Epistemic Beliefs: Relationship to Future Expectancies and Quality of Life in Cancer Patients.

Authors

• Paul K J Han, Center for Outcomes Research and Evaluation, Maine Medical Center (P.K.J.H., E.S., E.A., J.D., C.G., F.L.L.), Portland, Maine; Tufts University School of Medicine (P.K.J.H., E.A., T.D.S., F.L.L.), Boston, Massachusetts. Electronic address: paul.han@nih.gov.Follow
• Elizabeth Scharnetzki, Center for Outcomes Research and Evaluation, Maine Medical Center (P.K.J.H., E.S., E.A., J.D., C.G., F.L.L.), Portland, Maine.Follow
• Eric Anderson, Center for Outcomes Research and Evaluation, Maine Medical Center (P.K.J.H., E.S., E.A., J.D., C.G., F.L.L.), Portland, Maine; Tufts University School of Medicine (P.K.J.H., E.A., T.D.S., F.L.L.), Boston, Massachusetts.Follow
• John DiPalazzo, Center for Outcomes Research and Evaluation, Maine Medical Center (P.K.J.H., E.S., E.A., J.D., C.G., F.L.L.), Portland, Maine.Follow
• Tania D Strout, Tufts University School of Medicine (P.K.J.H., E.A., T.D.S., F.L.L.), Boston, Massachusetts; Department of Emergency Medicine, Maine Medical Center (T.D.S.), Portland, Maine.Follow
• Caitlin Gutheil, Center for Outcomes Research and Evaluation, Maine Medical Center (P.K.J.H., E.S., E.A., J.D., C.G., F.L.L.), Portland, Maine
• F Lee Lucas, Center for Outcomes Research and Evaluation, Maine Medical Center (P.K.J.H., E.S., E.A., J.D., C.G., F.L.L.), Portland, Maine; Tufts University School of Medicine (P.K.J.H., E.A., T.D.S., F.L.L.), Boston, Massachusetts.
• Emily Edelman, The Jackson Laboratory (E.E., J.R.), Bar Harbor, Maine.
• Jens Rueter, The Jackson Laboratory (E.E., J.R.), Bar Harbor, Maine.

Document Type

Article

Publication Date

4-1-2022

Institution/Department

CORE; Center for Outcomes Research and Evaluation

Journal Title

Journal of pain and symptom management

MeSH Headings

Adaptation, Psychological, Humans, Knowledge, Neoplasms, Quality of Life, Regression Analysis

Abstract

CONTEXT: Expectations about the future (future expectancies) are important determinants of psychological well-being among cancer patients, but the strategies patients use to maintain positive and cope with negative expectancies are incompletely understood.

OBJECTIVES: To obtain preliminary evidence on the potential role of one strategy for managing future expectancies: the adoption of "epistemic beliefs" in fundamental limits to medical knowledge.

METHODS: A sample of 1307 primarily advanced-stage cancer patients participating in a genomic tumor testing study in community oncology practices completed measures of epistemic beliefs, positive future expectancies, and mental and physical health-related quality of life (HRQOL). Descriptive and linear regression analyses were conducted to assess the relationships between these factors and test two hypotheses: 1) epistemic beliefs affirming fundamental limits to medical knowledge ("fallibilistic epistemic beliefs") are associated with positive future expectancies and mental HRQOL, and 2) positive future expectancies mediate this association.

RESULTS: Participants reported relatively high beliefs in limits to medical knowledge (M = 2.94, s.d.=.67) and positive future expectancies (M = 3.01, s.d.=.62) (range 0-4), and relatively low mental and physical HRQOL. Consistent with hypotheses, fallibilistic epistemic beliefs were associated with positive future expectancies (b = 0.11, SE=.03, P< 0.001) and greater mental HRQOL (b = 0.99, SE=.34, P = 0.004); positive expectancies also mediated the association between epistemic beliefs and mental HRQOL (Sobel Z=4.27, P<0.001).

CONCLUSIONS: Epistemic beliefs in limits to medical knowledge are associated with positive future expectancies and greater mental HRQOL; positive expectancies mediate the association between epistemic beliefs and HRQOL. More research is needed to confirm these relationships and elucidate their causal mechanisms.

ISSN

1873-6513

First Page

512

Last Page

521

Recommended Citation

Han PKJ, Scharnetzki E, Anderson E, et al. Epistemic Beliefs: Relationship to Future Expectancies and Quality of Life in Cancer Patients. J Pain Symptom Manage. 2022;63(4):512-521. doi:10.1016/j.jpainsymman.2021.12.017