After my dad had talked to me about getting a cataract surgery, I became interested in the psychology behind medical avoidance, especially related to chronic conditions.
“Fear of progression in chronic illnesses other than cancer: a systematic review and meta-analysis of a transdiagnostic construct” Excerpt
“Within psycho-oncology, fear of progression (FoP) is subsumed under the umbrella of FCR, according to the consensus definition most commonly used, whereby FCR refers to the ‘fear, worry or concern about cancer returning or progressing’ (Lebel et al.). There are many other chronic illnesses in which it is well documented that patients fear a recurrence or the progression of their illness. For example, people who have had a heart attack fear another attack (Eifert 1992), people with diabetes fear complications and long-term consequences of the disease (Zettler et al. 1995) and people with Multiple Sclerosis (MS) fear relapse and progression of their symptoms (Khatibi et al. 2020).
However, participants with other illnesses voiced more concerns over the impact of their illness on their family than have been documented in the FCR literature. This was particularly the case for those with illnesses where serious cognitive and physical impairment were possible. Fears of progression or recurrence were also triggered by social comparisons, which were in the context of this study, negative downward comparisons to others with the same illness whose function had been more compromised and was a stark reminder of what could happen, should recurrence or progression occur.
Both vigilance and avoidance have been noted to be related to FCR (Heathcote & Eccleston), and both acceptance and seeking knowledge have been theorised to be helpful in relation to FCR (Fardell et al.). Interestingly, adherence was seen to be related to knowledge seeking, as well as the mental burden of illness. That is, it seemed that adherence could be engaged in as a coping strategy for managing either the actual health threat or the fear associated with the threat.
Hence, our meta-synthesis suggests that people with chronic illness also report that knowledge is helpful in allowing patients to be able to adhere to treatment and feel that there are things that they can do to control their health and mitigate against risks of recurrence, where possible.” (Sharpe et. al. 2021).
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REVIEW
I became interested in the topic when my dad revealed to me that he needed cataract surgery. He told me he was scared, and did not want to schedule the appointment. I was perplexed by this because they needed to remove his cataract in order to find out if his nerve was damaged which would lead to blindness that could not be cured. I assumed that this had something to do with how he received information about the surgery, but now I am realizing that he was avoiding care, likely to avoid learning that he could have a chronic condition. This avoidance trait is interesting to me and this article discusses how it shows up in conditions other than just cancer related conditions. It also talks about how acceptance of the problem and knowledge is important in mitigating anxiety responses. This is valid towards my capstone, because the climate is such a big topic, we as humans sometimes avoid thinking about it in order to lessen anxiety. I could use the methods talked about in this article related to fighting against chronic illness healthcare avoidance into my project. It’s an unexpected relationship that I can use further.
REFERENCES
Sharpe, L., Michalowski, M., Richmond, B., Menzies, R. E., & Shaw, J. (2022). Fear of progression in chronic illnesses other than cancer: a systematic review and meta-analysis of a transdiagnostic construct. Health Psychology Review, 17(2), 301–320. https://doi.org/10.1080/17437199.2022.2039744
