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Thomas Valentine Dissertation Final.pdf (8.73 MB)

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Illness Perceptions and Psychological and Physical Health Outcomes in Non-Small Cell Lung Cancer: A Self-Regulatory Model Approach

Valentine, Thomas Robert
http://orcid.org/0000-0001-9415-936X
http://rave.ohiolink.edu/etdc/view?acc_num=osu1594830809190808

Abstract Details

2020, Doctor of Philosophy, Ohio State University, Psychology.
Lung cancer is the leading cause of cancer mortality worldwide. The predominant histological subtype—non-small cell lung cancer (NSCLC)—is most frequently diagnosed in its advanced stage (i.e., Stage IV), when survival averages only four to nine months with treatment. Several studies speak to the immense psychological and physical toll this illness takes on individuals’ lives; however, little is known about how patients with advanced NSCLC perceive their illness. This is despite evidence linking illness perceptions to disease-related outcomes in other chronic illnesses, and the potential for interventions that target dysfunctional illness perceptions to improve such outcomes. To address this gap, this study—guided by Leventhal’s Self-Regulatory Model of Illness Behavior—utilized a longitudinal design to examine the relationship between baseline illness perception profiles and psychological and physical outcomes in patients recently diagnosed with advanced NSCLC (N = 186). First, latent profile analysis categorized patients into groups sharing similar illness perceptions (i.e., “illness perception profiles”). The optimal solution included three profiles, labeled as “coping” (n = 41), “coping but concerned” (n = 62), and “struggling” (n = 83). Patients with the “coping” profile reported generally positive perceptions of their illness; patients with the “coping but concerned” profile endorsed high levels of concern despite relatively positive ratings of other illness perception dimensions; and patients with the “struggling” profile reported generally negative perceptions of their illness. Hierarchical linear regression models revealed baseline illness perception profile to explain a significant amount of variance in anxiety and depressive symptoms, physical symptoms, and health-related quality of life, beyond that accounted for by sociodemographic and disease variables. Controlling for relevant covariates, patients with the “struggling” profile, relative to those with the “coping” profile, reported significantly worse anxiety and depressive symptoms, physical symptoms, and health-related quality of life. Linear mixed models tested the baseline illness perception profiles as predictors of trajectories of anxiety and depressive symptoms, physical symptoms, and health-related quality of life over an 8-month follow-up period. All outcomes, with the exception of cough severity, were significantly worse for patients with the “struggling” profile compared to patients with the “coping” profile. Overall, anxiety symptoms, depressive symptoms, overall physical symptoms, and cough severity improved with time, whereas dyspnea severity, pain severity, and self-rated health status did not significantly change. There were no interactions between profile and time. Finally, a Cox regression testing baseline illness perception profile membership as a predictor of overall survival during an 18-month observation period revealed that profile membership was not a significant predictor of survival. In summary, patients who possess a “struggling” illness perception profile at lung cancer diagnosis are at significantly increased risk for negative psychological and physical outcomes. Patients with this profile have the greatest need for psychosocial treatment.
Barbara Andersen, PhD (Advisor)
Theodore Beauchaine, PhD (Committee Member)
Jennifer Cheavens, PhD (Committee Member)
157 p.
Psychology
lung cancer; illness perceptions; self-regulation theory; latent profile analysis; anxiety; depression; cough; dyspnea; pain; quality of life; survival

Recommended Citations

Citations

  • Valentine, T. R. (2020). Illness Perceptions and Psychological and Physical Health Outcomes in Non-Small Cell Lung Cancer: A Self-Regulatory Model Approach [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1594830809190808

    APA Style (7th edition)

  • Valentine, Thomas. Illness Perceptions and Psychological and Physical Health Outcomes in Non-Small Cell Lung Cancer: A Self-Regulatory Model Approach. 2020. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1594830809190808.

    MLA Style (8th edition)

  • Valentine, Thomas. "Illness Perceptions and Psychological and Physical Health Outcomes in Non-Small Cell Lung Cancer: A Self-Regulatory Model Approach." Doctoral dissertation, Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1594830809190808

    Chicago Manual of Style (17th edition)

osu1594830809190808
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This open access ETD is published by The Ohio State University and OhioLINK.