The Self-regulation Model of Illness Applied to Smoking Behavior in Lung Cancer

The Ohio State University College of Public Health, Ohio, USA.
Cancer nursing (Impact Factor: 1.97). 06/2009; 32(4):E15-25. DOI: 10.1097/NCC.0b013e3181a0238f
Source: PubMed


Thirteen to 20% of lung cancer patients continue to smoke after diagnosis. Guided by Self-regulation Theory, the purpose of this study was to examine illness perceptions over time in a sample of lung cancer patients. This prospective 1-group descriptive longitudinal design study included participants 18 years or older, with a lung cancer diagnosis within the past 60 days who self-reported smoking within the past 7 days. At baseline, patients completed a sociodemographics and tobacco use history questionnaire. The Illness Perception Questionnaire-Revised (IPQ-R) was repeated at 3 time points (baseline, 2-4 weeks, and 6 months). Fifty-two participants provided data for the IPQ-R at baseline, 47 at 2 to 4 weeks, and 29 at 6 months. Differences between mean scores for each illness representation attribute of the IPQ-R at repeated time points were calculated by within-subjects repeated-measures analysis of variance and Wilcoxon Signed-Rank Tests. Identity (baseline vs 2-4 weeks: P = .026; baseline vs 6 months: P = .005) and acute/chronic timeline (P = .018) mean scores significantly increased over time; personal and treatment control mean scores significantly decreased over time (P = .007 and P = .047, respectively). Understanding the context in which a patient perceives disease and smoking behavior may contribute to developing interventions that influence behavior change.

6 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cancer survivors can face significant physical and psychosocial challenges; there is a need to identify and predict which survivors experience what sorts of difficulties. As highlighted in the UK National Cancer Survivorship Initiative, routine post-diagnostic collection of patient reported outcome measures (PROMs) is required; to be most informative, PROMs must be linked and analysed with patients' diagnostic and treatment information. We have designed and built a potentially cost-efficient UK-scalable electronic system for collecting PROMs via the internet, at regular post-diagnostic time-points, for linking these data with patients' clinical data in cancer registries, and for electronically managing the associated patient monitoring and communications; the electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system. This study aims to test the feasibility of the ePOCS system, by running it for 2 years in two Yorkshire NHS Trusts, and using the Northern and Yorkshire Cancer Registry and Information Service. Non-metastatic breast, colorectal and prostate cancer patients (largest survivor groups), within 6 months post-diagnosis, will be recruited from hospitals in the Yorkshire Cancer Network. Participants will be asked to complete PROMS, assessing a range of health-related quality-of-life outcomes, at three time-points up to 15 months post-diagnosis, and subsequently to provide opinion on the ePOCS system via a feedback questionnaire. Feasibility will be examined primarily in terms of patient recruitment and retention rates, the representativeness of participating patients, the quantity and quality of collected PROMs data, patients' feedback, the success and reliability of the underpinning informatics, and the system running costs. If sufficient data are generated during system testing, these will be analysed to assess the health-related quality-of-life outcomes reported by patients, and to explore if and how they relate to disease, treatment and/or individual differences characteristics. There is currently no system in the UK for collecting PROMs online and linking these with patients' clinical data in cancer registries. If feasible, ePOCS has potential to provide an affordable UK-scalable technical platform to facilitate and support longitudinal cohort research, and improve understanding of cancer survivors' experiences. Comprehensive understanding of survivorship difficulties is vital to inform the development and provision of supportive services and interventions.
    BMC Medical Informatics and Decision Making 10/2011; 11(1):66. DOI:10.1186/1472-6947-11-66 · 1.83 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In clinical practice, medical staff is often unaware that what they think about patient's disease differs much from the perceptions and feelings of the patient. The aim of the study was to analyse the differences in psychological perception of lung cancer between patients treated with combined regimen for lung cancer (n = 30), medical staff (n = 94) and medical students (n = 303). A total of 427 persons were enrolled in this questionnaire study using Imagination and Perception of Illness Scale (IPIS) by Sak. The IPIS scale items described: loss of motivation to carry out specific activities (eight items), mental sphere destruction (six items), physical sphere destruction (eight items), pessimism (four items), being a burden to others (three items) and loss of control over the illness (three items). A seven-point scale from '0', meaning the choice of maximum positive feature, to '6', meaning the choice of maximum negative feature, was used. The higher result obtained within a given factor signified the more negative perception of the illness. In all IPIS items, the results among patients were significantly lower than among medical staff or students (P = 0.018 and P = 0.001, respectively). Medical staff and students perceive lung cancer as causing more profound destruction in patient's mental and physical spheres than patients do. Patients treated for lung cancer with combined regimen perceive their disease more optimistically than what is imagined by medical staff and students, and may underestimate the threat. It may be explained by psychological adaptation of patients to their disease during prolonged treatment. We believe that informing lung cancer patients in detail about their illness should be recommended to enhance self-awareness and doctor-patient cooperation.
    European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 12/2011; 41(3):607-11. DOI:10.1093/ejcts/ezr046 · 3.30 Impact Factor
  • Source
Show more


6 Reads
Available from