Illness meanings and perceptions of control and uncertainty in women with breast cancer

Abstract

Illness Meanings and Perceptions of Control and Uncertainty in Women with Breast Cancer -- A descriptive correlational study with longitudinal and cross-sectional components was conducted to (a) describe the factors shaping meanings of breast cancer, and how meanings changed during treatment, and (b) investigate relationships among illness meanings, perceptions of control, uncertainty, feelings about the illness, and attitudes toward chemotherapy. Fifteen women were included in the longitudinal portion of the study and nine in the cross-sectional component. The Multidimensional Health Locus of Control (MHLC) Scales, Meaning of Illness Questionnaire Self-Report (MIQ-SR), Personal Profile Record and the Cancer Meaning Questionnaire (CMQ) were the data collection instruments. Descriptive and inferential statistics were used for data analysis. Qualitative data were analyzed using the Constant Comparative Method of Analysis. -- Appraisals of the illness and treatment varied from initial treatment to follow-up and were influenced by perceptions of control, feelings about the illness, uncertainty and attitudes toward chemotherapy. Results from repeated measures AN0VA analyses indicated significant changes in Chance Health Locus of Control (X² 7.65, p <.02) and attitudes toward chemotherapy (X² 6.61, p <.03) . Step-wise multiple regression analysis indicated that internal locus of control beliefs and feelings about the illness and chemotherapy treatment were significant predictors of illness meanings. Attitudes toward chemotherapy were significant predictors of illness meaning over time. Qualitative data analyses supported findings from the Meaning of Illness factors as measured by the MIQ-SR Questionnaire. Results also suggest that nurses are perceived as primary sources of information and support. -- Key Words: breast cancer; meaning of illness; control; uncertainty; primary appraisal; secondary appraisal; coping; feelings/attitudes.