Meaning in illness, patient satisfaction with care, use of care, and health outcomes with cancer survivors

Article 1 Objective: With growing number of cancer survivors in the United States by virtue of early detection and effective medical interventions, their post-treatment health has become an important aspect of care. Patients’ perception of meaning of cancer has been identified as an influential factor to health. However, due to lack of clear definition of meaning of illness, understanding its effect on health has been challenging. This study aimed to examine relationships between illness-specific and benefit-finding meaning and physical and psychological health with post-treatment cancer survivors. Methods: Illness-specific meaning was measured by the Constructed Meaning Scale; and benefit-finding meaning by five items. Physical health consisted of 14 concerns; psychological health of eight concerns. Sample was consisted of 3,541 cancer survivors with various types of cancer. Structural equation modeling was used for analysis. Results: Positive illness-specific meaning significantly affected both better physical and psychological health; whereas higher benefit-finding meaning significantly affected both health outcomes negatively. Socio-demographic and cancer-related factors were identified regarding two types of meaning of illness and health outcomes. Conclusions: This study identified opposite effects of meaning of illness on health outcomes depending on types of meaning. Its results also showed a clear connection between meaning of illness and both physical and psychological health; which suggested the importance for medical and mental health providers to be aware of when treating cancer survivors. Healthcare providers need to feel comfortable addressing meaning of illness issues with their patients as part of their post-treatment care. Article 2 Objective: With early detection and effective medical interventions, the number of cancer survivors in the US is rapidly growing. Therefore, more attention should be paid to cancer survivors’ health after treatment and factors that affect their health. This study examined patient satisfaction and use of care as factors of better health outcomes under the biopsychosocial framework. Methods: This study employed structural equation modeling to examine the relation between patient satisfaction with care and use of care (medical, mental, and social care) and health outcome (physical and psychological health) among a sample of 3,541 survivors with various types of cancer. Results: Higher patient satisfaction with care showed a significant positive relation with less physical and psychological concerns, however more use of care showed mixed findings in relation to health. More use of social care was related to less physical concerns; but more use of medical care was associated with more physical concerns; and more use of all three types of care were related to more psychological concerns. Significant socio-demographic and cancer-related factors were identified regarding patient satisfaction and use of care.
Conclusion: Findings supported the biopsychosocial framework by showing interrelations among medical, psychological, and social factors in cancer care. This study also suggested the importance of survivors’ perception of care on health and psychological and social interventions for physical health.