title: Illness perceptions and changes in lifestyle following a gynecological cancer diagnosis: A longitudinal analysis.
abstract: This study explores patterns of lifestyle change and whether more threatening illness perceptions are associated with lifestyle changes post-treatment for smoking, alcohol consumption and Body Mass Index (BMI) among gynecological cancer patients.
  
  
  
  In total, 395 cancer patients (N=221 endometrial; N=174 ovarian) were included in this secondary analysis of longitudinal data. Lifestyle outcomes were assessed through self-reported questionnaires after initial treatment and 6, 12, and 18months of follow-up. Illness perceptions were assessed with the Brief Illness Perception Questionnaire (BIPQ). Latent class growth curve analyses were conducted to identify patterns of lifestyle change and linear mixed models using between-subject and within-subject effects to explore the association between BIPQ items and alcohol consumption (glasses/week) and BMI (kg/m2).
  
  
  
  After initial treatment, 15% (N=57) of the patients smoked, 53% (N=203) drank alcohol, and 60% (N=236) were overweight or obese. Overall, smokers made no considerable changes, but one subgroup of low level smokers reported positive decline. A slight decrease was observed for alcohol consumption among low and moderate level alcohol drinker subgroups, whereas BMI remained stable among endometrial cancer patients and increased for ovarian cancer patients. Moreover, patients with lower trust in their treatment to cure the disease drank more alcohol (β=0.32 glasses/week [95% CI 0.09; 0.56]).
  
  
  
  Change in lifestyle after a gynecological cancer treatment is not self-evident. Moreover, more threatening illness perceptions were not related to a healthier lifestyle. This study underlines the need for lifestyle-promoting activities to facilitate lifestyle improvement among gynecological cancer patients.
authors.affiliation: Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands.
authors.forename: Marlou E C L
authors.initials: MECL
authors.lastname: van Broekhoven
authors.affiliation: Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands; CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: Belle H
authors.initials: BH
authors.lastname: de Rooij
authors.affiliation: Department of Obstetrics and Gynaecology, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk, The Netherlands.
authors.forename: Johanna M A
authors.initials: JMA
authors.lastname: Pijnenborg
authors.affiliation: Department of Obstetrics and Gynaecology, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk, The Netherlands.
authors.forename: M Caroline
authors.initials: MC
authors.lastname: Vos
authors.affiliation: Department of Gynecology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Dorry
authors.initials: D
authors.lastname: Boll
authors.affiliation: Department of Gynecology and GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Roy F P M
authors.initials: RFPM
authors.lastname: Kruitwagen
authors.affiliation: Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands; CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands; Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Lonneke V
authors.initials: LV
authors.lastname: van de Poll-Franse
authors.affiliation: Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands; CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands. Electronic address: N.Ezendam@iknl.nl.
authors.forename: Nicole P M
authors.initials: NPM
authors.lastname: Ezendam
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000523:psychology; D015992:Body Mass Index; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005260:Female; D000070497:Healthy Lifestyle; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D010347:Patient Care Planning; D010353:Patient Education as Topic / Q000379:methods; D012907:Smoking / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Gynecological cancer patients; Illness perceptions; Latent class growth curve analysis; Lifestyle; Longitudinal study; Survivorship