Perceived and Received Social Support and Illness Acceptance Among Breast Cancer Patients: The Serial Mediation of Meaning-Making and Fear of Recurrence.

BACKGROUND AND PURPOSE: The literature indicates connections between social support and acceptance of a personal diagnosis of breast cancer, but these relationships are likely to be mediated due to numerous connections between social support and illness acceptance with meaning-making and fear of recurrence. We decided to investigate whether meaning-making and fear of recurrence serially mediated the relationship between perceived and received social support and illness acceptance. METHODS: The current research examined 246 adult women patients with a breast cancer diagnosis who were undergoing radiotherapy/chemotherapy treatment in oncological hospitals. This cross-sectional study based on a mediational model was reported according to the STROBE checklist. RESULTS: Our results supported the mediational model in which meaning-making and fear of recurrence serially mediated the relationship of both perceived and received social support with illness acceptance. Furthermore, the mediating power of meaning-making was more significant than the fear of recurrence. CONCLUSION: Meaning structures and anxiety played an important mediating role in breast cancer patients. Finding additional meaning and goals and experiencing lower fear enables the patients to effectively make use of social support and accept their illness. PRACTICE IMPLICATIONS: The current study identified factors that increase illness acceptance among breast cancer patients as it showed that patients can gain a greater understanding of the nature of their illness by becoming more aware of their own goals and values and reduce anxiety by learning about their current state of the illness.

Breast cancer is the most common cancer in women in the world, and the hardships of the cancer experience are considered potentially traumatic events associated with psychological effects. One of the most important factors responsible for the patient's daily functioning is illness acceptance. Therefore, we investigated whether meaning-making and fear of recurrence serially mediated the relationship between perceived and received social support and illness acceptance. We examined 246 adult women patients with a breast cancer diagnosis. In our study, patients with breast cancer who received more social support had a better understanding of their illness and lower fear of recurrence. Moreover, women with breast cancer characterized by a sense of purpose and optimism experienced lower anxiety about a potential relapse of the disease. Meaning structures and anxiety played an important mediating role in breast cancer patients. Finding additional meaning and goals and experiencing lower fear enables the patients to make use of social support and accept their illness effectively.

Marital satisfaction, partner communication, and illness acceptance among couples coping with breast cancer: A dyadic approach.

OBJECTIVE: Associations between marital satisfaction and illness acceptance are mediated by different factors. This study examines whether partner communication mediates relationships between marital satisfaction and illness acceptance among couples coping with breast cancer within a dyadic approach. METHODS: One hundred and thirty-six couples were examined: 136 women with a diagnosis of breast cancer and their 136 spouses without a history of cancer. Questionnaires measuring marital satisfaction, partner communication, and illness acceptance were used. SEM analysis was applied to examine mediation effects. RESULTS: For the patients, marital satisfaction was positively associated with supportive self-communication, supportive partner communication, and illness acceptance. For the spouses, marital satisfaction was positively correlated with supportive self-communication and supportive partner communication, yet, it was negatively correlated with deprecating communication of both self and partner. The associations between marital satisfaction and illness acceptance were mainly mediated by supportive communication (self and partner). CONCLUSIONS: An examination of partner communication within a dyad is crucial for understanding relationships between marital satisfaction and illness acceptance in breast cancer patients. These relationships predominantly depend on the supportive communication of cognitive and emotional information between the spouses.

The relationship between patient-family caregiver congruence/incongruence in acceptance of illness and family caregivers' anticipatory grief.

