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Identifier 000367227
Title Αναπαραστάσεις ασθένειας και επίπεδα κατάθλιψης σε καρκινοπαθείς
Alternative Title Illness perceptions and levels of depression in cancer patients
Author Γιανούση , Ζωή Λ
Thesis advisor Σαμώνης, Γεώργιος
Reviewer Γεωργούλιας, Βασίλειος
Παρίτσης,Νικόλαος
Παπαδάκη Ελένη
Μαυρουδής, Δημήτρης
Μπίτσιος, Παναγιώτης
Καραδήμας, Ε
Abstract Ιllness perceptions determine the way individuals react to their illness. Patients’ psychological adjustment to their illness includes: 1) illness representation, 2) coping, 3) appraisal. These stages are mutually affected and are dynamically inter-related through time. According to the common sense model, representations consist of 5 dimensions: 1) illness identity, 2) causes, 3) time-line, 4) consequences and 5) controllability/curability. Carer’s ways of reaction to their patient’s illness and their behavior towards them is affected by the ideas they shape about the illness of their relatives. The degree of congruence between carers’ and patients’ representations has been so far, studied in patients suffering from myocardial infarction. Undoubtedly, cancer patients suffer from depression due to the possibility of a painful death. Individuals form different illness perceptions for different illnesses, although illness perception components are the same. There is also a different point of view for different kind of illnesses between patients. At this point, the present study contributes with important information on the structure of cancer patients’ undergoing chemotherapy representations Moreover, the present study contributes to the knowledge regarding the degree of congruence between cancer patients’ and their main caregivers’ illness perceptions, mainly because this fact has not yet been studied in the field of cancer, although it has been studied on myocardial infarction patients. 140 The present study aims to: 1) assess cancer patients’ illness perceptions and the psychometric properties of the Greek translation of the Revised Illness Perceptions Questionnaire (IPQ-R) 2) assess the levels of depression in cancer patients and their main caregivers, 3) assess the relationship between illness perceptions and depression both in patients and caregivers, 4) assess the degree of congruence of illness perceptions between cancer patients and caregivers, 5) assess the affect of the degree of congruence in illness perceptions on both patients’ and caregivers’ depression and finally, 6) assess possible changes of illness perceptions within a period of three months after the first assessment. Hypotheses: Hypothesis 1: The structure of cancer patients’ illness perceptions are similar to the structure of illness perceptions in patients suffering from other chronic conditions, with a difference in the structure of causal attributions. However, the structure of causal attributions are similar to the causal attribution theory. The assessment of the psychometric properties of the Greek translation of the Revised Illness Perception Questionnaire provides satisfactory results. Hypothesis 2: Participants score high in depression scales. Hypothesis 3: Illness perceptions components are related to depression levels both in patients and caregivers. Hypothesis 4: Patients’ illness perceptions components differ significantly from caregivers’ illness perceptions components. Hypothesis 5: The degree of congruence between patients’ and caregivers’ illness perceptions is related to the levels of depression and is a predictive factor for depression. 141 Hypothesis 6: There are significant changes in illness perceptions components three months following the first assessment. METHOD A total of 252 cancer patients of the University Hospital of Heraklion and 176 main caregivers took part in the study. A Greek translation of the Revised Illness Perception Questionnaire (IPQ-R), which psychometric properties are assessed as part of the study, was handed out to the participants in order to assess their illness perceptions. Moreover, the standardized in Greek version of the Beck Depression Inventory (B.D.I.) was also handed out to the participants in order to assess their levels of depression. Demographic and medical information was also gathered from patients’ medical file. RESULTS Hypothesis 1: Cancer patients’ illness perceptions reveal a similar structure to the one suggested by the common sense model, with the only difference being that consequences and emotional representations loaded to the same factor, providing a model of six, instead of seven factors of the original questionnaire. As far as causal representations are concerned, our hypothesis was confirmed, since their structure was different, however in accordance with causal attribution theory. Moreover, the psychometric properties of the scale provided satisfactory results and suggest that it is safe to use for the purposes of the specific study. Hypothesis 2: High levels of depression were found for the participants, since 55% of the patients and 44% of the caregivers scored high on the depression scale. Hypothesis 3: Correlations between patients’ illness perceptions components and levels of depression were significant for all the dimensions, except for the dimension of external causal attributions. Caregivers’ levels of depression were related 142 significantly with consequences and emotional representations, acute/chronic timeline and illness identity. Hypothesis 4: Patients and caregivers differ significantly only in the dimension of consequences and emotional representations, with caregivers scoring higher. Hypothesis 5: A percentage between 22% and 36% of the patient-caregiver dyads had congruent beliefs about the illness. Personal control was the only dimension which incongruence between patients and caregivers was significantly related to patients’ levels of depression. Also, treatment control was the dimension which incongruence was significantly related to caregivers’ levels of depression. With only those two significant correlations, it was not a surprise that none of the illness perceptions incongruences was found to be a predictive factor for participants’ depression. Hypothesis 6: Three months after the first assessment, and as far as patients are concerned, the only difference was found in the dimension of acute/chronic timeline with patients forming the belief that their illness is more chronic after the three month period. As far as caregivers are concerned, the only difference was found in the illness coherence dimension with caregivers scoring higher in the second assessment. Fewer dimensions were found to be significantly related to the levels of depression than in the first assessment. Significantly different beliefs between patients and caregivers were found in the dimension illness coherence, in contrast to the first assessment, where differences were significant only on the dimension consequences and emotional representations. Congruent illness beliefs were found on a percentage between 27% and 41% of the patients-caregivers dyads. CONCLUSIONS Translation of the IPQ-R has good reliability and similar structure to that of the original. The need for more specific standardization of the scale for cancer patients 143 has been revealed, as the authors have suggested. Participants showed high levels of depression, significantly correlated to their illness perceptions. The degree of congruence of personal control was related to patients’ levels of depression and the degree of congruence of treatment control was related to caregivers’ levels of depression. A percentage between 22% and 36% of the patient-caregivers dyads, depending on the illness perceptions components, had divergent perceptions. Common sense model plays an important role for a more integrated assessment of the cancer patient and his caregiver.
Language Greek
Subject Cancer patients
Caregivers
Depression
Illness perception
Illness percertions
Psychiatry
Questionnair revised
Αναπαραστάσεις ασθένειας
Ερωτηματολόγιο αντίληψης ασθενών
Καρκινοπαθείς
Κατάθλιψη
Φροντιστές
Issue date 2010-07-20
Collection   School/Department--School of Medicine--Department of Medicine--Doctoral theses
  Type of Work--Doctoral theses
Permanent Link https://elocus.lib.uoc.gr//dlib/1/c/9/metadata-dlib-c964fb431ac568e0e673f1f153ded461_1309422089.tkl Bookmark and Share
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