Illness representations, coping and outcome in prostate disease : an exploratory study

The aims of the study were, to investigate and compare the illness representations of men with prostate cancer or benign prostatic hyperplasia (BPH) and to explore their relationship to coping and outcome. The study employed a correlational cross-sectional design. Seventeen men with prostate cancer and nineteen men with BPH completed the Illness Perception Questionnaire (IPQ), COPE short-form and three outcome measures. There were no significant differences between the two groups on any of the measures. With regard to illness representations, both groups saw their condition as chronic, caused by chance, with few consequences and with little chance of cure/control. Perception of a strong illness identity, in the cancer group, was associated with higher levels of depression and symptom score. In the BPH group, identify was associated with a greater perceived intrusiveness of the condition and with less satisfaction. A belief in greater consequences was also related to a perception of greater intrusiveness, by men with BPH. Coping strategies demonstrated only one significant relationship with outcome in each group, with behavioural disengagement and denial being associated with a higher symptom score in the cancer and BPH groups respectively. Regression analyses indicated that overall the illness representation dimensions of identity and consequences were stronger predictors of outcome than coping. Thus these dimensions of illness representations seem to play a role in outcome for both prostate cancer and BPH. The clinical and theoretical implications of these findings are discussed. Limitations of the present study are acknowledge and ideas for future research are presented.