Illness Perceptions in Chronic Lymphocytic Leukemia: Testing Leventhal's Self-regulatory Model. Issue 9 (26th December 2018)

• Record Type: Journal Article
• Authors: Westbrook, Travis D; Morrison, Eleshia J; Maddocks, Kami J; Awan, Farrukh T; Jones, Jeffrey A; Woyach, Jennifer A; Johnson, Amy J; Byrd, John C; Andersen, Barbara L
• Is Part Of: Annals of behavioral medicine. Volume 53:Issue 9(2019)
• Page Start: 839
• Page End: 848
• Publication Date: 2018-12-26
• Subjects: Illness perceptions -- Chronic lymphocytic leukemia -- Active surveillance -- Relapsed refractory disease; Medicine and psychology -- Periodicals; Sick -- Psychology -- Periodicals; Behavioral Medicine; 616.0019
• DOI: 10.1093/abm/kay093
• Languages: English
• ISSNs: 0883-6612

Abstract

Abstract: Background: Leventhal's Self-regulatory Model proposes that somatic characteristics of a health threat (e.g., symptom severity), and prior experience with the threat (e.g., unsuccessful treatment), are determinants of illness perceptions. Chronic lymphocytic leukemia (CLL) is appropriate for test of these postulates, having three phases differing in symptom severity and prior treatment experiences: indolent disease requiring no treatment (active surveillance; AS), symptomatic disease requiring a first treatment (FT), and highly symptomatic disease in those who have relapsed and/or failed to respond to prior treatments (relapsed/refractory; RR). Purpose: To test symptom severity and prior treatment experiences as determinants of illness perceptions, illness perceptions were characterized and contrasted between CLL groups. Methods: Three hundred and thirty CLL patients (AS, n = 100; FT, n = 78; RR, n = 152) provided illness perception data on one occasion during a surveillance visit (AS) or prior to beginning treatment (FT, RR). Results: Analysis of variance with planned comparisons revealed that consequences, identity, and concern were least favorable among RR patients, followed by FT, then AS ( p s < .01). AS patients endorsed the lowest levels of coherence ( p s < .01), and the most chronic illness timeline ( p s < .01). FT patients endorsed the highest levels of personal and treatment control ( p s < .01). Conclusions: Data provide preliminary empirical support for Self-regulatory Model postulates that symptom severity and prior disease experiences influence illness perceptions. Unique knowledge needs for AS patients and elevated psychological/physical symptoms for later-stage CLL patients may warrant clinical attention. Abstract : For adults with chronic leukemia, beliefs about their disease, such as how controllable it is, how well they understand it, and how it effects them emotionally, are associated with the severity of their disease and previous experiences with leukemia treatment.