OBJECTIVE: Cancer is a family affair that negatively impacts the lives of patients and their family caregivers. This study takes a dyadic perspective to investigate the effect of patient-family caregiver illness acceptance congruence/incongruence on family caregivers' anticipatory grief (AG) and examine whether caregivers' resilience moderates the abovementioned relationship. METHODS: For the study, 304 dyads of advanced lung cancer patients and their family caregivers from three tertiary hospitals in Jinan, Shandong Province, China were recruited. The data were analyzed using polynomial regressions and response surface analyses. RESULTS: Family caregivers' AG was lower when patient-family caregiver illness acceptance was congruent rather than incongruent. Lower patient-caregiver illness acceptance congruence was associated with higher AG in family caregivers compared with higher illness acceptance congruence. Family caregivers reported significantly higher AG only if their illness acceptance was lower than that of their patients. In addition, caregivers' resilience moderated the effects of patient-caregiver illness acceptance congruence/incongruence on family caregivers' AG. CONCLUSIONS: Patient-family caregiver illness acceptance congruence was beneficial to family caregivers' AG; resilience can be a protective factor for buffering the impact of illness acceptance incongruence on family caregivers' AG.

Associations Between Prognostic Awareness, Acceptance of Illness, and Psychological and Spiritual Well-being Among Patients With Heart Failure.

BACKGROUND: This study aimed to (1) investigate the association of prognostic awareness with psychological (distress level and emotional well-being) and spiritual well-being among patients with heart failure, and (2) assess the main and moderating effects of illness acceptance on the relationship between prognostic awareness and psychological and spiritual well-being. METHODS AND RESULTS: This study used baseline data of a Singapore cohort of patients with heart failure (N = 245) who had New York Heart Association class 3 or 4 symptoms. Patients reported their awareness of prognosis and extent of illness acceptance. Multivariable linear regressions were used to investigate the associations. Prognostic awareness was not significantly associated with psychological and spiritual well-being. Illness acceptance was associated with lower levels of distress (ß [SE] = -0.9 [0.2], P < .001), higher emotional well-being (ß [SE] = 2.2 [0.4], P < .001), and higher spiritual well-being (ß [SE] = 5.4 [0.7], P < .001). Illness acceptance did not moderate the associations of prognostic awareness with psychological and spiritual well-being. CONCLUSIONS: This study suggests that illness acceptance could be a key factor in improving patient well-being. Illness acceptance should be regularly assessed and interventions to enhance illness acceptance should be considered for those with poor acceptance.

A tailored intervention for illness acceptance improves adherence and quality of life in adults with haemophilia using prophylaxis.

INTRODUCTION: Adherence to prophylactic treatment (prophylaxis) in persons with haemophilia is challenging and has been reported at only ±50%. Acceptance problems are one of the main reasons for non-adherence in haemophilia. An evidence-based intervention was developed based on an acceptance and commitment therapy (ACT) approach. AIM: To evaluate a tailored intervention focused on illness acceptance in adults with haemophilia who were prescribed prophylaxis. METHODS: A pre-post study was executed in adults with haemophilia who were prescribed prophylaxis. A series of 8 2-hour group trainings were held, including 3-8 participants/series. Adherence (VERITAS-Pro, optimum 0), health-related quality of life (HRQoL, SF-36, optimum 100) and illness perception (BIPQ, optimum 0) were measured at start, after six months and 12 months and analysed using Wilcoxon signed-rank test. RESULTS: Twenty-four patients (median age 47 years, range 27-74) were included. After 12 months, adherence improved in 68% of patients, quality of life in 48% and illness perception in 31%. Adherence (total score) improved from 35 to 25 (P<0.01). HRQoL showed clinically relevant improvement in domains of social-functioning (P = 0.04), role-emotional, physical-functioning, role-physical and bodily pain. Illness perception improved statistically significant on domains of affect (P = 0.01), concern (P = 0.01) and understanding (P = 0.04). Patients evaluated the training useful, an eye-opener, a personal enrichment and insightful. CONCLUSION: The tailored group intervention resulted in significant improvement of adherence, quality of life and illness perception. Based on our current experience, we have implemented it in clinical practice and collaborate with the patient association to make it available for all Dutch people with haemophilia.

