title: Health-related quality of life in patients with hepatocellular carcinoma: the mediation effects of illness perceptions and coping.
abstract: BACKGROUND
  The aims of this study were to explore health-related quality of life (HRQOL) in patients with hepatocellular carcinoma (HCC). We report the following: (1) differences in HRQOL between patients with HCC and the general population; (2) significant physical and psychological predictors of HRQOL; and (3) mediation effects of illness perceptions and coping on HRQOL.
  
  
  METHODS
  Patients with HCC (n = 286) from Taiwan completed standardized measures of HRQOL, illness perception (cognitive representations, emotional representations and illness comprehensibility) and coping (emotion-oriented and problem-orientation coping). Demographic and physical variables were also collected.
  
  
  RESULTS
  Patients with HCC had worse global HRQOL, physical, role, cognitive and social functioning, but better emotional functioning than the general population. Physical variables and cognitive representation were significant predictors of global HRQOL, physical functioning and emotional functioning. Cognitive representation mediated the relationships between physical variables and global HRQOL, physical functioning and emotional functioning, but coping only mediated the relationship between cognitive representation and global HRQOL.
  
  
  CONCLUSIONS
  The results suggest that physical variables have direct effects on global HRQOL and physical functioning, but there were also partial mediations through cognitive representation. The effect of physical variables on emotional functioning was mediated through cognitive and emotional representations. Patients with better performance status and positive illness perceptions tended to report better HRQOL, but those with negative illness perceptions and who used more emotion-oriented coping had worse HRQOL. Limitations of the work associated with use of theory and measures developed in Europe and the US are discussed, as are the clinical implications for patients with HCC.
authors: Department of Human Development, Tzu Chi University, Hualien, Taiwan. dibe1011@yahoo.com.tw
authors: Sheng-Yu
authors: SY
authors: Fan
authors: Christine
authors: C
authors: Eiser
authors: Ming-Chih
authors: MC
authors: Ho
authors: Cheng-Yao
authors: CY
authors: Lin
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000523:psychology*; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006304:Health Status; D006801:Humans; D008113:Liver Neoplasms / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010465:Perception; D011788:Quality of Life; D012044:Regression Analysis; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires