Introduction: Lower health-related quality of life (HRQoL) is associated with fatigue, poor mental and poor gastrointestinal health during the first three months after colorectal cancer (CRC) treatment. Research indicates that maintaining usual activities has a positive impact on HRQoL after treatment for CRC. Illness perceptions have been associated with HRQoL in other cancer diseases, and self-efficacy has been associated with HRQoL in gastrointestinal cancer survivors. Our knowledge about illness perceptions and self-efficacy in relation to maintaining everyday activities and HRQoL following CRC treatment is incomplete. Aim: To explore associations between HRQoL, fatigue, mental health, gastrointestinal health, illness perceptions and self-efficacy in relation to maintaining everyday activities, three months after surgical CRC treatment. A further aim was to test the Maintain Function Scale in a CRC population. Method: The study was cross-sectional. Forty-six persons participated. Data were collected using questionnaires. Descriptive and analytical statistics were used. Results: Persons who were more fatigued, depressed, worried, and had more diarrhea were more likely to report lower HRQoL. Increased fatigue and diarrhea were associated with decreased HRQoL. Concerning illness perceptions, persons who reported negative emotions and negative consequences of CRC were more likely to report lower HRQoL. Persons scoring higher on self-efficacy were more likely to report higher HRQoL. Increased self-efficacy was associated with increased HRQoL. The Maintain Function Scale was suitable for assessing self-efficacy in relation to maintaining everyday activities. Conclusions: Nursing support to improve self-efficacy and illness perceptions and to minimize symptoms during recovery should have a favorable impact on HRQoL.

AIMS AND OBJECTIVES: The aim of the present study was twofold: 1) to measure changes in health-related quality of life (HRQoL), two dimensions of illness perceptions (i.e., consequences and emotional representations), fatigue and self-efficacy in persons treated for CRC during the first year after surgical treatment, and 2) to study how fatigue, illness perceptions and self-efficacy measured at 3 months affect HRQoL at 12 months post-surgery.

BACKGROUND: There are fluctuations in HRQoL during the first year after treatment for colorectal cancer (CRC), and fatigue may negatively influence HRQoL. Illness perceptions (consequences and emotional representations) and self-efficacy have been shown to be associated with HRQoL in other cancer diagnoses. Concerning CRC, there is a lack of knowledge concerning how illness perceptions and self-efficacy change during recovery, and how these variables and fatigue at 3 months relate to HRQoL at 12 months.

DESIGN: A prospective longitudinal design.

METHODS: Thirty-nine persons surgically treated for colorectal cancer, of whom 17 had a colostoma, participated. HRQoL, fatigue, illness perceptions and self-efficacy were assessed using QLQ-C30, the Revised Illness Perception Questionnaire and the Maintain Function Scale. Descriptive and analytical statistics were used.

RESULTS: No changes were reported in levels of HRQoL, fatigue, or illness perceptions. Self-efficacy was lower at 12 months compared to 3 months. Fatigue and one dimension of illness perceptions mediated the effect of self-efficacy at 3 months on HRQoL at 12 months.

CONCLUSION: Persons treated for CRC who have lower self-efficacy 3 months post-surgery are inclined to have more negative illness perceptions concerning emotions and to experience more fatigue.

RELEVANCE TO CLINICAL PRACTICE: Nurses need to support persons with fatigue and negative illness perceptions concerning emotions and to bolster their self-efficacy, i.e., carry out follow-up consultations focusing on illness management, symptoms, emotions and information on ways to increase self-efficacy. This article is protected by copyright. All rights reserved.

Illness is constituted by subjective experiences of symptoms and their psychosocial consequences. Illness perceptions concern people’s lay beliefs about understandings and interpretation of a disease and expectations as to disease outcome. Our knowledge about illness perceptions and coping in relation to the cancer care context among persons with colorectal cancer (CRC) and their partners is incomplete. The aim of the present study was to explore illness perceptions in relation to contemporary cancer care settings among CRC survivors and partners. The present research focused on illness rather than disease, implying that personal experiences are central to the methodology. The grounded theory method used is that presented by Kathy Charmaz. The present results explore illness perceptions in the early recovery phase after being diagnosed and treated for cancer in a contemporary cancer care setting. The core category outlook on the cancer diagnosis when quickly informed, treated, and discharged illustrates the illness perceptions of survivors and partners as well as the environment in which they were found. The cancer care environment is presented in the conceptual category experiencing contemporary cancer care settings. Receiving treatment quickly and without waiting was a positive experience for both partners and survivors; however partners experienced the information as massive and as causing concern. The period after discharge was being marked by uncertainty and loneliness, and partners tended to experience non-continuity in care as more problematic than the survivor did. The results showed different illness perceptions and a mismatch between illness perceptions among survivors and partners, presented in the conceptual category outlook on the cancer diagnosis. One illness perception, here presented among partners, focused on seeing the cancer diagnosis as a permanent life-changing event. The other illness perception, here presented among survivors, concentrated on leaving the cancer diagnosis behind and moving forward. The importance of illness perceptions among survivors, and the differences in illness perceptions between survivors and partners, should be recognized by healthcare professionals to achieve the goals of person-centered contemporary cancer care.