Illness representations, coping, and illness outcomes in people with cancer: systematic review and meta-analysis

Background: Cancer is a leading cause of illness burden,with people with cancer at high risk for negative health and coping outcomes. The Common Sense Model (CSM) has been employed widely to understand individual responses to cancer. However, research is disparate, and a systematic review examining the associations of the CSM’s illness representation dimensions with health and coping outcomes in people with cancer, had not yet been conducted.

Methods: A systematic literature search identified 51 relevant studies,with 36 providing sufficient data for meta-analysis. A narrative review of remaining studies was conducted.

Findings: Random-effects meta-analysis revealed, for example, small to moderate effects (Fischer’s Z= .267 - .287) between personal control, problem-focused coping, and cognitive reappraisal, and moderate to large effects (Z= .355 - .731) between identity, consequences, emotional representations, and distress.

Discussion: This first systematic review and meta-analysis indicates how illness representations relate to illness outcomes in people with cancer.High heterogeneity suggests potential moderators of the relationships between illness representations and health and coping outcomes, including diagnostic, prognostic, and treatment related variables.