Illness perceptions are associated with mortality among 1552 colorectal cancer survivors: a study from the population-based PROFILES registry.

Melissa S Y Thong,Pauline A J Vissers,Adrian A Kaptein,Lonneke V Van De Poll-Franse,Gerard Vreugdenhil

doi:10.1007/s11764-016-0536-5

Abstract

PurposeCancer survivors construct perceptions of illness as a (mal)adaptive mechanism. These perceptions motivate/drive subsequent self-management behaviors toward symptoms and treatment that influence health outcomes. Negative illness perceptions have been associated with increased mortality in other chronically ill groups. However, this association is under-researched in cancer survivors. We aimed to explore the association between illness perceptions and mortality in stage I–III progression-free colorectal cancer (CRC) survivors.MethodsWe used data from the population-based Patient Reported Outcomes Following Initial treatment and Long Term Evaluation of Survivorship (PROFILES) registry of two CRC survivorship studies conducted in 2009 and 2010. We accessed clinical data from the Netherlands Cancer Registry, and mortality data from municipal personal records database. Follow-up was until 31 December 2014. Survivors (n = 1552) completed the Brief Illness Perception Questionnaire. Cox proportional hazard models estimated the association between illness perceptions and mortality.ResultsNegative illness perceptions on consequences (adjusted hazard ratio (HRadj) 1.60, 95 % confidence interval (CI) 1.14–2.25) and emotion (HRadj 1.65, 95 % CI 1.18–2.31) were associated with higher mortality, after adjusting for demographic, clinical, and lifestyle factors. Smoking and inadequate physical activity were independently associated with mortality for all Brief Illness Perception Questionnaire (BIPQ) dimensions.ConclusionsSurvivors’ perceptions of their illness are important as these perceptions may influence health outcomes during survivorship period. Clinical practice needs to identify and address maladaptive illness perceptions to support more adaptive self-management behaviors and enhance survivorship.Implications for cancer survivorsCancer survivors may benefit from interventions that address potentially maladaptive perceptions and encourage more adaptive self-management behaviors.

Highlights

Cancer survivors with similar clinical characteristics can have vastly different perceptions of and responses to their illness
Smoking and inadequate physical activity were independently associated with mortality for all Brief Illness Perception Questionnaire (BIPQ) dimensions
Our study aimed to explore the association of illness perceptions with mortality in progression-free colorectal cancer (CRC) survivors diagnosed within 5 years of survey and treated with curative intent

Summary

Introduction

Cancer survivors with similar clinical characteristics can have vastly different perceptions of and responses to their illness. J Cancer Surviv (2016) 10:898–905 observations, or received information of the illness and related symptoms [2] These representations or illness perceptions motivate subsequent self-management behaviors such as lifestyle changes [3, 4] and treatment adherence [5] that can determine health outcomes. The CSM is a relevant model for cancer survivorship as it considers individuals as problem solvers actively involved in the management of their own health It implies that maladaptive cognitions of cancer survivors can be addressed, through interventions, to achieve better health outcomes when they have a more adaptive understanding of their condition and are able to evaluate the effects of acting on this understanding [6]

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