The Levels of Depression, Anxiety, Acceptance of Illness, and Medication Adherence in Patients with Multiple Sclerosis - Descriptive and Correlational Study.

Emotional functioning is one of the factors affecting medication adherence in patients with multiple sclerosis (MS). Adherence to treatment is a very important element in the therapy of patients with MS and requires from them cooperation, positive emotional status and acceptance of illness. This study evaluated the role of depression, anxiety, and the acceptance of illness on adherence to disease-modifying therapies (DMT) in MS. A group of 226 MS patients was included. The Beck Depression Inventory (BDI), the Hospital Anxiety and Depression Scale-Modified Version (HADS-M), the Acceptance of Illness Scale (AIS) and the Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ) were used. It was shown that 41% of patients reported the symptoms of anxiety, 28% reported the symptoms of depression, and 63% were irritated and aggressive (HADS-M). Over 80% of patients accept their disease to varying degrees. There was a correlation between the results of HADS-M, BDI, and AIS and the domains of MS-TAQ. Analysis of the multiple-regression model showed that only being very satisfied with treatment positively affects adherence to DMT in MS patients. It has to be concluded that anxiety and depression have a significant negative impact on medication adherence in MS patients. However, MS patients with an increased acceptance of their illness have a higher rate of adherence to DMT. The emotional state of a patient is an important factor that can both positively and negatively affect their adherence and their resulting prognosis.

Psychological factors associated with self-management in multiple sclerosis.

OBJECTIVE: Patient's engagement in their own treatment has been shown to improve clinical outcomes. A better understanding of the association between self-management in multiple sclerosis (MS) and potentially modifiable psychological factors may provide clinicians with strategies to design and stimulate better patient activation for self-managing health. Therefore, in this study, we examined whether cognitive factors, namely self-efficacy, acceptance of illness, optimism, and health locus of control (HLC), are associated with self-management in MS. METHODS: This is a cross-sectional study. A total of 382 patients with MS who completed the MS Self-Management Scale-Revised and the questionnaires that measure self-efficacy, optimism, illness acceptance, and HLC were included in the study. RESULTS: A hierarchical multiple regression revealed that power of others' HLC (b = 0.42, P ≤ .001), optimism (b = 0.27, P ≤ .01), internal HLC (b = -0.11, P = .017), and self-efficacy (b = 0.11, P = .031), together with control variables (longer disease duration and higher disability), explained 30% of the variance in the dependent variable. CONCLUSIONS: In the case of MS, self-management is associated with patient's perception that healthcare professionals control their health, higher self-efficacy, optimism, and, surprisingly, lower internal HLC. The results of this study indicate the vital role of the healthcare staff in encouraging the patients with MS toward activities related to self-management and provide new insights on the psychological intervention aimed at improving self-management by patients.

Perception of cancer in patients diagnosed with the most common gastrointestinal cancers.

BACKGROUND: Gastrointestinal cancers, including colorectal cancer, stomach cancer and pancreatic cancer are among the most common cancers in Poland. Cancer patients usually assess their quality of life much worse than the general population, while negative emotions associated with the illness may affect the results of treatment. METHODS: The study involved 378 patients with colorectal cancer, stomach cancer and pancreatic cancer, treated as outpatients at the Oncology Center - Maria Sklodowska-Curie Institute in Warsaw in 2013-2018. Standardized tools were used in the study: the Beliefs about Pain Control Questionnaire (BPCQ), the Pain Coping Strategies Questionnaire (CSQ), Approval Illness Scale (AIS), Mental Adjustment to Cancer (MiniMAC). The main goal of the study was to assess pain control, pain management strategies, illness acceptance and adaptation to cancer in patients with the most common gastrointestinal cancers. RESULTS: Patients with gastrointestinal cancers ascribe the greatest role in controlling pain to internal factors (M = 16.84, SE = .34), and the highest score in this area was obtained by patients with colorectal cancer (M = 17.33, SE = .35). The most frequently chosen strategy is declaring coping (M = 20.95, SE = .57), although patients with pancreatic cancer obtained a high score also in the area of catastrophizing (M = 17.99, SE = 1.14). The average value of illness acceptance for patients with gastrointestinal cancers was M = 25.00 (SE = .50) and it was the lowest in the group of patients diagnosed with pancreatic cancer (M = 23.41, SE = 1.16), and the highest in a group of people with colorectal cancer (M = 27.76, SE = .51). Patients with gastrointestinal cancers obtained the highest values of the MiniMAC test in the area of the fighting spirit (M = 21.30, SE = .25), characteristic mainly for patients with colorectal cancer. Patients with pancreatic cancer were characterized by high anxiety and helplessness/hopelessness. CONCLUSIONS: Patients with gastrointestinal cancers use different methods of pain control and pain coping strategies, with active behaviors being preferred by patients with colorectal cancer and destructive - by patients with pancreatic cancer. The majority of socio-economic variables, as well as the treatment method, affect the patients' behaviors.

