Patients and survivors of differentiated thyroid cancer (DTC) report experiencing significant distress despite excellent disease prognosis. Predictors of distress in this population, however, are largely unexplored. Two factors that relate to distress in other cancer populations are patient subjective experiences with information provision and patient illness perceptions. Thus, evaluation of information experiences and illness perceptions among survivors of DTC is warranted. In particular, the unique prognosis and treatment associated with DTC invites investigation of the relationship between patient subjective experiences with information quantity (termed "information adequacy" in this study) and distress in this population. Thus, the primary goals of this thesis are 1) to examine how information adequacy and illness perceptions relate to distress in survivors of DTC, and 2) to investigate illness perceptions as a mechanism by which information adequacy and distress are related. Further, research suggests that distress and reduced emotional functioning among survivors of thyroid cancer extend years after initial diagnosis; however, the relationship between time and distress among survivors of DTC remains unclear and understudied. The extent to which time moderates relationships between information adequacy, illness perceptions, and distress also remains unexplored. Thus, secondary goals of this thesis are 1) to examine the relationship between time (specifically "years-since-diagnosis") and distress, and 2) to examine time as a moderator of relationships between information adequacy, illness perceptions, and distress in survivors of DTC. A sample of 284 participants identified in the Patient Reported Outcomes Following Initial Treatment and Long-term Evaluation of Survivorship (PROFILES) registry were included in structural equation modeling. Relationships between information adequacy, illness perceptions, and distress were evaluated in Model 1. Results largely supported the hypothesized model: greater information adequacy was associated with better illness perceptions, better illness perceptions were associated with less distress, and greater information adequacy was indirectly related to less distress via better illness perceptions. A direct relationship between information adequacy and distress, however, was not observed. Secondary thesis aims were explored in Model 2. Results did not support moderation hypotheses, and a direct relationship between years-since-diagnosis and distress was not demonstrated. A revised model yielded ancillary findings that having fewer years-since-diagnosis was associated with worse illness perceptions, and with greater distress via worse illness perceptions. Thus, overall study results revealed a notable relationship between illness perceptions and distress among survivors of DTC. Future research should investigate whether interventions to address illness perceptions result in decreased distress in this population. The demonstrated link between information adequacy and illness perceptions invites further investigation of informational interventions in particular as a method to address illness perceptions. Future research should also investigate the extent to which illness perceptions mediate relationships between information experiences and distress in other cancer populations.
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Master of Science (M.S.)
College of Sciences
Length of Campus-only Access
Masters Thesis (Open Access)
Wiener, Chelsea, "Relationships Between Information Adequacy, Illness Perceptions, and Distress Among Survivors of Differentiated Thyroid Cancer" (2016). Electronic Theses and Dissertations. 4996.