An Evaluation of the Influence of Perceptions of Breast Cancer on Distress in Irish Women
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Breast cancer is the most common form of invasive cancer diagnosed in women in Ireland. It can cause distress in healthy women considering their risk of developing the disease, as well as in women who have been diagnosed with breast cancer. The Self-Regulatory Model of Illness Behaviour (SRM; Leventhal, Meyer, & Nerenz, 1980) asserts that perceptions of an illness can impact upon an individuals¿ response to a health threat. This series of studies assessed the role of the Self-Regulatory model, and specifically illness perceptions, in determining breast cancer-related distress in both healthy women and women with breast cancer. In Study 1, 948 women from the community completed measures of risk perceptions, illness perceptions, cancer-related worry, frequency of breast self-examination, and intentions to attend breast cancer screening. Analyses revealed that holding higher perceptions of risk, a greater understanding of breast cancer, more negative emotional representations, and a more chronic timeline, predicted 14% of the variance in breast cancer worry. Intentions to attend breast cancer screening; however, was not predicted by these variables. In Study 2, 105 women with breast cancer completed measures of medical information, perceived stress, illness perceptions, coping, and distress at diagnosis; and 57 of these women completed measures of distress 12 months post-diagnosis. At diagnosis, greater perceived stress and more negative illness perceptions predicted greater general and cancer-related distress. Coping had less impact on cancer-related distress than illness perceptions. At 12 months post-diagnosis, baseline levels of illness perceptions failed to explain any of the variance, whilst coping accounted for 9% of the variance in cancer-related distress. Analyses also revealed that anxious preoccupation mediated the relationship between illness perceptions and cancer-related distress. The results underscore the importance of the inclusion of appraisal of stress in women with breast cancer, as previous stressful events may influence how women respond to a subsequent diagnosis. In Study 3, 20 women diagnosed with breast cancer who required chemotherapy as part of their treatment were interviewed about their coping strategies and their effectiveness during chemotherapy. Combinations of coping strategies were important in dealing with the side effects of chemotherapy. Anticipating side effects and engaging in strategies to minimize their impact highlights the importance of the provision of accurate information of the side effects of treatment, and the potential for these strategies as components of effective interventions to reduce distress in women receiving chemotherapy. In sum, the studies provide support that the components of the Self-Regulatory Model of Illness Behaviour, most notably illness perceptions, are predictors of distress in both healthy women and women with breast cancer. The research highlights the importance of measuring both illness perceptions and coping together, and emphasizes the value of components of the Self-Regulatory Model as a framework to develop future interventions to reduce cancer-related distress.