Illness acceptance as mediator for cancer-related complaints and psychological distresses among Malaysian cancer patients.

Aim: The present study investigated the relationship between psychological problems, illness acceptance and cancer-related complaints among Malaysian cancer patients. Patients & methods: One hundred and six cancer patients were recruited and were requested to complete validated self-reported questionnaires that measured their psychological distresses, sleep quality, pain, fatigue and illness acceptance. Results: There was a significant relationship between cancer-related symptoms, illness acceptance and psychological distresses commonly experienced by local cancer patients (p < 0.05). Illness acceptance was shown to be a mediator of cancer-related complaints and psychological distresses. Conclusion: Malaysian cancer patients with more cancer-related complaints reported a higher level of psychological distresses and poorer illness acceptance. Increased level of illness acceptance was suggested in managing cancer patients with psychological distresses and cancer-related complaints.

The influence of selected psychological variables on quality of life of chronically dialysed patients.

BACKGROUND: The impact of illness acceptance in assessment of health-related quality (HRQoL) between chronic diseases remains unclear. Depression and anxiety reduce HRQoL and worsen prognosis. We describe the relationship between illness acceptance, anxiety and depression, and HRQoL in chronic dialysis patients. MATERIAL: The study included 105 patients with chronic kidney disease (mean age 65.8 years), treated with chronic dialysis. Three validated instruments were used, including the Acceptance of Illness Scale (AIS), the Hospital Anxiety and Depression Scale (HADS) and the Short Form Health Survey (SF-36). For statistical analysis, Student's t-test and Pearson's r correlation coefficient were carried out. RESULTS: Spearman's rho correlation analyses were carried out on the patients' quality of life (PCS and MCS), and their anxiety, depression and illness acceptance scores. The results showed acceptance of illness to be positively correlated with quality of life in terms of PCS (rho = 0.43) and MCS (rho = 0.36), and depression and anxiety to be negatively correlated with quality of life in both domains (PCS: rho = -0.39 and rho = -0.56, respectively; MCS: rho = -0.56 and rho = -0.78, respectively). The multiple-factor analysis for anxiety, depression and acceptance of illness showed acceptance of illness to be a significant independent determinant of higher quality of life in the PCS (ß = 1.580; p < 0.000) and MCS (ß = 1.980; p < 0.000) domains. The analysis also showed anxiety to be a significant independent determinant of lower quality of life in the MCS domain (ß = -0.432; p = 0.041), while depression was found to be a significant independent determinant of lower scores in both the PCS (ß = -3.557; p < 0.00) and the MCS (ß = -1.257; p < 0.00) domains. CONCLUSION: Acceptance of illness significantly affects HRQoL in dialysis patients - higher acceptance scores result in higher quality-of-life scores. Symptoms of depression and anxiety also significantly affect HRQoL in dialysis patients - a higher intensity of symptoms lead to lower quality-of-life scores.

