Perceived Control Mediates the Prospective Impact of Relationship Quality in the Year After Colorectal Cancer Diagnosis
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ORIGINAL ARTICLE
Perceived Control Mediates the Prospective Impact of Relationship Quality in the Year After Colorectal Cancer Diagnosis Wai Kai Hou, Ph.D. & Jacky Ho Yin Wan, BSc
Published online: 27 August 2011 # The Society of Behavioral Medicine 2011
Abstract Background Negative cancer-related intrusive thoughts reduce the benefit of relationship quality on the psychological adjustment of cancer patients. Little is known about the role of perceived control over cancer-related problems in the association between relationship quality and adjustment. Purpose This study examined whether perceived personal control (i.e., on one’s own) and collective control (i.e., collaboration with family/friends) mediate the associations between relationship quality and psychological outcomes. Methods Chinese colorectal cancer patients (n=234) were assessed at diagnosis (T1) and at 3- (T2) and 12-month (T3) follow-ups. Results T2 collective control mediated the association between T1 family relationship quality and T3 satisfaction with life. The negative association between T1 family relationship quality and T3 depression was independent of T2 personal/collective control. Conclusions Collective control mediates the relationship between family relationship quality and satisfaction with life, suggesting the need for interventions to enhance relationship quality and perceived control among newly diagnosed cancer patients.
W. K. Hou (*) Department of Psychological Studies, The Hong Kong Institute of Education, 10 Lo Ping Road, Tai Po, NT, Hong Kong e-mail: [email protected] J. H. Y. Wan Department of Psychology, The University of Hong Kong, Hong Kong, Hong Kong
Keywords Chinese . Colorectal cancer . Relationship quality . Perceived control over cancer-related problems . Mediational model
Introduction Similar to traumatic events like natural disasters and terrorist attacks, cancer as a life-threatening disease challenges patients’ ‘world assumptions’—a set of fundamental beliefs that are learned from life experiences about themselves, their relationships with others, and their future—that are persistent in ordinary circumstances but susceptible to change in the face of stressful events [1–3]. It is the discrepancy between the world assumptions and the meanings inherent in cancer experience that leads to psychological distress [4]. To resolve the discrepancy, accommodation and assimilation of the cancer-related experiences into the ordinary belief system are needed [5, 6]. Complete integration of the cancer experience is indicated by regaining a sense of self-worth, predictability, or control, whereas incomplete integration is manifested into recurrent negative cancer-related intrusive thoughts [1–3]. The Social-Cognitive Processing Model [2, 7] was developed to address specifically the influence of social relationships on cognitive adjustment of cancer patients. The model asserts that a supportive social environment is essential for integration of the cancer-related information into existing mental models, resulting in positive psyc
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