Determinants of Illness Perception in Chronic Lymphocytic Leukemia: Examining the Role of Treatment Phase, Symptoms, and Symptom Change
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The Ohio State University / OhioLINK
2018
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| Online Access: | http://rave.ohiolink.edu/etdc/view?acc_num=osu1532937726180735 |
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ndltd-OhioLink-oai-etd.ohiolink.edu-osu15329377261807352021-08-03T07:07:53Z Determinants of Illness Perception in Chronic Lymphocytic Leukemia: Examining the Role of Treatment Phase, Symptoms, and Symptom Change Westbrook, Travis Dexter Psychology chronic lymphocytic leukemia illness perception self-regulatory theory Leventhal's Self-Regulatory Model of Illness Behavior (1980) proposes that, in response to a health-relevant stimulus such as a physical symptom or disease diagnosis, individuals generate a mental representation of the stimulus, or illness perception, which guides coping behaviors and influences psychological and physical health outcomes. Despite extensive research linking illness perceptions to coping and health in several disease groups, lesser attention has focused on better understanding determinants of illness perceptions themselves. The goal of the current project was to test a fundamental postulate of self-regulatory theory, which suggests that illness perceptions are influenced primarily by somatic characteristics of the illness stimulus (e.g., symptom type and severity), prior experiences with the stimulus (e.g., treatment success or failure), and changes in the stimulus over time. To do so, two studies were conducted, both in samples of patients with chronic lymphocytic leukemia (CLL). Using a cross-sectional design, Study 1 contrasted illness perceptions among CLL patients (N=330) from three groups differing in symptom severity and prior CLL experiences: active surveillance (n=100), initiating a first treatment (n=78), and initiating treatment for relapsed/refractory disease (n=152). Analysis of variance revealed that, while consequences, identity (symptoms), and illness concern were poorer among patients at each successive phase of treatment, perceptions of how well one understands CLL (coherence) and how long CLL will last (timeline) were poorest among those earliest in the trajectory (i.e., active surveillance). Patients initiating a first treatment believed most strongly that they could personally control CLL (personal control) and that treatment would be helpful (treatment control). Study 2, using a longitudinal, single group design, examined specifically the role of somatic stimulus severity among relapsed/refractory CLL patients (N=152) initiating treatment with targeted therapy (i.e., ibrutinib). Using both subjective (i.e., self-reported fatigue), and objective (i.e., hemoglobin, lymph node volume, organ enlargement, lymphocyte count) measurements of somatic stimulus severity, several relationships consistent with self-regulatory theory emerged. First, both subjective fatigue and objective disease markers covaried with illness perceptions at pre-treatment, and the majority of illness perceptions improved over the first 2- and 5-months of treatment when rapid changes to illness stimuli were occurring. Moreover, multiple regression analyses indicated that, controlling for number of prior CLL therapies, changes in subjective and objective stimuli which occurred during the first 2- and 5- months of treatment accounted for significant portions of variance in illness perception change. Cumulatively, results provide novel confirmatory support for Leventhal's postulate that symptoms and disease experiences are central factors in the development of illness perceptions. Implications for theory and research are discussed. 2018 English text The Ohio State University / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=osu1532937726180735 http://rave.ohiolink.edu/etdc/view?acc_num=osu1532937726180735 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws. |
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NDLTD |
| language |
English |
| sources |
NDLTD |
| topic |
Psychology chronic lymphocytic leukemia illness perception self-regulatory theory |
| spellingShingle |
Psychology chronic lymphocytic leukemia illness perception self-regulatory theory Westbrook, Travis Dexter Determinants of Illness Perception in Chronic Lymphocytic Leukemia: Examining the Role of Treatment Phase, Symptoms, and Symptom Change |
| author |
Westbrook, Travis Dexter |
| author_facet |
Westbrook, Travis Dexter |
| author_sort |
Westbrook, Travis Dexter |
| title |
Determinants of Illness Perception in Chronic Lymphocytic Leukemia: Examining the Role of Treatment Phase, Symptoms, and Symptom Change |
| title_short |
Determinants of Illness Perception in Chronic Lymphocytic Leukemia: Examining the Role of Treatment Phase, Symptoms, and Symptom Change |
| title_full |
Determinants of Illness Perception in Chronic Lymphocytic Leukemia: Examining the Role of Treatment Phase, Symptoms, and Symptom Change |
| title_fullStr |
Determinants of Illness Perception in Chronic Lymphocytic Leukemia: Examining the Role of Treatment Phase, Symptoms, and Symptom Change |
| title_full_unstemmed |
Determinants of Illness Perception in Chronic Lymphocytic Leukemia: Examining the Role of Treatment Phase, Symptoms, and Symptom Change |
| title_sort |
determinants of illness perception in chronic lymphocytic leukemia: examining the role of treatment phase, symptoms, and symptom change |
| publisher |
The Ohio State University / OhioLINK |
| publishDate |
2018 |
| url |
http://rave.ohiolink.edu/etdc/view?acc_num=osu1532937726180735 |
| work_keys_str_mv |
AT westbrooktravisdexter determinantsofillnessperceptioninchroniclymphocyticleukemiaexaminingtheroleoftreatmentphasesymptomsandsymptomchange |
| _version_ |
1719454507637669888 |