Illness Perceptions of Patients with Late-Stage Cancer and Their Partners
Croom, Andrea Rose
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As treatments improve and patients with late-stage cancer live longer, it is important to examine factors associated with their psychological adjustment and illness-related behaviors. The current studies used the Common-sense Model of Self-regulation (Leventhal, Brissette, & Leventhal, 2003) to understand how patients and their partners manage the demands of this understudied illness context. The Common-sense Model proposes that individuals create mental representations about their illness to make sense of and develop strategies to manage the illness. The current studies were the first to examine (a) whether patients’ illness perceptions are associated with advanced illness behaviors (e.g., completing advance directives; NCI, 2005), which are crucial for receiving quality care at the end-of-life, and (b) whether perceptions of both patients and partners are associated with psychological adjustment. A dyadic perspective is important because cancer is not an individual experience, but rather affects significant others in the patient’s life. Female patients with late-stage breast, gynecological, or lung cancer and their spouses or unmarried partners independently completed self-report measures of their illness perceptions, relationship experience, psychological adjustment, and advanced illness behaviors (N= 105 patients and 88 partners). Data were examined at both intrapersonal (individual) and interpersonal (dyadic) levels. The first study demonstrated that patients’ individual perceptions of cancer were better predictors of their quality of life than clinical characteristics of cancer (e.g., stage, illness duration). Advanced illness behaviors were associated with higher quality of life and were predicted by illness perceptions (i.e., illness severity and illness coherence), as well as by clinical and personal characteristics. The second study suggested that patients’ and partners’ psychological adjustment reflected their individual illness perceptions, as well as aspects of their relationship (i.e., relationship quality and social constraints in discussing cancer). There was limited evidence that incongruence in patients’ and partners’ illness perceptions was related to poorer adjustment, potentially because illness perception congruence was high. Findings from these studies demonstrate the importance of designing interventions to improve communication between patients, partners, and health care professionals about late-stage cancer beliefs.