Reducing perceptions of illness intrusiveness may improve quality of life and mental health among patients with cardiopulmonary disease. To better understand relationships between coping style, locus of control, perceived illness intrusiveness, and disease severity, we analyzed data from 227 older Veterans with chronic obstructive pulmonary disease or congestive heart failure. Regressions revealed illness intrusiveness to be associated with younger age and greater disease severity, less internal locus of control, and avoidant/emotion-focused coping. Avoidant/emotion-focused coping but not active coping mediated the relationship between illness severity and illness intrusiveness. Findings suggest that supportive psychological interventions may reduce illness intrusiveness by targeting an avoidant/emotion-focused coping style and associated behaviors.
ArrarasJIWrightSJJusueG. (2002) Coping style, locus of control, psychological distress and pain-related behaviours in cancer and other diseases. Psychology, Health & Medicine7: 181–187.
2.
BaronRMKennyDA (1986) The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology51: 1173–1182.
3.
BennettJARiegelBBittnerV. (2002) Validity and reliability of the NYHA classes for measuring research outcomes in patients with cardiac disease. Heart and Lung: The Journal of Acute and Critical Care31(4): 262–270.
4.
BollenKAStineR (1990) Direct and indirect effects: Classical and bootstrap estimates of variability. Sociological Methodology20: 115–140.
5.
CarverCS (1997) You want to measure coping but your protocol’s too long: Consider the Brief COPE. International Journal of Behavioral Medicine4: 92–100.
6.
CoultasDFrederickJBarnettB. (2005) A randomized trial of two types of nurse-assisted home care for patients with COPD. Chest128: 2017–2024.
7.
CullyJA. (2012) Brief cognitive behavioral therapy in primary care: A hybrid type 2 patient randomized effectiveness-implementation design. Implementation Science7: 64.
8.
DanceyCPFriendJ (2008) Symptoms, impairment and illness intrusiveness: Their relationship with depression in women with CFS/ME. Psychology & Health23(8): 983–999.
9.
DevinsGM (2010) Using the Illness Intrusiveness Ratings Scale to understand health-related quality of life in chronic disease. Journal of Psychosomatic Research68(6): 591–602.
10.
DevinsGMMandinHHonsRB. (1990) Illness intrusiveness and quality of life in end-stage renal disease: Comparison and stability across treatment modalities. Health Psychology9(2): 117–142.
11.
EdworthySMDobkinPLClarkeAE. (2003) Group psychotherapy reduces illness intrusiveness in systemic lupus erythematosus. Journal of Rheumatology30: 1011–1016.
12.
FletcherCMElmesPCFairburnMB. (1959) The significance of respiratory symptoms and the diagnosis of chronic bronchitis in a working population. British Medical Journal2(5147): 257–266.
13.
GibsonKRuedaSRourkeSB. (2011) Mastery and coping moderate the negative effect of acute and chronic stressors on mental health-related quality of life in HIV. AIDS Patient Care and STDS25(6): 371–381.
14.
GoudsmitEMStoutenBHowesS (2009) Illness intrusiveness in myalgic encephalomyelitis: An exploratory study. Journal of Health Psychology14: 215–221.
15.
HayesAF (2012) PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling. Available at: http://www.afhayes.com/public/process2012.pdf
16.
JiaHUpholdCRWuS. (2004) Health-related quality of life among men with HIV infection: Effects of social support, coping, and depression. AIDS Patient Care and STDS18: 594–603.
17.
KraemerHCWilsonTFairburnCG. (2002) Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry59: 877–883.
18.
LorigKRRitterPLLaurentDD. (2006) Internet-based chronic disease self-management: A randomized trial. Medical Care44: 964–971.
19.
MacKinnonDPLockwoodCMHoffmanJM. (2002) A comparison of methods to test mediation and other intervening variable effects. Psychological Methods7: 83–104.
20.
MahlerDAWellsCK (1988) Evaluation of clinical methods for rating dyspnea. Chest93: 580–586.
21.
MullinsLLChaneyJMBaldersonB. (2000) The relationship of illness uncertainty, illness intrusiveness, and asthma severity to depression in young adults with long-standing asthma. International Journal of Rehabilitation and Health5: 177–186.
22.
MyaskovskyLDewMASwitzerGE. (2003) Avoidant coping with health problems is related to poorer quality of life among lung transplant candidates. Progress in Transplantation13(3): 183–192.
23.
New York Heart Association (NYHA) (1964) Diseases of the Heart and Blood Vessels: Nomenclature and Criteria for Diagnosis (6th edn). Boston, MA: Little, Brown and Co.
24.
PaukertALLeMaireACullyJA (2009) Predictors of depressive symptoms in older veterans with heart failure: The impact of treatment transitions between dialysis and transplantation on illness cognitions and quality of life—A prospective study. Aging and Mental Health13(4): 601–610.
25.
RoeschSCWeinerB (2001) A meta-analytic review of coping with illness: Do casual attributions matter?Journal of Psychosomatic Research50(4): 205–219.
26.
RutledgeTReisVALinkeSE. (2006) Depression in heart failure: A meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. Journal of American College of Cardiology48: 1527–1537.
27.
SpitzerRLWilliamsJBKroenkeK. (1994) Utility of a new procedure for diagnosing mental disorders in primary care: The PRIME-MD 1000 study. JAMA272(22): 1749–1756.
28.
TamburrinoMBLynchDJNagelRW. (2009) Primary Care Evaluation of Mental Disorders (PRIME-MD) screening for minor depressive disorder in primary care. Primary Care Companion to the Journal of Clinical Psychiatry11(6): 339–343.
29.
WallstonKASteinMJSmithKA (1994) Form C of the MHLC Scales: A condition-specific measure of locus of control. Journal of Personality Assessment63: 534–553.
