title: Interpretation of illness in patients with chronic diseases from Shanghai and their associations with life satisfaction, escape from illness, and ability to reflect the implications of illness.
abstract: OBJECTIVE
  The aim of this study is to analyze how patients with chronic diseases from Shanghai interpret their disease, and how these interpretations influence patients' life satisfaction, intention to escape from their illness and their ability to reflect on the implications of their illness.
  
  
  METHODS
  A cross-sectional study enrolling 142 patients (mean age (50 ± 16) years; 63% men, 37% women) with chronic diseases (60% cancer) was recruited in the Changhai Hospital of Traditional Chinese Medicine, Shanghai, China and surveyed using standardized questionnaires.
  
  
  RESULTS
  Patients with chronic diseases from Shanghai interpreted their illness mostly as an Adverse Interruption of Life (55%), as a Threat/Enemy (50%), but also as a Challenge (49%), and only rarely as a Call for Help (18%) or as a Punishment (13%). Particularly fatalistic negative (i.e., Threat/Enemy, Adverse Interruption of Life) and strategy-associated disease interpretations (i.e., Relieving Break, Call for Help) were moderately associated with patients' intention to escape from illness. In contrast, positive interpretations (i.e., something of Value, Challenge) and also the guilt-associated negative interpretation Failure were moderately related with patients' ability to reflect on their illness. However, life satisfaction was weakly associated only with the view that illness might be a Challenge. Interestingly, 58% of those who would see their illness as an Adverse Interruption (AI+) could see it also as a Challenge (Ch+). Detailed analyses showed that AI+Ch+ patients differ from their AI+Ch- counterparts significantly with respect to their ability to reflect life and implications of illness (F=9.1; P=0.004).
  
  
  CONCLUSIONS
  The observed interpretations of illness, particularly the negative perceptions, could be used as indicators that patients require further psychological assistance to cope with their burden. Helping AI+ patients see their illness also as a Challenge, and thus develop a higher Reflection on Life Concerns, would be greatly beneficial, and encourages further research.
authors.affiliation: Institute of Integrative Medicine, Faculty of Medicine, Witten/Herdecke University, 58313 Herdecke, Germany; E-mail: arndt.buessing@uni-wh.de.
authors.forename: Arndt
authors.initials: A
authors.lastname: Büssing
authors.affiliation: Institute of Integrative Medicine, Faculty of Medicine, Witten/Herdecke University, 58313 Herdecke, Germany.
authors.forename: Ariane
authors.initials: A
authors.lastname: von Bergh
authors.affiliation: Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai 200433, China.
authors.forename: Xiao-feng
authors.initials: XF
authors.lastname: Zhai
authors.affiliation: Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai 200433, China.
authors.forename: Chang-quan
authors.initials: CQ
authors.lastname: Ling
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology; D010549:Personal Satisfaction