‘How can I take things as they happen?’ unveiling illness perceptions among patients with gastrointestinal tract cancer: a mixed-methods study

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Abstract Background Illness perceptions are defined as patients’ cognitive and emotional representations of their disease. These perceptions influence how individuals engage in health-related behaviours, including treatment adherence, long-term surveillance, and healthy lifestyle adoption. Understanding of illness perceptions among patients with gastrointestinal (GI) tract cancer remains limited. This study aimed to describe illness perceptions, examine their associated factors, and achieve a comprehensive understanding using a mixed methods approach. Methods A convergent mixed methods design was employed. In the quantitative strand, the Brief Illness Perception Questionnaire (IPQ) was used to assess illness perceptions and nine dimensions: consequences, timeline, personal control, treatment control, identity, concern, emotional response, understanding, and causes. Data were analysed using descriptive and inferential statistics. In the qualitative strand, semi-structured interviews were conducted and analysed using content analysis. Quantitative and qualitative findings were integrated through side-by-side comparison and presented using a narrative-weaving approach organised by shared illness perception dimensions. Results In total, 253 patients with GI tract cancer from four tertiary hospitals in mainland China completed the questionnaire, and 37 participants from this cohort were interviewed. Nearly one-third of patients reported moderate to high negative illness perceptions. Poorer illness perceptions were observed among patients with esophagus cancer, low education, stage IV, no surgery, and Eastern Cooperative Oncology Group performance status ≥ 1. Integration of the qualitative and quantitative findings demonstrated confirmation in the dimensions of identity and causes, and expansion in the dimensions of consequences, timeline, personal control, treatment control, concern, emotional response, and understanding. Patients reported high concern about prognosis and death while expressing strong motivation to adopt healthy lifestyles to promote recovery. However, their limited knowledge of illness management constrained their sense of personal control. Support from family members, healthcare providers, and peers with similar experiences helped patients interpret illness more positively. Conclusions The integration of quantitative and qualitative results support the applicability of the Brief-IPQ for evaluating illness perceptions in this population. Interventions that enhance illness-related communication with healthcare professionals, engage family members and peers in providing support for illness-related concerns, and promote the adoption and maintenance of healthy lifestyles may help patients develop more adaptive illness perceptions.