Promoting Adjustment in Uveal Melanoma Survivorship: A Randomized Trial Targeting Illness Perceptions

Introduction: This dissertation project was a randomized controlled trial of a brief psychoeducational intervention targeting three illness perceptions (chronicity, control, coherence) in a sample of uveal melanoma (UM) survivors at UCLA (N = 101). Illness perceptions have been shown to be associated with psychological and disease-related adjustment in the context of chronic illnesses at large (e.g., Hagger et al., 2017), and within UM patient populations specifically (e.g., Hoch et al., 2023). More positive (i.e., less threatening) illness perceptions have been shown to be associated with better mental health outcomes in the context of chronic illness. Method: The intervention consisted of two psychoeducational videos in which participants’ ocular oncologist discussed considerations for promoting mental, physical, and visual adjustment across the course of UM survivorship. The control group received an enhanced treatment as usual manipulation comprised of a mental health resource information sheet. Participants completed four study visits via online surveys, including a baseline visit (T0) during which they completed assessments and were randomized to the intervention (n = 53) or control (n = 48) condition and received their respective study manipulations. Assessments were repeated one (T1) and two (T2) weeks later, with a final assessment (T3) administered four weeks after the third study visit. I hypothesized that participants randomized to the treatment condition would evidence less threatening illness perceptions over the course of the study than would participants in the control condition. Results: Multilevel models tested interactions between study condition and time to evaluate treatment effects on illness perception and psychological distress outcomes. Number of years since UM diagnosis and pre-randomization levels of approach- and avoidance-oriented coping were included in separate models as moderators. No interactions between study condition and time were statistically significant (with or without additional moderator variables). Participants’ feedback suggested that both the psychoeducational and control interventions were rated as informative, acceptable, and credible. Participants reported that both interventions would have been particularly helpful at the time of UM diagnosis. Conclusion: We recommend that future trials test the psychoeducational intervention at more specific and relevant clinical milestones to optimize desired changes in illness perceptions (e.g., following UM diagnosis).

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