When is ignorance bliss? The effects of knowledge on quality of life among socioeconomically disadvantaged cancer patients

Heidi Allison Greger, Purdue University

Abstract

Cancer patients differ in their ability and willingness to "hear" about their illness. The fear that bad news or full disclosure of unpleasant information destroys hope in patients, and therefore impedes coping, is a very real one among physicians. Using a stress, appraisal, and coping framework, this research examined cancer as an illness stressor in order to determine how cancer patients' knowledge of their disease operates as a coping strategy and, moreover, how this particular coping strategy affects patients' quality of life. Is it preferable to be knowledgeable about one's illness? Or are there conditions under which ignorance contributes to a higher quality of life among cancer patients? The specific conditions examined in this study were individuals' perceived control over their illness and the duration of the disease. Interviews were conducted with 113 cancer patients from a socioeconomically disadvantaged background. Patients were primarily elderly, black women. The findings of the study offer limited support for the theoretical framework applied to these data. Results of the analysis did not support the premise that coping is a determinant of adaptation. Knowledge (or lack thereof) was not found to be associated with patients' quality of life. Control, however, was found to be significantly, though negatively, related to quality of life, opposite to what had been hypothesized. Control was also found to be positively related to knowledge, as hypothesized. Duration of the illness was not associated with either coping strategy or adaptation. An interesting and unexpected finding in this sample was that two types of knowledge were operative: knowledge that patients had about themselves and their cancer experience (e.g., knowing where their cancer started) and knowledge that patients had about cancer in a more general sense (e.g., knowing whether smoking causes cancer). Results indicated that these two types of knowledge were inversely related to one another. A possible explanation for this relationship is that when patients, because they are knowledgeable about cancer in general, recognize that they may be implicated in the cause of their own cancer, they are less able to deal with knowledge about cancer as it relates to themselves. These findings regarding how cancer patients use knowledge as a coping strategy are suggestive of the fruitfulness of extending the approach taken in the present study to include an investigation of causal attributions of cancer among cancer patients.

Degree

Ph.D.

Advisors

Stahl, Purdue University.

Subject Area

Sociology

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