Skip to main content

Advertisement

Log in

Illness perceptions among cancer survivors

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

The purpose of the study is to document in Hong Kong Chinese cancer survivors cross-sectional associations between illness perceptions, physical symptom distress and dispositional optimism.

Methods

A consecutive sample of 1036 (response rate, 86.1 %, mean age 55.18 years, 60 % female) survivors of different cancers recruited within 6 months of completion of adjuvant therapy from Hong Kong public hospitals completed the Brief Illness Perception Questionnaire (B-IPQ), Chinese version of the Memorial Symptom Assessment Scale Short-Form (MSAS-SF), and the revised Chinese version of Life Orientation Test (C-LOT-R), respectively. Stepwise multiple regression analyses examined adjusted associations.

Results

IPQ seriousness, symptom identity, illness concern, and emotional impact scores varied by cancer type (p < 0.01). Stress-related, lifestyle, environment, psychological/personality, and health-related factors were most frequently attributed causes of cancer. After adjustment for sample differences, physical symptom distress was significantly associated with all illness perception dimensions (p < 0.01), excepting control beliefs. Optimism was positively correlated with perceived personal and treatment control (p < 0.01) and illness understanding (p < 0.01), but negatively correlated with other IPQ dimensions (all p < 0.01). IPQ domain differences by cancer type were eliminated by adjustment for sample characteristics.

Conclusion

Illness perceptions did not differ by cancer type. Greater physical symptom distress and lower levels of optimism were associated with more negative illness perceptions.

Implications

Understanding how cancer survivors make sense of cancer can clarify an important aspect of adaptation. This in turn can inform interventions to facilitate adjustment. Knowledge contributions include evidence of physical symptom distress correlating with most dimensions of illness perception. Optimism was also associated with cancer survivors’ illness perceptions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Overview of 2012 Hong Kong cancer statistics (2014) Hong Kong

  2. Sanchez-Jimenez A, Cantarero-Villanueva I, Delgado-Garcia G, Molina-Barea R, Fernandez-Lao C, Galiano-Castillo N, Arroyo-Morales M (2014) Physical impairments and quality of life of colorectal cancer survivors: a case–control study. Eur J Cancer Care. doi:10.1111/ecc.12218

    Google Scholar 

  3. Davis KM, Kelly SP, Luta G, Tomko C, Miller AB, Taylor KL (2014) The association of long-term treatment-related side effects with cancer-specific and general quality of life among prostate cancer survivors. Urology 84(2):300–306. doi:10.1016/j.urology.2014.04.036

    Article  PubMed  Google Scholar 

  4. Schmitz KH, Speck RM, Rye SA, DiSipio T, Hayes SC (2012) Prevalence of breast cancer treatment sequelae over 6 years of follow-up: the pulling through study. Am Cancer Soc 118(8 Suppl):2217–2225. doi:10.1002/cncr.27474

    Google Scholar 

  5. Leventhal H, Meyer D, Nerenz D (1980) The common sense representation of illness danger. In: Rachman S (ed) Medical psychology, vol 2. Pergamon Press, New York, pp 7–30

    Google Scholar 

  6. Leventhal H, Steele D (1984) Illness representations and coping with health threats. In: Rachman S (ed) Handbook of psychology and health, vol 4. Erlbaum, Hillside, pp 219–252

    Google Scholar 

  7. Holly R, Paula W (2013) Illness cognitions and perceptions. Encyclopedia of behavioral medicine. 1027–1030. doi:10.1007/978-1-4419-1005-9_967

  8. Nerenz D, Leventhal H (1983) Self-regulation theory in chronic illness. In: Burish T, Bradley L (eds) Coping with chronic disease. Research and applications. Academic, New York, pp 13–37

    Google Scholar 

  9. Armstrong TS (2003) Symptoms experience: a concept analysis. Oncol Nurs Forum 30(4):601–606. doi:10.1188/03.ONF.601-606

    Article  PubMed  Google Scholar 

  10. Leventhal H, Brissette I, Leventhal E (2003) The common-sense model of self-regulation of health and illness. In: Cameron L, Leventhal H (eds) The self-regulation of health and illness behaviour. Routledge, UK, pp 42–65

    Google Scholar 

  11. Wong WS, Fielding R (2013) Suppression of emotion expression mediates the effects of negative affect on pain catastrophizing: a cross-sectional analysis. Clin J Pain 29(10):865–872. doi:10.1097/AJP.0b013e31827da3b5

    Article  PubMed  Google Scholar 

  12. Wong WS, Lam HM, Chen PP, Chow YF, Wong S, Lim HS, Jensen MP, Fielding R (2015) The fear-avoidance model of chronic pain: assessing the role of neuroticism and negative affect in pain catastrophizing using structural equation modeling. Int J Behav Med 22(1):118–131. doi:10.1007/s12529-014-9413-7

