Quality of life following cancer treatment: impact of illness perceptions, distress, fatigue, and cognitive failures

Abstract

Background We describe the interplay between several psycho-emotional factors leading to a lower quality of life (QoL) in cancer survivors. The Antecedent-Beliefs-Consequences framework of cognitive behavioural therapy facilitated understanding the association between illness perceptions (IPs), distress, fatigue, cognitive failures, and QoL. Methods Through a cross-sectional design, cancer survivors (n=57) were compared to matched controls on IPs, distress, fatigue, cognitive failures, and QoL. Patients were on average 2.7 years following treatment for lymphoma, breast cancer, germ cell tumours, and sarcoma. Findings All factors differed between groups. QoL was influenced by the perception of symptoms and illness duration (27.1%), distress and fatigue (29.7%), and cognitive failures (5.6%). Anxiety mediated 95% of the impact of IPs on cognitive failures; cognitive failures mediated 45% of the impact of anxiety on QoL; depression mediated 65% of the impact of IPs on QoL. Discussion Negative IPs led to mood changes, which triggered cognitive failures, influencing patients’ QoL. Discussing patients’ perception of the duration and number of post-treatment symptoms may improve their QoL. However, longitudinal monitoring is warranted to explain whether these variables may be causally related.