Illness perceptions, coping and psychological distress. The lived experience of non muscle invasive bladder cancer: a mixed methods approach

A diagnosis of cancer and its subsequent treatment can have a significant impact on an person’s mental wellbeing. The way patients perceive and cope with their illness can help to understand emotional distress. Using the Self -Regulation Model of Common Sense Illness Representations (SRM) as a theoretical framework, this thesis aimed to 1) examine the ability of illness perceptions and coping to predict psychological distress in non-muscle invasive bladder cancer (NMIBC) patients’ on surveillance and 2) achieve insight into the lived experiences of NMIBC. A mixed-methods research design was utilised which assessed illness perceptions, coping and psychological distress in (N = 84) participants. Semi-structured interviews were carried out with a subset (N = 10) of the sample. All interviews were recorded and transcribed verbatim. Hierarchical regression analyses revealed that illness perceptions and avoidant coping predicted 20.5% of the variance in depression and 54.7% in anxiety. Stronger perceptions of Timeline, Emotional Representations and avoidant coping were found to be the key predictors of emotional distress. Interview data were analysed using Interpretative Phenomenological Analysis (IPA) which generated three super-ordinate themes. These comprised of: Making Sense of NMIBC, The Dynamic Nature of Illness Perceptions and Coping. This is the first study to date that utilised the SRM to examine illness perceptions, coping and psychological distress in NMIBC patients on surveillance, and the first to include a qualitative component to examine the full SRM in the context of NMIBC. The quantitative and qualitative findings are integrated and presented in the context of the extant literature.