Centre for Psycho-Oncology Research & Training, School of Public Health, University of Hong Kong, Patrick Manson Building, 7, Sassoon Rd., Pokfulam, HongKong.
Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
Head Neck. 2018 Nov;40(11):2362-2371. doi: 10.1002/hed.25343. Epub 2018 Oct 11.
Leventhal's commonsense model implies illness perceptions influence illness outcomes. This study examined illness perceptions among head and neck cancer survivors, and whether these predicted subsequent psychological distress.
A total of 124 survivors of head and neck cancer (87% nasopharyngeal carcinoma; NPC) completed measures of psychological distress (Hospital Anxiety and Depression Scale; HADS), illness perceptions (Brief Illness Perception Questionnaire; B-IPQ), dispositional optimism (revised Chinese version of the Life Orientation Test; C-LOT-R), and clinical and demographic data approximately12.9 months after diagnosis (T1). Six months later (T2) psychological distress (HADS) was again measured. Adjusted multivariate analyses tested whether illness perceptions predicted T2 HADS scores.
Illness perception dimensions were significantly intercorrelated (0.01-0.68), explaining 8.0% of anxiety and 4.8% of depression symptom variability at T2. After adjustment for T1 distress, illness identity (β = 0.270, P < .01) and sex identification as a woman (β = 0.275, P < .01) predicted T2 anxiety symptoms while illness identity (β = 0.195, P < .05), unemployment (β = 0.195, P < .05), and pessimism (β = -0.227, P < .01) predicted T2 depression symptoms.
Perceived illness identity predicted psychological distress, accounting for modest levels of distress variance. Unresolved symptoms may exacerbate distress.
莱文索尔的常识模型表明疾病认知会影响疾病结果。本研究调查了头颈部癌症幸存者的疾病认知，以及这些认知是否预测了随后的心理困扰。
共有 124 名头颈部癌症幸存者（87%为鼻咽癌；NPC）完成了心理困扰（医院焦虑抑郁量表；HADS）、疾病认知（简要疾病认知问卷；B-IPQ）、性格乐观（生活取向测验的修订中文版；C-LOT-R）以及诊断后约 12.9 个月（T1）的临床和人口统计学数据的测量。6 个月后（T2）再次测量心理困扰（HADS）。调整后的多元分析检验了疾病认知是否预测 T2 HADS 评分。
疾病认知维度之间存在显著相关性（0.01-0.68），可解释 T2 焦虑症状的 8.0%和抑郁症状的 4.8%变异。在调整了 T1 困扰后，疾病身份（β=0.270，P<.01）和女性性别认同（β=0.275，P<.01）预测了 T2 焦虑症状，而疾病身份（β=0.195，P<.05）、失业（β=0.195，P<.05）和悲观（β=-0.227，P<.01）预测了 T2 抑郁症状。
感知疾病身份预测了心理困扰，解释了适度的困扰变异。未解决的症状可能会加重困扰。
