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Worry and the Formation of Cognitive Representations of Illness in Individuals Undergoing Surgery for Suspected Lung Cancer

Lehto, Rebecca H. PhD, RN, OCN; Cimprich, Bernadine PhD, RN, FAAN

doi: 10.1097/01.NCC.0000343363.75752.f1
Articles

Worry involving repetitive thoughts about threats and concerns is prevalent when confronted with a life-threatening illness such as cancer. Worry may contribute to the formation of negative cognitive representations of illness that can have a detrimental effect on behavioral and adaptive outcomes. The study examined for the first time (a) the relationship between worry and early formation of cognitive representations of illness in individuals with suspected lung cancer over the presurgical and postsurgical period and (b) associations between worry and anxiety, sex, age, and educational level. Correlational statistical analyses were used to assess worry and cognitive representations in 42 individuals before lung surgery and again 3 weeks postsurgery. Higher worry was significantly related to more threatening content in multiple illness domains. Repeated-measures analysis of variance using high- and low-worry strata showed significant interactions between worry and time on certain illness domains indicating that high worry was associated with increased threat and negative contents in cognitive representations of illness over time. Multiple regression analyses showed that trait anxiety was the only significant predictor of worry in a regression model including age, sex, education, and anxiety before surgery. Findings suggest that higher worry at time of diagnosis is associated with the development of negative and more threatening contents in cognitive representations of illness in individuals with suspected lung cancer.

Authors' Affiliations: College of Nursing, Michigan State University, East Lansing (Dr Lehto); University of Michigan School of Nursing, Ann Arbor (Dr Cimprich).

This study was supported by Neuroscience/Neurobehavior Nursing Research Training Grant (T32 NR007074, National Institute of Health, National Institute of Nursing Research); Worry and Illness Representations in Cancer Patients, (F31 NR007695, National Institute of Health, National Institute of Nursing Research).

Corresponding author: Rebecca H. Lehto, PhD, RN, OCN, College of Nursing, Michigan State University, W138 Owen Graduate Hall, East Lansing, MI 48825-1109 (rebecca.lehto@hc.msu.edu).

Accepted for publication February 20, 2008.

© 2009 Lippincott Williams & Wilkins, Inc.