Evaluation of coping with chronic rheumatic disease, in the context of socio-demographic factors and disease duration, based on the example of patients with ankylosing spondylitis.

OBJECTIVES: Ankylosing spondylitis (AS) impairs patients' functioning, reducing their quality of life. The author of salutogenesis, Antonovsky, claims that maintaining an inner balance in a chronic disease is possible through a high sense of coherence. The aim of the current study was to identify socio-demographic factors and disease duration related to the feeling of coherence of patients with AS, acceptance of disease and risk of depression. MATERIAL AND METHODS: The study was conducted on 82 patients with diagnosed AS. The research method was a diagnostic survey using the Life Orientation Questionnaire (SOC-29), Beck Depression Inventory (BDI) and Acceptance of Illness Scale (AIS). RESULTS: In the study, the majority of the patients were male (89%), aged 42 (±11.3). The average duration of AS is 13 (±7.8) years. It was reported that with age, illness acceptance got worse (rp = -0.567, p < 0.0001), and the risk of depressive disorders increased (rp = 0.648, p < 0.0001). The longer the patient suffered from AS, the weaker was their illness acceptance (rp = -0.446, p < 0.0001) and sense of coherence (rp = -0.448, p < 0.001) whereas the risk of depressive disorder increased (rp = 0.479, p < 0.0001). A high linear correlation between illness acceptance and sense of coherence (rp = 0.638, p < 0.0001) and a very high negative correlation between overall sense of coherence and risk of depression (rp = -0.857, p < 0.0001) were observed. CONCLUSIONS: Patients with low sense of coherence demonstrated poorer adaptation to the illness and a greater risk of depressive disorders. Factors lowering the sense of coherence and illness acceptance and increasing risk of depression in the studied patients with AS were progressing illness, older age and lower education level.

Illness acceptance, pain perception and expectations for physicians of the elderly in Poland.

BACKGROUND: Ageing of society is a significant challenge to public health, both socially and health wise. Adaptation to illness and its acceptance play an important role in control and patients' self-control in many diseases of old age. The right attitude of doctors to patients, especially, geriatric patients determines, among others, a patient's quality of life and acceptance of illness. Recently, there has been observed the rapid development of research on interactions between pain as a physiological process and its perception by an individual. The aim of the study was to evaluate the acceptance of illness, perception of pain and expectations of geriatric patients for physicians among the inhabitants of Bialystok (Poland) over the age of 60. METHODS: The study included 300 people, inhabitants of Bialystok and the surrounding area - aged over 60: 100 elderly residents of a nursing home, 100 students of the University of the Third Age in Bialystok and 100 students of the University of Healthy Senior. The study used three standardised psychometric scales: Patient Request Form (PRF), Acceptance of Illness Scale (AIS) and The Beliefs about Pain Control Questionnaire (BPCQ). RESULTS: The median of the overall score of AIS was 26 points, which is considered average in terms of acceptance of illness. The median value of the influence of internal factors on the control of pain in case of BPCQ scale was generally16 of 30 points, the influence of physicians - 15 of 24 points, while random events - 14 of 24 points. The overall result for PRF scale proved that the respondents were the least expected to look for emotional support (5 of 12 points). It was established that the group affiliation significantly affected the result of AIS (p < 0.001). There was also noted a negative relation between AIS and the search for emotional support (PRF) depending on the group. The higher the AIS value, the lower the score in case of search for emotional support (PRF). CONCLUSIONS: Neither gender nor age played a significant role in acceptance of illness, control of pain or expectations for physicians. The key variable determining the occurrence of dependencies between the studied features was being a part of a group. The elderly residents of the nursing home were negatively distinguished from the other two studied groups. The respondents, in regard to other groups described in the literature, were characterised by relatively high values in illness acceptance, pain control and expectations for physicians.

