Skip to main content

Illness representations and psychological adjustment of Greek couples dealing with a recently-diagnosed cancer: dyadic, interaction and perception-dissimilarity effects

Abstract

The aim was to examine the impact of the dyadic, interaction and dissimilarity effects of the illness representations on the psychological health of recently diagnosed cancer patients and spouses in Greece. The sample consisted of 298 individuals nested in 149 couples. Effects were examined with the Actor–Partner Interdependence Model. Both actor (i.e., within person) and partner (i.e., between partners) effects were detected for both patients’ and spouses’ psychological symptoms. The negative association of patients’ psychological symptoms with their representations of illness coherence was weak at the higher and medium levels, and stronger at the lower levels of spouse corresponding representations. Patient–partner discrepancy in perceived illness consequences was associated with more psychological symptoms in patients. Adaptation to cancer is a dyadic process within the context of which patient and partner psychological well-being is affected by each other’s understanding of illness. Thus, the parallel examination of the illness representations of both partners is needed from the early phases of the illness trajectory.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  • Applebaum, A., & Breitbart, W. (2013). Care for the cancer caregiver: A systematic review. Palliative & Supportive Care, 11, 231–252.

    Article  Google Scholar 

  • Badr, H., Carmack, C. L., Kashy, D. A., Cristofanilli, M., & Revenson, T. A. (2010). Dyadic coping in metastatic breast cancer. Health Psychology, 29, 169–180.

    PubMed  PubMed Central  Article  Google Scholar 

  • Baum, A., & Andersen, B. L. (2001). Psychosocial interventions for cancer. Washington, DC: American Psychological Association.

    Book  Google Scholar 

  • Benyamini, Y., Gozlan, M., & Kokia, E. (2009). Women’s and men’s perceptions of infertility and their associations with psychological adjustment: A dyadic approach. British Journal of Health Psychology, 14, 1–16.

    PubMed  Article  Google Scholar 

  • Benyamini, Y., Medalion, B., & Garfinkel, D. (2007). Patient and spouse perceptions of the patient’s heart disease and their associations with received and provided social support and undermining. Psychology and Health, 22, 765–785.

    Article  Google Scholar 

  • Berg, C. A., & Upchurch, R. (2007). A developmental-contextual model of couples coping with chronic illness across the adult life span. Psychological Bulletin, 133, 920–954.

    PubMed  Article  Google Scholar 

  • Bodenmann, G. (2005). Dyadic coping and its significance for marital functioning. In T. A. Revenson, K. Kayser, & G. Bodenmann (Eds.), Couples coping with stress: Emerging perspectives on dyadic coping (pp. 33–50). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • Carver, C. S., & Antoni, M. (2004). Finding benefit in breast cancer during the year after diagnosis predicts better adjustment 5 to 8 years after diagnosis. Health Psychology, 23, 595–598.

    PubMed  Article  Google Scholar 

  • Cook, W. L., & Kenny, D. A. (2005). The Actor–Partner Interdependence Model: A model of bidirectional effects in developmental studies. International Journal of Behavioral Development, 29, 101–109.

    Article  Google Scholar 

  • Dempster, M., McCorry, N. K., Brennan, E., Donnelly, M., Murray, L. J., & Johnston, B. T. (2011). Illness perceptions among carer-survivor dyads are related to psychological distress among oesophageal cancer survivors. Journal of Psychosomatic Research, 70, 432–439.

    PubMed  Article  Google Scholar 

  • Dimitraki, G., & Karademas, E. C. (2014). The association of type 2 diabetes patient and spouse illness representations with their well-being: A dyadic approach. International Journal of Behavioral Medicine, 21, 230–290.

    PubMed  Article  Google Scholar 

  • Ellis, J. (2012). The impact of lung cancer on patients and carers. Chronic Respiratory Disease, 9, 39–47.

    PubMed  Article  Google Scholar 

  • Fagundes, C. P., Berg, C. A., & Wiebe, D. J. (2012). Intrusion, avoidance, and daily negative affect among couples coping with prostate cancer: A dyadic investigation. Journal of Family Psychology, 26, 246–253.

    PubMed  Article  Google Scholar 

  • Figueiras, M. J., & Weinman, J. (2003). Do similar patient and spouse perceptions of myocardial infarction predict recovery? Psychology and Health, 18, 201–216.

