Coping as mediators of illness representations in the common sense model: a meta-analysis

Abstract

Background: We tested a process model based on Leventhal et al.’s (1980) common-sense model in which the effects of illness representations on illness-related outcomes are mediated by coping strategies. The model reflects the generalized hypothesis that individuals who represent an illness as sufficiently threating engage in coping procedures to manage the threat perceptions and coping procedures will likely affect illness outcomes including functioning and disease status. Method: We conducted a database search of studies testing relations among illness representation dimensions, coping strategies, and illness outcomes from patient groups with chronic conditions or illnesses based on the common sense model. We then used meta-analytic techniques to derive corrected effect sizes among the three sets of variables than constitute the process model. Results: Path analytic models based on the meta-analysed correlations yielded theoretically predictable patterns of effects among the representation, coping, and outcome variables. Importantly, there were significant indirect effects of representation dimensions on illness outcomes mediated by coping strategies. Discussion: Results provide the first synthesised test of the key mechanism by which representations impact illness outcomes.