Relationships Between Quality of Life in the Psychological Domain, Acceptance of Illness, and Healthcare Services in Patients with Asthma.

Asthma patients should be considered not only in terms of the medical aspects, but also the nonmedical issues associated with the psychological domain, since these are factors that can significantly improve patients' health state, quality of life, and illness acceptance, and can contribute to the reduction of healthcare utilization. The purpose of this study was to assess the acceptance of illness among asthma patients and their quality of life in the psychological domain, as well as to identify factors that influence illness acceptance and quality of life in the psychological domain. We examined 172 patients with asthma (median age: 58; range: 18-89 years) recruited from two pulmonology wards. We demonstrate that the patients with low levels of illness acceptance and a high healthcare service index had low quality of life in the mental domain. Older age; being separated, divorced, or widowed; and having BMI > 25, all significantly affect the levels of quality of life and illness acceptance. In conclusion, measurements of health-related quality of life and illness acceptance are useful for estimating the impact and progression of asthma. These results confirm that psychological functioning should be taken into account alongside the somatic state.

Intimate relationship quality, self-concept and illness acceptance in those with multiple sclerosis.

Lower levels of Intimate Relationship Quality (IRQ) have been found in those with Multiple Sclerosis (MS) compared to the general population. This study examined an MS sample to see whether IRQ was positively associated with self-concept, whether IRQ was positively associated with MS illness acceptance and whether IRQ was predicted by self-concept and illness acceptance. In this cross-sectional study, 115 participants with MS who were in an intimate relationship completed an online survey advertised on MS related websites. The survey assessed demographic variables, MS illness variables and levels of IRQ, self-concept and illness acceptance. Results revealed that IRQ was significantly positively associated with self-concept and with illness acceptance. Multiple hierarchical linear regression analysis revealed that, after controlling for illness duration and level of disability, self-concept significantly predicted IRQ but illness acceptance did not significantly predict IRQ. This study addressed several gaps and methodological flaws in the literature and was the first known to assess predictors of IRQ in those with MS. The results suggest that self-concept could be a potential target for individual and couple psychological interventions to improve IRQ and contribute to improved outcomes for those with MS.

Perceived quality of life and acceptance of illness in people with type 2 diabetes mellitus.

OBJECTIVES: Type 2 diabetes exerts a significant impact on the patient's quality of life. Its chronic nature, incurability and complications weaken the motivation of patients to fight the disease and its acceptance. The aim of research was to determine whether and to what extent diabetes modulates the quality of life of patients and in particular which domain of the patient's life is most limited. In addition, we looked at whether the quality of life perceived by patients is determined by gender and whether and to what extent they accept their illness. MATERIAL AND METHODS: A study on 100 patients with type 2 diabetes from the Wielkopolska region in Poland was carried out at the end of 2013/beginning of 2014 using a diagnostic survey, and the research techniques were a standardized questionnaire - ADDQoL19 (Audit of Diabetes-Dependent Quality of Life 19) and the AIS questionnaire (Acceptance of Illness Scale) developed by Felton and modified by Juczynski. RESULTS: The results suggest that the quality of life of the patients was "neither good nor bad", whereby women perceive it as being lower than men. While analysing the impact of diabetes on the different domains of the lives of men and women, it should be stressed that most affected were diet, satisfying appetite, independence, financial position, feelings about the future, sex life, and freedom in the consumption of drinks. More than half of men and women did not accept their illness; however, younger persons unlike older accepted diabetes to a much greater degree. CONCLUSIONS: Type 2 diabetes negatively affects the quality of life of patients and its impact is felt more by women. In both sexes, the most affected domain of quality of life is the lack of nutritional freedom. The acceptance of illness is dependent upon age.

Health locus of control and symptom distress: The mediating role of illness acceptance and symptom severity in acute leukemia patients.

