Kontakt X:X | DOI: 10.32725/kont.2025.034

The relationship between illness acceptance, psychological well-being, and anxiety in individuals with chronic diseases: a cross-sectional studySocial Sciences in Health - Original article

Hamza Siğirci1, *, Şerife Güzel2
1 Karamanoğlu Mehmetbey University, Faculty of Health Sciences, Department of Health Management, Karaman, Turkey
2 Selçuk University, Faculty of Health Sciences, Department of Health Management, Konya, Turkey

The study aims to examine the relationship between illness acceptance, psychological well-being, and anxiety in individuals with chronic diseases. Data were collected from 510 participants through face-to-face surveys. The data collection instruments included a personal information form, the Illness Acceptance Scale, the Anxiety Scale, and the Psychological Well-Being Scale. Analyses were conducted using SPSS 26 software. Since the data showed a normal distribution, parametric tests were employed. The majority of participants were female, under 45 years of age, had completed primary education, and were married. Circulatory system diseases were the most common, and most patients had been diagnosed for 13 years or longer. Significant differences were observed between the scales based on variables such as disease diagnosis and gender. A weak negative correlation was found between illness acceptance and psychological well-being, while a weak positive correlation was observed between illness acceptance and anxiety. The results highlight the complex and multidimensional nature of the relationship between illness acceptance, psychological well-being, and anxiety. They emphasize the importance of individuals' adaptation to illness in this context, and indicate that factors such as disease stage, symptoms, and treatment should be considered to achieve clearer results.

Keywords: Anxiety; Chronic diseases; Health care; Non-communicable diseases; Psychological well-being
Conflicts of interest:

The authors have no potential conflicts of interest to declare with respect to the research, authorship, and/or publication of this article.

Received: May 7, 2025; Revised: July 18, 2025; Accepted: July 30, 2025; Prepublished online: August 13, 2025 

Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. . Akyay A (2016). Endişe ve anksiyete ölçeği, problemlere karşi olumsuz tutum ölçeği ve bilişsel kaçinma ölçeği'nin Türkçeye uyarlanmasi, geçerliliği ve güvenirliliği [Validity and Reliability Study for the Turkish Adaptation of the Worry and Anxiety Questionnaire, Negative Problem Orientation Questionnaire and Cognitive Avoidance Questionnaire]. (Master Thesis). Üsküdar Üniversitesi Sosyal Bilimler Enstitüsü.
    2. . Bieñ A, Rzoñca E, Kañczugowska A, Iwanowicz-Palus G (2015). Factors affecting the quality of life and the illness acceptance of pregnant women with diabetes. Int J Environ Res Public Health 13(1): 68. DOI: 10.3390/ijerph13010068. Go to original source... Go to PubMed...
    3. . Borkovec TD, Ray WJ, Stober J (1998). Worry: A Cognitive Phenomenon Intimately Linked to Affective, Physiological, and Interpersonal Behavioral Processes. Cognit Ther Res 22: 561-576. DOI: 10.1023/A:1018790003416 Go to original source...
    4. . Bulut S, Dilmaç B (2018). Üniversite öğrencilerinin sahip olduğu değerler psikolojik iyi oluş ve mutluluk düzeyleri arasindaki yordayici ilişkiler. OPUS Int J Soc Res 9(16): 349-374. DOI: 10.26466/opus.472450. Go to original source...
    5. . Büssing A, Matthiessen PF, Mundle G (2008). Emotional and rational disease acceptance in patients with depression and alcohol addiction. Health Qual Life Outcomes 6: 4. DOI: 10.1186/1477-7525-6-4. Go to original source... Go to PubMed...
    6. . Büyükkaya Besen D (2009). Hastaliği kabul ölçeği'nin Türk toplumundaki diyabetik bireylere uyarlanmasi ve etkileyen faktörlerin belirlenmesi [The adaptation of the acceptance of illness scale to the diabetic patients in Turkish society and thedetermination of the affecting factors]. (Doctoral Thesis). Dokuz Eylül Üniversitesi Sağlik Bilimleri Enstitüsü.
    7. . Carver CS, Scheier MF, Weintraub JK (1989). Assessing coping strategies: A theoretically based approach. J Pers Soc Psychol 56(2): 267-283. DOI: 10.1037/0022-3514.56.2.267 Go to original source... Go to PubMed...
    8. . Casier A, Goubert L, Gebhardt WA, Baets FD, Aken SV, Matthys D, Crombez G (2013). Acceptance, well-being and goals in adolescents with chronic illness: A daily process analysis. Psychol Health 28(11): 1337-1351. DOI: 10.1080/08870446.2013.809083. Go to original source... Go to PubMed...
    9. . Casier A, Goubert L, Huse D, Theunis M, Franckx H, Robberecht E, et al. (2008). The role of acceptance in psychological functioning in adolescents with cystic fibrosis: A preliminary study. Psychol Health 23(5): 629-638. DOI: 10.1080/08870440802040269. Go to original source... Go to PubMed...
    10. . CDC (2024). About Chronic Diseases. Chronic Disease. [online] [cit. 2025-01-22]. Available from: https://www.cdc.gov/chronic-disease/about/index.html
    11. . Chlapecka A, Wolfová K, Fryèová B, Cermakova P (2023). Educational attainment and anxiety in middle-aged and older Europeans. Sci Rep 13(1): 13314. DOI: 10.1038/s41598-023-40196-4. Go to original source... Go to PubMed...
    12. . Cipora E, Konieczny M, Sobieszczañski J (2018). Acceptance of illness by women with breast cancer. Ann Agric Environ Med 25(1): 167-171. DOI: 10.26444/aaem/75876. Go to original source... Go to PubMed...
    13. . Czerw A, Religioni U, Szumilas P, Sygit K, Partyka O, Mêkal D, et al. (2022). Normalization of the AIS (Acceptance of Illness Scale) questionnaire and the possibility of its use among cancer patients. Ann Agric Environ Med 29(2): 269-273. DOI: 10.26444/aaem/144197. Go to original source... Go to PubMed...
    14. . Dayilar H, Oyur G, Kamer E, Sariçiçek A, Cengiz F, Haciyanli M (2017). Kolon ameliyati öncesi hastalarin anksiyete düzeylerinin değerlendirilmesi [Evaluation of anxiety levels of patients before colon surgery]. Turk J Colorectal Dis 27(1): 6-10. DOI: 10.4274/tjcd.26122. Go to original source...
    15. . Diener E, Wirtz D, Biswas-Diener R, Tov W, Kim-Prieto C, Choi D, Oishi S (2009). New Measures of Well-Being. In: Diener E (Ed.). Assessing Well-Being. Dordrecht: Springer 39: 247-266. DOI: 10.1007/978-90-481-2354-4_12. Go to original source...
    16. . Dugas MJ, Freeston MH, Provencher MD, Lachance S, Ladouceur R, Gosselin P (2001). Le Questionnaire sur l'Inquiétude et l'Anxiété. Validation dans des échantillons non cliniques et cliniques [The Worry and Anxiety Questionnaire: Validation in non-clinical and clinical samples]. Journal de Thérapie Comportementale et Cognitive 11(1): 31-36.
    17. . Felton BJ, Revenson TA (1984). Coping with chronic illness: A study of illness controllability and the influence of coping strategies on psychological adjustment. J Consult Clin Psychol 52(3): 343-353. DOI: 10.1037/0022-006X.52.3.343 Go to original source... Go to PubMed...
    18. . Hamama-Raz Y, Bergman YS, Ben-Ezra M, Tirosh Y, Baruch R, Nakache R (2018). Attachment patterns moderate the relation between coping flexibility and illness acceptance among kidney transplant recipients. Anxiety Stress Coping 31(5): 571-579. DOI: 10.1080/10615806.2018.1498667. Go to original source... Go to PubMed...
    19. . İlaslan E, Dalkiran Ş, Canli Özer Z, Balci MK (2021). Tip 2 diyabetli bireylerin hastaliği kabul düzeyi ve bakim verenlerin bakim verme yükü. Sürekli Tip Eğitimi Dergisi 30(2): 84-95. DOI: 10.17942/sted.803667. Go to original source...
    20. . Jalmsell L, Kreicbergs U, Onelöv E, Steineck G, Henter JI (2010). Anxiety is contagious - Symptoms of anxiety in the terminally ill child affect long-term psychological well-being in bereaved parents. Pediatr Blood Cancer 54(5): 751-757. DOI: 10.1002/pbc.22418. Go to original source... Go to PubMed...
    21. . Jaltuszewska S, Chojnacka-Szawlowska G, Majkowicz M, Zdonczyk S, Homenda W, Hebel K (2023). Illness perception and the severity of depression and anxiety symptoms in patients with multimorbidity: observational cohort studies. J Clin Med 13(1): 69. DOI: 10.3390/jcm13010069. Go to original source... Go to PubMed...
    22. . Jankowiak B, Kowalewska B, Krajewska-Ku³ak E, Milewski R, Turosz MA (2021). Illness acceptance as the measure of the quality of life in moderate psoriasis. Clin Cosmet Investig Dermatol 14: 1139-1147. DOI: 10.2147/CCID.S318603. Go to original source... Go to PubMed...
    23. . Juzwiszyn J, Dolczewska A, Chabowski M (2020). Quality of life and acceptance of illness in patients who underwent total thyroidectomy. Ann Ital Chir 91: 352-358.
    24. . Karademas EC, Tsagaraki A, Lambrou N (2009). Illness acceptance, hospitalization stress and subjective health in a sample of chronic patients admitted to hospital. J Health Psychol 14(8): 1243-1250. DOI: 10.1177/1359105309345169. Go to original source... Go to PubMed...
    25. . Kilinç M (2017). