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The function of fatigue and illness perceptions as mediators between self-efficacy and health-related quality of life during the first year after surgery in persons treated for colorectal cancer.
University of Gothenburg, Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
University West, Department of Health Sciences. University of Gothenburg, Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden.ORCID iD: 0000-0001-7804-0342
University West, Department of Health Sciences, Section for health promotion and care sciences.ORCID iD: 0000-0002-4722-009X
Malmö University, Department of Care Science, Faculty of Health and Society, Malmö.
2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. E1537-E1548Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2018. Vol. 27, no 7-8, p. E1537-E1548
Keywords [en]
Colorectal cancer, fatigue, health-related quality of life, illness perceptions, path analysis, recovery, self-efficacy
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-12075DOI: 10.1111/jocn.14300ISI: 000430825100027PubMedID: 29399917Scopus ID: 2-s2.0-85044476067OAI: oai:DiVA.org:hv-12075DiVA, id: diva2:1184658
Note

First published: 26 March 2018

Available from: 2018-02-22 Created: 2018-02-22 Last updated: 2018-05-14Bibliographically approved

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Brink, EvaCliffordson, Christina

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