OBJECTIVE: This study aims to explore the multiple mediating roles of illness acceptance and symptom severity between health locus of control and symptom distress in acute leukemia patients. METHODS: From June 2022 to March 2023, a convenience sampling method was used to recruit 208 acute leukemia patients in the inpatient center of a hospital in Hebei. The Chinese versions of Multidimensional Health Locus of Control Scale, Illness Acceptance Scale, and Anderson Symptom Assessment Scale was used in the cross-sectional study. RESULTS: All participants reported the presence of symptom distress. Symptom distress was significantly correlated with chance health locus of control, illness acceptance, and symptom severity (P＜0.05). Illness acceptance alone played a mediating role in the relationship between chance health locus of control and symptom distress in acute leukemia patients (ß=0.087, 95%CI 0.030-0.167). The indirect role of chance health locus of control on symptom distress through symptom severity alone was also statistically significant (ß=0.131, 95%CI 0.008-0.252). Furthermore, the multiple mediating role of chance health locus of control and symptom distress through illness acceptance and symptom severity combined was verified (ß=0.027, 95%CI 0.001-0.089). The alternative model is also valid, indicating bidirectional relationships between symptom severity, illness acceptance, and chance health locus of control, collectively influencing symptom distress. CONCLUSION: There is a positive relationship between chance health locus of control and symptom distress; additionally, increasing social psychological interventions for illness acceptance and strengthening the management of core symptoms will help alleviate the impact of health chance locus of control on symptom distress in acute leukemia patients. Longitudinal studies are needed to confirm the causal relationships among the variables explored within the model. IMPACT ON NURSING PRACTICE: It is recommended that healthcare professionals pay attention to the assessment of health locus of control in patients, identify patients with health chance locus of control in a timely manner, take measures to enhance their disease acceptance, and strengthen the management of core symptoms, thereby reducing their level of symptom distress.

Illness acceptance degree versus intensity of psychopathological symptoms in patients with psoriasis.

INTRODUCTION: Chronic inflammatory skin diseases such as psoriasis have undoubtedly a negative impact on the patients' quality of life. Many of them may face various limitations in their psychosocial lives because of symptoms indicating the presence of psychopathological phenomena. Mental disorders in patients with skin diseases occur much more frequently than in the general population. Studies show that a considerable percentage (30-60%) of dermatological patients suffers from mental disorders (depressive and anxiety disorders being the most common). A person's attitude towards illness, its acceptance, and also the recognition of its limitations may be of a great importance in the process of the disease control. AIM: To evaluate of the relationship between the illness acceptance degree, and the presence and intensity of psychopathological symptoms in patients with psoriasis. MATERIAL AND METHODS: The research was conducted on a group of 54 people (23 men and 31 women), who were treated for psoriasis in the Department of Dermatology and Venereology, Medical University of Lodz and in the Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz. The following research methods were used: a questionnaire prepared for the purpose of the research, Acceptance of Illness Scale (AIS) and Symptom Checklist (SCL-90). RESULTS: It was found that there was a relationship between the skin illness acceptance degree and intensity of psychopathological symptoms in patients with psoriasis (negative correlations). CONCLUSIONS: The higher the degree of illness acceptance is, the better mental condition of patients with psoriasis is. The intensity of psychopathological symptoms is also affected by the duration of illness, other people's attitude to the skin disease, age and education level of the patients examined.

Total Pain and Illness Acceptance in Pelvic Cancer Patients: Exploring Self-Efficacy and Stress in a Moderated Mediation Model.