    Article  Google Scholar 

  • Georgas, J., Berry, J. W., van de Vijver, F. J. R., Kagitcibasi, C., & Poortinga, Y. H. (2006). Families across cultures: A 30-nation psychological study. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Giannousi, Z., Manaras, I., Georgoulias, V., & Samonis, G. (2010). Illness perceptions of Greek patients with cancer: A validation of the Revised Illness Perception Questionnaire. Psycho-Oncology, 19, 85–92.

    PubMed  Article  Google Scholar 

  • Given, B., Kozachik, S., Collins, C., Devoss, D., & Given, C. W. (2001). Caregiver role strain. In M. Maas, K. Buckwalter, M. Hardy, T. Tripp-Reimer, & M. Titler (Eds.), Nursing care of older adults diagnosis: Outcome and interventions (pp. 679–695). St Louis, MO: Mosby.

    Google Scholar 

  • Hack, T. F., & Degner, L. F. (2004). Coping responses following breast cancer diagnosis predict psychological adjustment three years later. Psycho-Oncology, 13, 235–247.

    PubMed  Article  Google Scholar 

  • Hagedoorn, M., Sanderman, R., Bolks, H. N., Tuinstra, J., & Coyne, J. C. (2008). Distress in couples coping with cancer: A meta-analysis and critical review of role and gender effects. Psychological Bulletin, 134, 1–30.

    PubMed  Article  Google Scholar 

  • Hagger, M. S., & Orbell, S. (2003). A meta-analytic review of the Common-Sense Model of illness representations. Psychology and Health, 18, 41–184.

    Article  Google Scholar 

  • Heijmans, M., de Ridder, D., & Bensing, J. (1999). Dissimilarity in patients’ and spouses’ representations of chronic illness: Explorations of relations to patient adaptation. Psychology and Health, 14, 51–466.

    Article  Google Scholar 

  • Joreskog, K. G., & Sorbom, D. (1993). LISREL 8 user’s guide. Lincolnwood, IL: Scientific Software International.

    Google Scholar 

  • Kafetsios, K., & Nezlek, J. B. (2012). Emotion and support perceptions in everyday social interaction: Testing the “less is more” hypothesis in two cultures. Journal of Social and Personal Relationships, 29, 165–184.

    Article  Google Scholar 

  • Karademas, E. C., & Giannousi, Z. (2013). Representations of control and psychological symptoms in couples dealing with cancer: A dyadic-regulation approach. Psychology and Health, 28, 7–83.

    Article  Google Scholar 

  • Kenny, D. A., Kashy, D. A., & Cook, W. L. (2006). Dyadic data analysis. New York: Guilford.

    Google Scholar 

  • Leventhal, H., Diefenbach, M., & Leventhal, E. A. (1992). Illness cognition: Using common sense to understand treatment adherence and affect cognition treatment. Cognitive Therapy and Research, 16, 223–230.

    Article  Google Scholar 

  • Leventhal, H., Halm, E., Horowitz, C., Leventhal, E. A., & Ozakinci, G. (2005). Living with chronic illness: A contextualized, self-regulation approach. In S. Sutton, A. Baum, & M. Johnston (Eds.), The SAGE handbook of health psychology (pp. 197–240). London: Sage.

    Google Scholar 

  • Leventhal, H., Meyer, D., & Nerenz, D. (1980). The common-sense representations of illness danger. In S. Rachman (Ed.), Medical psychology (Vol. 2, pp. 7–30). New York: Pergamon.

    Google Scholar 

  • Llewellyn, C. D., McGurk, M., & Weinman, J. (2007). Illness and treatment beliefs in head and neck cancer: Is Leventhal’s common sense model a useful framework for determining changes in outcomes over time? Journal of Psychosomatic Research, 63, 17–26.

    PubMed  Article  Google Scholar 

  • Manne, S. L., & Ostroff, J. S. (2008). Coping with breast cancer: A couples-focused group intervention. Therapist guide. New York: Oxford University Press.

    Book  Google Scholar 

  • Martin, R., & Leventhal, H. (2004). Symptom perception and health care-seeking behavior. In T. J. Boll, J. M. Raczynski, & L. C. Leviton (Eds.), Handbook of clinical health psychology (Vol. 2, pp. 299–328). Washington, DC: American Psychological Association.

