Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, location AMC, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
Support Care Cancer. 2019 May;27(5):1935-1944. doi: 10.1007/s00520-018-4451-3. Epub 2018 Sep 13.
According to the Common Sense Model of self-regulation, cancer survivors construct perceptions of their illness as a (mal)adaptive mechanism. These perceptions might impact on health care use. We aimed to explore the association between illness perceptions and health care use in stage I-II endometrial cancer (EC) survivors, and whether these associations differed by time since diagnosis.
A survey was conducted in 2008 by the population-based PROFILES registry among EC survivors diagnosed between 1999 and 2007. Survivors (n = 742, 77% response) completed the Brief Illness Perception Questionnaire (BIPQ) and questions on health care use in the past 12 months. Clinical data were accessed from the Netherlands Cancer Registry. Multiple logistic regression was used to evaluate the relationship between illness perceptions and health care use.
Between 15 and 22% of the survivors had negative illness perceptions. Survivors with more negative perceptions on consequences, timeline, treatment control, identity, cognitive representation, concern, emotion, and emotional representation were more likely to make ≥ 1 visit to their family physician/general practitioner in relation to their cancer when compared with survivors with more positive illness perceptions. More negative perceptions on consequences, timeline, identity, and concern were associated with ≥ 2 general or cancer-related visits to the medical specialists. The association between negative illness perceptions and health care use was more prominent among long-term (>5 years post-diagnosis) EC survivors.
Negative illness perceptions among EC survivors were associated with higher health care use. For individuals with maladaptive illness perceptions, visits to their health care provider may reduce worry about their illness. Future research might address the effects of intervening in maladaptive illness perceptions on use of health care in this category of survivors.
根据自我调节的常识模型，癌症幸存者将其对疾病的看法构建为一种（适应不良的）机制。这些看法可能会影响医疗保健的使用。我们旨在探讨 I 期-II 期子宫内膜癌（EC）幸存者的疾病认知与医疗保健使用之间的关联，以及这些关联是否因诊断后时间的不同而有所不同。
2008 年，基于人群的 PROFILES 登记处对 1999 年至 2007 年间诊断出的 EC 幸存者进行了一项调查。幸存者（n=742，应答率为 77%）完成了简短疾病认知问卷（BIPQ）和过去 12 个月医疗保健使用情况的问题。临床数据来自荷兰癌症登记处。多因素逻辑回归用于评估疾病认知与医疗保健使用之间的关系。
15%至 22%的幸存者对疾病有负面认知。与对疾病认知更积极的幸存者相比，对后果、时间轴、治疗控制、身份、认知表现、担忧、情绪和情绪表现有更负面认知的幸存者更有可能因癌症而至少一次就诊家庭医生/全科医生。对后果、时间轴、身份和担忧有更负面认知的幸存者与至少两次去看普通科医生或癌症专科医生相关。在长期（诊断后>5 年）EC 幸存者中，负面疾病认知与医疗保健使用之间的关联更为明显。
EC 幸存者的负面疾病认知与更高的医疗保健使用有关。对于有适应不良疾病认知的个体，就诊可能会减轻他们对疾病的担忧。未来的研究可能会研究干预适应不良的疾病认知对这一类幸存者医疗保健使用的影响。