    Article  CAS  PubMed  Google Scholar 

  13. McAndrew L, Mora P, Quigley K, Leventhal E, Leventhal H (2014) Using the common sense model of self-regulation to understand the relationship between symptom reporting and trait negative affect. Int J Behav Med 21(6):989–994. doi:10.1007/s12529-013-9372-4

    Article  PubMed  Google Scholar 

  14. Thune-Boyle ICV, Myers LB, Newman SP (2006) The role of illness beliefs, treatment beliefs, and perceived severity of symptoms in explaining distress in cancer patients during chemotherapy treatment. Behav Med 32(1):19–29

    Article  PubMed  Google Scholar 

  15. Lam WWT, Li WWY, Bonanno GA, Mancini AD, Chan M, Or A, Fielding R (2012) Trajectories of body image and sexuality during the first year following diagnosis of breast cancer and their relationship to 6 years psychosocial outcomes. Breast Cancer Res Treat 131(3):957–967

    Article  PubMed  Google Scholar 

  16. Lam WWT, Soong I, Yau TK, Wong KY, Tsang J, Yeo W, Suen J, Ho WM, Sze WK, Ng AWY, Kwong A, Suen D, Fielding R (2013) The evolution of psychological distress trajectories in women diagnosed with advanced breast cancer: a longitudinal study. Psycho-Oncology 22(12):2831–2839

    Article  CAS  PubMed  Google Scholar 

  17. Lam WWT, Ye M, Fielding R (2012) Trajectories of quality of life among Chinese patients diagnosed with nasopharyngeal cancer. PloS One 7(9):e44022. doi:10.1371/journal.pone.0044022

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  18. Carver CS, Scheier MF (2014) Dispositional optimism. Trends Cogn Sci 18(6):293–299

    Article  PubMed Central  PubMed  Google Scholar 

  19. Hurt C, Burn D, Hindle J, Samuel M, Wilson K, Brown R (2014) Thinking positively about chronic illness: an exploration of optimism, illness perceptions and well-being in patients with Parkinson’s disease. Br J Health Psychol 19(2):363–379

    Article  PubMed  Google Scholar 

  20. Vollmann M, Scharloo M, Langguth B, Kalkouskaya N, Salewski C (2014) Illness representations as mediators of the relationship between dispositional optimism and depression in patients with chronic tinnitus: a cross-sectional study. Psychol Health 29(1):81–93. doi:10.1080/08870446.2013.828294

    Article  Google Scholar 

  21. Henselmans I, Sanderman R, Helgeson VS, de Vries J, Smink A, Ranchor AV (2010) Personal control over the cure of breast cancer: adaptiveness, underlying beliefs and correlates. Psycho-Oncology 19(5):525–534

    Article  PubMed  Google Scholar 

  22. Zenger M, Brix C, Borowski J, Stolzenburg JU, Hinz A (2010) The impact of optimism on anxiety, depression and quality of life in urogenital cancer patients. Psycho-Oncology 19(8):879–886

    Article  PubMed  Google Scholar 

  23. Gray NM, Hall SJ, Browne S, Johnston M, Lee AJ, Macleod U, Mitchell ED, Samuel L, Campbell NC (2014) Predictors of anxiety and depression in people with colorectal cancer. Support Care Cancer 22(2):307–314

    Article  PubMed  Google Scholar 

  24. Mickeviciene A, Vanagas G, Jievaltas M, Ulys A (2013) Does illness perception explain quality of life of patients with prostate cancer? Med Lith 49(5):235–241

    Google Scholar 

  25. Husson O, Thong MSY, Mols F, Oerlemans S, Kaptein AA, van de Poll-Franse LV (2013) Illness perceptions in cancer survivors: what is the role of information provision? Psycho-Oncology 22(3):490–498

    Article  PubMed  Google Scholar 

  26. Hopman P, Rijken M (2015) Illness perceptions of cancer patients: relationships with illness characteristics and coping. Psycho-Oncology 24(1):11–18

    Article  PubMed  Google Scholar 

  27. Broadbent E, Petrie KJ, Main J, Weinman J (2006) The brief illness perception questionnaire. J Psychosom Res 60(6):631–637

    Article  PubMed  Google Scholar 

  28. Xue F, Lin Y Brief illness perception questionnaire: Chinese version. http://www.uib.no/ipq/pdf/B-IPQ-Chinese.pdf. Accessed on 01 Aug 2010

  29. Fan SY, Eiser C, Ho MC, Lin CY (2013) Health-related quality of life in patients with hepatocellular carcinoma: the mediation effects of illness perceptions and coping. Psycho-Oncology 22(6):1353–1360

    Article  PubMed  Google Scholar 

  30. Schaefert R, Honer C, Salm F, Wirsching M, Leonhart R, Yang JZ, Wei J, Lu W, Larisch A, Fritzsche K (2013) Psychological and behavioral variables associated with the somatic symptom severity of general hospital outpatients in China. Gen Hosp Psychiatry 35(3):297–303

