The Influencing Factors on Self-Rated Health in Korean Patients With Colorectal Cancer

Patients with cancer want accurate and proper information to cope with situations with cancer. Fundamental treatment principle is colectomy for colorectal cancer, and the patients want information about treatment plan, prognosis, physical and psychological changes owing to colostomy, which is a main factor rising information needs. Information seeking behavior has related to better physical ability and emotional support in patients. Specially, information seeking for patients with cancer, is related to self-care, and coping ability after diagnosis and treatment, and has positive effect on self-rated health (SRH) and improving health behaviors. Information seeking behavior for patients with colon cancer, but, is not well known, and their level was lower than one for patients with breast cancer or with prostatic cancer. Health locus of control (HCL) is perceived ability or ability controlling health to cope surrounding situations between one’s behavior and outcome. Internal health locus of control (IHLC) is belief that one’s behavior determine health, as subcategory of HCL. IHLC, especially, positive effect on health, and has negative relationship with stress, anxiety, and depression, and positive relationship with quality of life. The high IHLC was reported that made patients be full of fight with cancer, and psychological maladjustment low in Korea. HCL, at the same time, effect on sense of coherence (SOC) that personal ability to control and utilize appropriate internal sources for overcoming stress when one encounter stressors.

Purpose: Based on the salutogenetic model as a theory to guide health promotion, study hypothesis is formulated that information seeking, HLC, and SOC effect on one’s health in stressful situation of diagnosis and treatment of colon cancer. The purposes of this study were to measure levels of health-related information seeking behaviors, HLC, SOC, and SRH among Korean patients with colorectal cancer, and to identify factors influencing SRH.

Methods: With correlational survey, data were collected from December 2016 to March 2017 with total 122 patients with colorectal cancer via convenience sampling. A self-reported questionnaire was used to assess health-related information seeking behaviors, HLC, SOC, and SRH. Health-related information seeking behaviors, HCL, SOC, SRH were measured by Seeking Information about Health and Seeking Information about Cancer, Multidimensional health locus of control scales, Antonovsky’s SOC scale, Health Self Rating Scale, respectively.

Results: Most participants (89.3%) reported health-related information seeking behaviors. Their most found information contents were cancer diet, how to improve health, therapy methods, and carcinogenesis or metastasis, and in this process, they were concerned about the quality of the information. Mean scores of IHLC, SOC, and SRH were 25.34, 57.66, and 9.89, respectively. There were differences in SRH by gender, occupation, caregiver, metastasis state, and colostomy status. Factors influencing better SRH were gender (male), colostomy state, and higher SOC that explained 19.2% of the variances.

Conclusion: Subjective health state among patients with colorectal cancer was better when being male, not having colostomy, and higher levels of SOC. It is necessary to develop and apply strategic tailored intervention for colorectal cancer patients to improve their health. Further study needs to explore various factors influencing health status of these patients, and to consider measuring objective health measures according to diagnosis periods of patients with colorectal cancer.