Is avoidance of illness uncertainty associated with distress during oncology treatment? A daily diary study

Abstract

Objective: The aim of this study was to explore the daily relationship between illness uncertainty, avoidance of uncertainty, well-being and treatment-related distress among patients with cancer receiving treatment with curative intent. It was hypothesised that daily illness uncertainty, daily avoidance of uncertainty and daily treatment-related distress would be negatively associated with daily well-being. It was also hypothesised that daily illness uncertainty and daily avoidance of uncertainty would be positively associated with daily treatment-related distress.

Design: Thirty-one patients receiving oncology treatment with curative intent completed a daily diary for seven consecutive days. Data were analysed using multilevel modelling.

Main outcome measures: Daily illness uncertainty, avoidance of illness uncertainty, treatment-related distress and well-being.

Results: As hypothesised, on days when patients with cancer reported heightened treatment-related distress they experienced diminished well-being. And on days when patients reported more experiential avoidance of illness uncertainty, they also experienced heightened levels of treatment-related distress. No other daily associations were significant.

Conclusion: These findings indicate that patients with cancer experience day-to-day fluctuations in distress and well-being throughout oncology treatment. Avoidance of illness uncertainty-related thoughts and/or emotions are associated with daily distress, but not daily well-being.

Keywords:

• Cancer
• oncology treatment
• uncertainty
• experiential avoidance
• within-person
• idiographic

Acknowledgements

The authors thank all participants who completed this study. And they thank Jo Tuaine and Dr Lyndell Kelly at Dunedin Hospital for their support during the recruitment process.

Compliance with ethical standards

This study received the appropriate ethical and locality approvals.

Disclosure statement

The authors declared no potential conflict of interests with respect to the research, authorship and/or publication of this article.