title: From despair to hope: a longitudinal study of illness perceptions and coping in a psycho-educational group intervention for women with breast cancer.
abstract: OBJECTIVE
  This study examined the cross-sectional and longitudinal relationships of illness perceptions, coping, and distress in women with breast cancer. Illness perceptions and coping at baseline and changes in these variables over time served as possible predictors of distress at two follow-up points.
  
  
  METHODS
  Fifty-seven women with breast cancer who participated in a psychosocial aftercare programme completed a questionnaire before the start of the intervention, directly after the end of the intervention, and 1 year after the start of the intervention. Study variables were assessed with the Illness Perception Questionnaire-Revised (illness perceptions), the COPE (coping), and the Hopkins Symptom Check List (distress).
  
  
  RESULTS
  Results showed that 43% of variance in distress at baseline was explained by participants' illness perceptions. Cyclical timeline perceptions were the strongest predictor of distress at baseline. Longitudinal data revealed that after the end of the intervention, the intensity of general distress and breast cancer-related emotions had decreased significantly. Partial correlations showed that baseline illness perceptions were unrelated to distress at follow-up. However, changes in illness perceptions (perceptions about the cyclical and chronic timeline and symptoms associated with breast cancer) showed significant associations with distress at both follow-up assessments. Associations of follow-up distress with coping styles were less consistent.
  
  
  CONCLUSIONS
  Our results suggest that changes in illness perceptions are related to an improvement or worsening of patients' emotional well-being over time. These findings hold promise for the development of interventions that specifically target patients' representations of their illness.
authors.affiliation: Department of Clinical Oncology, Leiden University Medical Center, The Netherlands. m.j.fischer@lumc.nl
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Fischer
authors.forename: Marion E
authors.initials: ME
authors.lastname: Wiesenhaan
authors.forename: Aukje
authors.initials: A
authors.lastname: Does-den Heijer
authors.forename: Wim C
authors.initials: WC
authors.lastname: Kleijn
authors.forename: Johan W R
authors.initials: JW
authors.lastname: Nortier
authors.forename: Adrian A
authors.initials: AA
authors.lastname: Kaptein
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000359:Aftercare / Q000379:methods*; D000704:Analysis of Variance; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000523:psychology*; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008875:Middle Aged; D008960:Models, Psychological; D015397:Program Evaluation; D012657:Self-Help Groups; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires