Learning Objective #1: Understand cognitive representations of breast cancer of Thai women, who have a uniquely different culture

Learning Objective #2: Understand the association of cognitive representations of breast cancer and emotional responses in Thai women with breast cancer

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This is the first study to examine cognitive representation of illness and its role contributing to emotional responses in Thai women with breast cancer. The specific aim of the study was to examine the relationship between cognitive representations of illness and emotional responses of Thai women newly diagnosed with breast cancer. According to Leventhal's self-regulatory model, response to illness is based upon cognitive representations, consisting of five components: identity, causes, time-line, consequences, and cure/controllability. A descriptive, cross-sectional study was conducted with 45 Thai women newly diagnosed with early stage breast cancer. Participants were assessed after primary surgery and before chemotherapy or radiotherapy. The Conceptual Content Cognitive Map (3CM) Method, an open-ended interview technique, and the established Illness Perception Questionnaire (IPQ) were used to assess cognitive representations. The Profile of Mood State-Short Form (POMS-SF) was used to obtain emotional responses. Data were analyzed using content analysis, Pearson's correlation, and regression analyses. Findings revealed that the identity, time-line, and consequences components had a significantly positive association with mood disturbance; the greater the symptoms, chronic time-line, and consequences patients perceived, the greater the mood disturbance. The cure/controllability component had a significantly negative association with total mood disturbance; the less patients perceived their illness could be cured or controlled, the greater the mood disturbance. The more negative statements patients reported through the 3CM, the more anxiety, depression, fatigue, and total mood disturbance they experienced. The more positive statements patients reported, the less depression. Multiple regression analyses indicated that the identity, time-line, and consequences components were significant predictors for total mood disturbance and negative emotional responses. The findings provide insight into the link of cognitive representations of breast cancer and emotional responses in Thai women, who have a uniquely different culture from women in Western countries, and allow nurses to provide tailored and effective interventions.