Abstract
PurposeQuality of life (QoL) is an important yet complex outcome of care in patients with advanced cancer. QoL is associated with physical and psychosocial symptoms and with patients’ illness perceptions (IPs). IPs are modifiable cognitive constructs developed to make sense of one’s illness. It is unclear how IPs influence patients’ QoL. A better understanding of this relationship can inform and direct high quality care aimed at improving patients’ QoL. We therefore investigated the mediating role of anxiety and depression in the association of IPs with QoL.MethodsData from 377 patients with advanced cancer were used from the PROFILES registry. Patients completed measures on IPs (BIPQ), QoL (EORTC QLQ-C30), and symptoms of anxiety and depression (HADS). Mediation analyses were conducted to decompose the total effect of IPs on QoL into a direct effect and indirect effect.ResultsAll IPs but one (“Comprehensibility”) were negatively associated with QoL (p<0.001); patients with more negative IPs tended to have worse QoL. The effect was strongest for patients who felt that their illness affected their life more severely (“Consequences”), patients who were more concerned about their illness (“Concern”), and patients who thought that their illness strongly affected them emotionally (“Emotions”). Anxiety mediated 41–87% and depression mediated 39–69% of the total effect of patients’ IPs on QoL.ConclusionNegative IPs are associated with worse QoL. Anxiety and depression mediate this association. Targeting symptoms of anxiety and depression, through the modification of IPs, has the potential to improve QoL of patients with advanced cancer.
Highlights
Patients with advanced, incurable cancer experience an impaired quality of life (QoL) [1]
Mild to severe symptoms of anxiety were reported by 26% of patients and 25% of patients reported mild to severe symptoms of depression
All but one (“Comprehensibility”) of the illness perceptions were negatively and significantly associated with QoL (p
Summary
Incurable cancer experience an impaired quality of life (QoL) [1]. A study among patients nearing death, including patients with advanced cancer, found a great variability in illness perceptions, indicating how differently patients perceive their illness [13]. These differences may be related to the individual’s illness, cultural factors (such as the interpretation of the patient role, as well as the cultural interpretation of the illness) and factors related to an individual’s personality [9]. Due to their modifiable nature, illness perceptions are a promising target for interventions aimed at improving patients’ experiences of their illness and thereby their QoL [8, 14, 15]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
