Optimism and taking control



The Doc writes:

There is accumulating scientific research that recovering from treatment for cancer and other serious illnesses can be helped by an optimistic approach and taking control of the things you can do something about, such as healthy eating, physical activity, alcohol use and smoking. Recent reports suggest that changes in these health practices are common, with 40-50% of cancer survivors reporting positive changes in diet, and about 20% reporting increased physical activity.

Two psychological theories explain how this may work.

The first theory is around the role of optimism in people’s recovery from illness and disease. Examining a possible relationship between patient outlooks and cancer treatment outcomes is a relatively new area of investigation, and these studies have yielded mixed results. Some suggest that having a pessimistic personality before receiving a cancer diagnosis might be predictive of treatment outcomes while others have not found such an association. Research investigating the role of optimism in women undergoing treatment for breast cancer has repeatedly found that optimistic people experience less distress and fatigue, and a better quality of life. Optimism also appears to protect against an urge to withdraw from social activities, and improve sleep quality, both important for the promotion of healing. A recent study focussing on lung cancer patients also discovered that those who exhibited an optimistic disposition experienced more favourable outcomes than those with a pessimistic disposition.

The second theory is the Common Sense Model of Illness Representation (or Self-Regulation theory) which was initially defined in the 1960s by Leventhal and colleagues [1]. The key component of this model focuses on ‘common-sense’ or lay beliefs about illness that help individuals to make sense of their illness and, in turn, direct coping efforts. The model suggests that people develop an understanding of their illness or diagnosis by formulating their own ideas about the illness, its causes, its consequences, how long it will last, and whether it can be cured or controlled. These ‘common-sense’ beliefs influence how people cope with, and take control of, their illness.

Research across a number of illnesses including cancer has demonstrated the relationship between illness representations, coping and outcome. Better outcomes tend to occur in people who believe they have stronger control over their illness, less of an emotional response, and consider that the illness will have fewer consequences on their life.

Patients who perceive cancer causes to be controllable are also more likely to engage in positive health practices. For example, breast cancer survivors who attributed their cancer to their diet, lack of exercise or alcohol use, were more likely to make positive changes in these behaviours [2]. In a similar way, cancer survivors who believed that good health practices are important in preventing recurrence are more likely to engage in them [3].
More research needs to be undertaken in this area to understand how these findings can be translated into ways to help people take control and sustain their optimism during their recovery from serious illness.

[1] Leventhal, Meyer & Nerenz, 1980
[2] Rabin & Pinto, 2006.
[3] Costanzo, Lutgendorf, Bradley, Rose, Anderson, 2005.

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