Illness perceptions of cancer patients: relationships with illness characteristics and effects on coping.

Background: Illness perceptions have proven to be predictive of coping and adjustment in many chronically ill patients. Insights into illness perceptions of cancer patients are however scarce. The purpose of the present study was to explore how people with cancer perceive their illness. Moreover, we examined the relationship between cancer patients' illness perceptions, their illness characteristics (type of cancer, post diagnosis time-span, and treatment) and coping strategies. Method: Participants were 325 cancer patients from a generic nationwide longitudinal panel-study among cancer patients in the Netherlands. They completed the revised Illness Perception Questionnaire (winter 2011/2012) and the Mental Adjustment to Cancer Scale (spring 2012). Patient and illness characteristics were derived from the National Cancer Registry (NCR) and through self-registration. Descriptive statistics were used to describe the study sample, and to compute means and distributions of the IPQ-R scales. Analyses of variance were conducted to examine whether illness perceptions are related to illness characteristics. Linear regression analyses were conducted to determine the relation between illness perceptions and coping. Results: Cancer patients generally perceive their illness as a chronic condition and have a strong belief in the effectiveness of cancer treatment. People with skin cancer experience relatively little negative consequences (p<.01). Recently treated patients experience more negative consequences (p<.001) and perceive their illness as more chronic (p<.01) than patients who were treated in the (distant) past. Perceptions of more personal control (p<.01) and immunity attributions (p<.05) are related to adaptive ways of coping, whereas beliefs about negative consequences (p<.05) and emotional representations (p<.001) are related to maladaptive ways of coping. Conclusions: The perception of cancer as a chronic condition is hold by many cancer patients themselves. How cancer patients perceive their illness is not strongly related to the type of cancer. Cancer patients' illness perceptions are modestly related to their way of coping: perceptions of personal control and immunity attributions relate to adaptive ways of coping, whereas beliefs about negative consequences and emotional representations relate to maladaptive ways of coping. Research Implications: The current research is one of the first to focus on illness perceptions of cancer patients and to relate these to cancer patients' coping strategies. Where known research on cancer patients' focuses on relatively recently diagnosed people, the current study also covers cancer patients in the chronic phase. Moreover, we were able to demonstrate that illness characteristics may be equally or even more important when it comes to the development of illness perceptions. Clinical Implications: The current study provides further insight into the relationship between cancer patients' illness perceptions and their coping styles. Since illness perceptions can be changed, it may be possible for cancer patients to adopt (more) adaptive coping strategies by intervening on the way they perceive their illness. Our results might therefore contribute to the development of support programmes that pay structural attention to the way cancer patients perceive their illness and help them cope with it