    Article  PubMed  Google Scholar 

  31. Lam WWT, Law CC, Fu YT, Wong KH, Chang VT, Fielding R (2008) New insights in symptom assessment: the Chinese versions of the Memorial Symptom Assessment Scale Short Form (MSAS-SF) and the Condensed MSAS (CMSAS). J Pain Symptom Manag 36(6):584–595

    Article  Google Scholar 

  32. Lai J, Yue X (2000) Measuring optimism in Hong Kong and mainland Chinese with the revised life orientation test. Personal Individ Differ 28(4):781–796. doi:10.1016/S0191-8869(99)00138-5

    Article  Google Scholar 

  33. McHugh ML (2011) Multiple comparison analysis testing in ANOVA. Biochem Med 21(3):203–209

    Article  CAS  Google Scholar 

  34. Yan J, You LM, He JG, Wang JF, Chen L, Liu BL, Zhou JJ, Chen JH, Jin SY (2011) Illness perception among Chinese patients with acute myocardial infarction. Patient Educ Couns 85(3):398–405

    Article  PubMed  Google Scholar 

  35. Hagger M, Orbell S (2003) A meta-analytic review of the common-sense model of illness representations. Psychol Health 18(2):141–184. doi:10.1080/088704403100081321

    Article  Google Scholar 

  36. Kertmen N, Sahin U, Keskin O, Solak M, Petekkaya I, Babacan T, Sarici F, Arik Z, Kizilarslanoglu B, Altundag K (2012) Comparison of clinicopathological characteristics and outcome of younger and older breast cancer patients. J BUON 17(4):797

    CAS  PubMed  Google Scholar 

  37. Fielding R, Lam WWT, Shun SC, Okuyama T, Lai YH, Wada M, Akechi T, Li WWY, Appon (2013) Attributing variance in supportive care needs during cancer: culture-service, and individual differences, before clinical factors. PloS One 8(5):e65099. doi:10.1371/journal.pone.0065099

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  38. Blank TO, Bellizzi KM (2008) A gerontologic perspective on cancer and aging. Am Cancer Soc 112(11):2569–2576

    Google Scholar 

  39. Verbrugge LM (1985) Gender and health: an update on hypotheses and evidence. J Health Soc Behav 26(3):156–182

    Article  CAS  PubMed  Google Scholar 

  40. Stergiou-Kita M, Grigorovich A, Tseung V, Milosevic E, Hebert D, Phan S, Jones J (2014) Qualitative meta-synthesis of survivors’ work experiences and the development of strategies to facilitate return to work. J Cancer Surviv 8(4):657–670

    Article  PubMed  Google Scholar 

  41. Folkman S (1984) Personal control and stress and coping processes: a theoretical analysis. J Pers Soc Psychol 46(4):839–852

    Article  CAS  PubMed  Google Scholar 

  42. Dumalaon-Canaria JA, Hutchinson AD, Prichard I, Wilson C (2014) What causes breast cancer? A systematic review of causal attributions among breast cancer survivors and how these compare to expert-endorsed risk factors. Cancer Causes Control 25(7):771–785

    Article  PubMed  Google Scholar 

  43. Costanzo ES, Lutgendorf SK, Bradley SL, Rose SL, Anderson B (2005) Cancer attributions, distress, and health practices among gynecologic cancer survivors. Psychosom Med 67(6):972–980

    Article  PubMed  Google Scholar 

  44. Ferrucci LM, Cartmel B, Turkman YE, Murphy ME, Smith T, Stein KD, McCorkle R (2011) Causal attribution among cancer survivors of the 10 most common cancers. J Psychosoc Oncol 29(2):121–140. doi:10.1080/07347332.2010.548445

    Article  PubMed Central  PubMed  Google Scholar 

  45. Oba S, Takatsuka N, Nagata C, Nagao Y, Yamamoto S, Shibuya C, Kashiki Y, Shimizu H (2009) Causal attributions to epidemiological risk factors and their associations to later psychological adjustment among Japanese breast cancer patients. Support Care Cancer 17(1):3–9

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by a grant from Hong Kong Cancer Fund. The authors are grateful to all the research assistants for their contributions of the data collection and management and to the cancer survivors who participated in the study.

Compliance with ethical standards

Ethical approval was granted by The University of Hong Kong and public Hospital Authority ethics committees. All procedures performed in studies involving human participants were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all participants included in the study.

Conflict of interest

The authors declare that they have no competing interests.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Wendy Wing Tak Lam.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, N., Fielding, R., Soong, I. et al. Illness perceptions among cancer survivors. Support Care Cancer 24, 1295–1304 (2016). https://doi.org/10.1007/s00520-015-2914-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-015-2914-3

Keywords

Navigation