[Lay etiologic theories and coping with illness in severe physical diseases. An empirical comparative study of female myocardial infarct, cancer, dialysis and multiple sclerosis patients].

In a multicenter approach 451 female patients, suffering from severe somatic diseases, were investigated on strains, disease-related attributions, coping and quality of life. Four diagnostic groups were involved, myocardial infarction (MI), Cancer (CA), end-stage renal disease (ESRD), and multiple sclerosis (MS). With respect to coping with the onset of illness or the diagnosis, all four groups accordingly reported placing trust in the doctors, compliance-related strategies, fighting spirit and information seeking as most markedly applied coping modes. But in each group a different predominant causal attribution of the disease was found, heredity in the MS-, pollution in the cancer, stress in the MI- and iatrogenic factors in the ESRD-group. The main influencing factors on the future course of the disease accordingly in all groups were "progress of medicine" and internal cognitive and behavioral factors. After statistical control of age, education, and duration of illness only the score "depressive coping" discriminated between the groups (MS-patients with highest, MI-patients with lowest scores). With respect to life satisfaction, MI- and cancer patients together formed a cluster with higher and ESRD- and MS-patients one with lower satisfaction. Cancer- and MS-patients considered fighting spirit as "most helpful" coping mode, while MI-patients favoured placing trust in the doctors and information seeking. Religion was found as second or third helpful coping mode.