    Google Scholar 

  • Merz, E. L., Malcarne, V. L., Ko, C. M., Sadler, M., Kwack, L., Varni, J. W., & Sadler, G. R. (2011). Dyadic concordance among prostate cancer patients and their partners and health-related quality of life: Does it matter? Psychology and Health, 26, 651–666.

    PubMed  PubMed Central  Article  Google Scholar 

  • Millar, K., Purushotham, A. D., McLatchie, E., George, W. D., & Murray, G. D. (2005). A 1-year prospective study of individual variation in distress, and illness perceptions, after treatment for breast cancer. Journal of Psychosomatic Research, 58, 335–342.

    PubMed  Article  Google Scholar 

  • Moss-Morris, R., Weinman, J., Petrie, K. J., Horne, R., & Cameron, L. D. (2002). The Revised Illness Perception Questionnaire (IPQ-R). Psychology and Health, 17, 1–16.

    Article  Google Scholar 

  • Mystakidou, K., Tsilika, E., Parpa, E., Katsouda, E., Galanos, A., & Vlahos, L. (2004). The Hospital Anxiety and Depression Scale in Greek cancer patients: Psychometric analyses and applicability. Supportive Care in Cancer, 12, 821–825.

    PubMed  Article  Google Scholar 

  • Roland, K. B., Rodriguez, J. L., Rees Paterson, J., & Trivers, K. F. (2013). A literature review of the social and psychological needs of ovarian cancer survivors. Psycho-Oncology, 22, 2408–2418.

    PubMed  Article  Google Scholar 

  • Romero, C., Lindsay, J. E., Dalton, W. T., Nelson, D. V., & Friedman, L. C. (2008). Husbands’ perceptions’ of wives’ adjustment to breast cancer: The impact on wives’ mood. Psycho-Oncology, 17, 237–243.

    PubMed  Article  Google Scholar 

  • Rosland, A.-M., Heisler, M., & Piette, J. D. (2012). The impact of family behaviors and communication patterns on chronic illness outcomes: A systematic review. Journal of Behavioral Medicine, 35, 221–239.

    PubMed  PubMed Central  Article  Google Scholar 

  • Rozema, H., Völlink, T., & Lechner, L. (2009). The role of illness representations in coping and health of patients treated for breast cancer. Psycho-Oncology, 18, 849–857.

    PubMed  Article  Google Scholar 

  • Satin, J., Linden, W., & Phillips, M. J. (2009). Depression as a predictor of disease progression and mortality in cancer patients: A meta-analysis. Cancer, 115, 5349–5361.

    PubMed  Article  Google Scholar 

  • Twiddy, M., House, A., & Jones, F. (2012). The association between discrepancy in illness representations on distress in stroke patients and carers. Journal of Psychosomatic Research, 72, 220–225.

    PubMed  Article  Google Scholar 

  • Weinman, J., Heijmans, M., & Figueiras, M. J. (2003). Carer perceptions of chronic illness. In L. D. Cameron & H. Leventhal (Eds.), The self-regulation of health and illness behaviour (pp. 207–219). New York: Routledge.

    Google Scholar 

  • Wu, L. M., Mohamed, N. E., Winkel, G., & Diefenbach, M. A. (2013). Patient and spouse illness beliefs and quality of life in prostate cancer patients. Psychology and Health, 28, 355–368.

    PubMed  PubMed Central  Article  Google Scholar 

  • Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale (validity and reliability). Acta Psychiatrica Scandinavica, 67, 361–370.

    PubMed  CAS  Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zoe Giannousi.

Ethics declarations

Conflict of interest

Zoe Giannousi, Evangelos C. Karademas and Georgia Dimitraki declare that they have no conflict of interest.

Human and animal rights and Informed consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Giannousi, Z., Karademas, E.C. & Dimitraki, G. Illness representations and psychological adjustment of Greek couples dealing with a recently-diagnosed cancer: dyadic, interaction and perception-dissimilarity effects. J Behav Med 39, 85–93 (2016). https://doi.org/10.1007/s10865-015-9664-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-015-9664-z

Keywords

  • Cancer
  • Oncology
  • Illness representations
  • Dyadic effects
  • Perception dissimilarity effects