Cancer patients experience pain not only in its physical dimension, but also in a broader context that includes psychological, social, and spiritual aspects due to a higher level of anxiety and stress. The present prospective, longitudinal study examined the relationship between total pain and illness acceptance among pelvic cancer patients, taking into consideration the moderated mediation effects of self-efficacy and stress. The study involved a sample of pelvic cancer patients receiving radiotherapy treatment. Assessments were completed at T1 (before radiotherapy), T2 (after 3-4 weeks), and T3 (after radiotherapy) to assess the psychosocial dynamics of illness acceptance (N = 267). The more physical, psychological, social, and spiritual pain symptoms the patients experienced, the less they accepted negative health conditions and the effects of their illness. Stress moderated the indirect effect between total pain dimensions and illness acceptance through self-efficacy, but it did not moderate the relationship between total pain and illness acceptance. The relationships between total pain dimensions and illness acceptance thus depend on both the mediating effect of self-efficacy and the moderating effect of stress. This highlights the need to control one's motivation and behavior and manage emotional strain or tension.

The Impact of Stress-Coping Strategies and the Severity of Psoriasis on Self-Esteem, Illness Acceptance and Life Satisfaction.

INTRODUCTION: The visibility of skin lesions is a significant burden for patients with psoriasis, who experience social hostility as well as many emotional and psychological problems. The recurrent nature of cutaneous manifestations and their location are also a source of emotional distress, which in turn is one of the main factors that intensifies skin lesions in these patients. The aim of the study was to assess the impact of the severity of psoriasis and stress-coping strategies on general psychometric measures in the affected patients. METHODS: The study used a short demographic questionnaire, Psoriasis Area and Severity Index (PASI), and four standardised general psychometric tools: Rosenberg Self-Esteem Scale (SES), Satisfaction With Life Scale (SWLS), Coping Inventory for Stressful Situations (CISS) and Acceptance of Illness Scale (AIS). A total of 111 patients participated in the study. RESULTS: The mean PASI score was 14.0 (12.1-15.9). The mean SWLS score was below average, i.e., 18.5 (17.3-19.7), and the SES score-26.8 points (26.1-27.5)-indicated self-esteem slightly above average among patients with psoriasis. The mean stress-coping level measured with CISS was 53.6 (51.9-55.2) for the task-oriented strategy (TOS), 46.2 (43.8-48.6) for the emotion-oriented strategy (EOS) and 50.1 (48.5-51.8) for the avoidance-oriented strategy (AOS). Higher PASI was associated with lower illness acceptance among men (r = 0.48) and lower self-esteem among women (r = 0.44). The level of life satisfaction was lower in respondents with higher PASI scores (mainly in the group of women, r = 0.44). CONCLUSIONS: Higher severity of psoriasis (PASI) and greater frequency of emotion-oriented stress-coping mechanisms (CISS) are factors that negatively affect the overall psychophysical condition of respondents.

Predictors of illness acceptance in women with endometriosis.

BACKGROUND: The study aimed to identify significant predictors of illness acceptance in women with endometriosis. As potential predictive factors, variables related to the disease (pain frequency, co-morbid infertility, diagnostic delay, years of living with the diagnosis), demographic variables (age, place of residence, education, income, the fact of having children) and psychological variables (pain coping strategies) were taken into account. PARTICIPANTS AND PROCEDURE: The study participants - 247 women with endometriosis - were recruited in Poland in medical facilities from 6 large voivodship cities and through a patients' association. The participants filled in the following questionnaires: the Acceptance of Illness Scale (AIS), Endometriosis Health Profile-30 (EHP-30), and the Coping Strategies Questionnaire (CSQ). The data were analysed with the method of stepwise hierarchical regression. RESULTS: The final significant model explained 24% of the variance of the AIS score. The model consisted of the following variables: pain frequency, reinterpreting pain sensations, pain catastrophizing and praying/hoping. Only two variables were significant predictors in this model: pain frequency and pain catastrophizing. Years with diagnosis, age, diagnostic delay, place of residence, education, income, and the fact of having children were not significant. CONCLUSIONS: The interventions addressed to patients should support their acceptance of chronic pain and help them to develop adaptive pain coping strategies. Due to the co-morbidity of endometriosis-related pain and depression the inclusion of antidepressant pharmacotherapy and psychotherapy based on cognitive techniques is recommended.