Illness perceptions, coping, and quality of life in vestibular schwannoma patients at diagnosis

Abstract

Objective: To evaluate illness perceptions, coping behavior, and quality of life (QOL) in patients with vestibular schwannoma (VS) at diagnosis.

Study design: Prospective patient analysis.

Setting: University Teaching Hospital, tertiary care clinic.

Patients: Consecutive patients with VS (n = 80) completed a set of questionnaires at diagnosis to assess psychological characteristics and QOL.

Intervention: Diagnostic and rehabilitative.

Main outcome measures: Psychological characteristics and QOL, measured via questionnaires focusing on illness perceptions (Illness Perception Questionnaire Revised), coping (Utrecht Coping List), and QOL (Medical Outcomes Study 36-Item Short Form Health Survey), were compared with normative data for the general Dutch population and to data concerning patients with other illnesses.

Results: The 36-Item Short Form Health Survey scores of VS patients at diagnosis were significantly decreased when compared with healthy controls, patients with head and neck cancer, benign prostate hypertrophy, chronic obstructive pulmonary disease, and deaf patients. Scores for illness perceptions were in between those of patients with acute pain and chronic pain for most subscales except illness identity, emotional representations, and illness coherence. In their coping behavior, VS patients scored lower on the subscale active coping, sought less social support, and expressed their emotions less, but also showed less passive coping compared with reference values.

Conclusion: Vestibular schwannoma patients experience impaired QOL compared with healthy controls and reference groups. Their illness perceptions are in between those of patients with acute and chronic pain, and their coping behavior is less active in general. This may have implications for clinical decision making and for optimizing interaction with patients. Changing illness perceptions and coping by means of an intervention and encouraging social support by means of patient support groups may improve QOL in VS patients.