Optimism and Physical Health-Related Quality of Life in Chronic Illness: Mediating Effects of Control Beliefs and Health Behaviors

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Optimism and Physical Health-Related Quality of Life in Chronic Illness: Mediating Effects of Control Beliefs and Health Behaviors, Is a Well-Researched Topic, It Is To Be Used As a Guide Or Framework For Your Research.

ABSTRACT

Among persons living with, or recovering from, chronic illness, poor physical health-related quality of life is a concern, as current and residual illness symptoms and treatment side effects may deleteriously impact physical functioning and fulfillment of daily roles. Numerous cognitive, emotional, and behavioral factors may impact perceptions of health status. Optimism, for example, is conceptualized as belief in the occurrence of positive future outcomes, and is beneficially associated with physical health-related quality of life. Further, optimism may contribute to enhanced perceptions of control and efficacy over disease symptoms and general health, manifesting as proactive health behaviors (e.g., wellness behaviors; treatment adherence) and, in turn, improved health-related quality of life. Across independent samples of persons living with remitted cancer (N = 164) or fibromyalgia (N = 508), we examined the serial mediating effects of health-related self-efficacy and proactive health behaviors in the relation between dispositional optimism and physical health-related quality of life. Participants completed online self-report measures, including the Life Orientation Test – Revised, Control Beliefs Inventory, Multidimensional Health Profile – Health Functioning Index, Wellness Behaviors Inventory, Medical Outcomes Study General Treatment Adherence Scale, and the Short-Form Health Survey. Significant serial mediation was observed across samples; higher dispositional optimism was associated with greater health-related self-efficacy and, in turn, greater engagement in proactive health behaviors and better physical health-related quality of life. For persons with remitted cancer, absence of other specific indirect effects indicates a need to consider the potential impact of unique aspects of disease, such as late effects of treatment or fear of recurrence, that may limit the beneficial effects of optimism exclusively through health-related self-efficacy or wellness behaviors. For persons with fibromyalgia, we found specific indirect effects through each mediating variable, lending support for the decoupling of cognitive and behavioral factors, consistent with pathophysiological and psychosomatic explanations of illness symptoms and approaches to treatment. Interventions designed to enhance optimism (e.g., cognitive-behavioral therapy; best possible self exercise) or self-efficacy (e.g., exercise skills training) may have positive downstream effects on health behavior engagement and perceptions of physical health-related quality of life among individuals living with remitted cancer or fibromyalgia.

TABLE OF CONTENTS

Page
ABSTRACT ……………………………………………………………………………………………………………………2
ACKNOWLEDGEMENTS ………………………………………………………………………………………………4
Chapter
1. INTRODUCTION ……………………………………………………………………………………………………….9
Cancer Survivors ………………………………………………………………………………………………….11
Fibromyalgia Syndrome ……………………………………………………………………………………….15
Physical Health-Related Quality of Life …………………………………………………………………17
Physical Health-Related Quality of Life in Cancer Survivors …………………………18
Physical Health-Related Quality of Life in Fibromyalgia ………………………………19
Factors Influencing Perceptions of Physical Health-Related Quality of Life …….22
Optimism ……………………………………………………………………………………………………………24
Optimism and Physical Health-Related Quality of Life in Cancer Survivors …….27
Optimism and Physical Health-Related Quality of Life in Fibromyalgia …………28
Perceived Control ………………………………………………………………………………………………..30
Health-Related Self-Efficacy and Physical Health-Related Quality of Life in Cancer Survivors ………………………………………………………………………………………32
Health-Related Self-Efficacy and Physical Health-Related Quality of Life in Fibromyalgia ……………………………………………………………………………………………33
Optimism, Health-Related Self-Efficacy, and Physical Health-Related Quality of Life in Cancer Survivors ……………………………………………………………………………35

Optimism, Health-Related Self-Efficacy, and Physical Health-Related Quality of Life in Fibromyalgia …………………………………………………………………………………36
Health Behaviors …………………………………………………………………………………………………37
Health Behaviors and Physical Health-Related Quality of Life in Cancer Survivors …………………………………………………………………………………………………39
Health Behaviors and Physical Health-Related Quality of Life in
Fibromyalgia …………………………………………………………………………………………….43
Optimism, Health-Related Self-Efficacy, Health Behaviors, and Physical Health-Related Quality of Life in Cancer Survivors ………………………………………………..47
Optimism, Health-Related Self-Efficacy, Health Behaviors, and Physical Health-Related Quality of Life in Fibromyalgia ………………………………………………………48
Statement of the Problem ……………………………………………………………………………………..50
Hypotheses …………………………………………………………………………………………………………50
2. METHOD ………………………………………………………………………………………………………………….52
Participants and Procedure ……………………………………………………………………………………52
Remitted Cancer Sample ……………………………………………………………………………52
Fibromyalgia Sample ………………………………………………………………………………..54
Measures ……………………………………………………………………………………………………………55
Life Orientation Scale – Revised (LOT-R) …………………………………………………..55
Control Beliefs Inventory (CBI) …………………………………………………………………56
Multidimensional Health Profile – Health Functioning Index (MHP-HF) ………..58
Wellness Behaviors Inventory (WBI) ………………………………………………………….59
Medical Outcomes Study General Adherence Scale (MOSGA) ……………………..60

Short-Form Health Survey (SF-36v2 and SF-12v2) ………………………………………61
Statistical Analyses ……………………………………………………………………………………………..64
Covariates ……………………………………………………………………………………………….64
Bivariate Analyses ……………………………………………………………………………………65
Serial Multivariate Mediation Analyses ………………………………………………………65
3. RESULTS …………………………………………………………………………………………………………………68
Bivariate Correlations ………………………………………………………………………………………….68
Remitted Cancer Sample ……………………………………………………………………………68
Fibromyalgia Sample ………………………………………………………………………………..69
Serial Mediation Results ………………………………………………………………………………………70
Remitted Cancer Sample ……………………………………………………………………………70
Fibromyalgia Sample ………………………………………………………………………………..73
4. DISCUSSION ……………………………………………………………………………………………………………77
Bivariate Associations of Study Variables ……………………………………………………………..78
Multivariate Analyses ………………………………………………………………………………………….83
Optimism and Physical Health-Related Quality of Life …………………………………84
Remitted cancer …………………………………………………………………………….85
Fibromyalgia …………………………………………………………………………………86
Serial Mediating Effects of Health-Related Self-Efficacy and
Health Behaviors ………………………………………………………………………………………87
Remitted cancer …………………………………………………………………………….88
Fibromyalgia …………………………………………………………………………………94
Comparative Multivariate Results Across Disease Samples ……………………………………..99

Limitations and Future Research Directions ………………………………………………………….109
Clinical Implications ………………………………………………………………………………………….114
Positive Psychology Interventions …………………………………………………………….115
Cognitive and Behavioral Interventions …………………………………………………….116
Acceptance and Commitment Therapy ………………………………………………………118
Self-Management Programs ……………………………………………………………………..120
Conclusion ……………………………………………………………………………………………………….121
REFERENCES ……………………………………………………………………………………………………………123
VITA ………………………………………………………………………………………………………………………….200

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YourPastQuestions Brand

Additional information

Author

Morgan Kate Treaster

No of Chapters

5

No of Pages

201

Reference

Yes

Format

PDF

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