry was not associated with PCS scores when the variables were dichotomized, but it was marginally related to PCS when it was continuous, b = 3.0, B = 0.09 (95% CI: −0.5 to 6.5), t = 1.7, p = 0.08. The 1.5-point difference in PCS scores (reported previously) is unlikely to be clinically significant [30, 35]. We report the dichotomized data for clarity of presentation. Furthermore, the extraordinarily skewed trust scores suggest that the 25% of participants who gave their physicians perfect trust ratings may be qualitatively different from participants who did not trust their physicians so completely.

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Authors and Affiliations

  1. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA

    Erika A. Waters Ph.D., M.P.H., Neeraj K. Arora Ph.D., William M. P. Klein Ph.D. & Paul K. J. Han M.D., M.P.H.

  2. Cancer Prevention Fellowship Program, Office of Preventive Oncology, National Cancer Institute, Bethesda, MD, USA

    Erika A. Waters Ph.D., M.P.H.

  3. Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA

    William M. P. Klein Ph.D.

  4. Department of Surgery (Prevention and Control), Washington University School of Medicine, 660 S. Euclid, Campus Box 8100, St. Louis, MO, 63110, USA

    Erika A. Waters Ph.D., M.P.H.

Authors
  1. Erika A. Waters Ph.D., M.P.H.
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  2. Neeraj K. Arora Ph.D.
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  3. William M. P. Klein Ph.D.
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  4. Paul K. J. Han M.D., M.P.H.
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Correspondence to Erika A. Waters Ph.D., M.P.H..

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Waters, E.A., Arora, N.K., Klein, W.M.P. et al. Perceived Risk, Trust and Health-related Quality of Life Among Cancer Survivors. ann. behav. med. 39, 91–97 (2010). https://doi.org/10.1007/s12160-010-9163-y

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  • DOI: https://doi.org/10.1007/s12160-010-9163-y

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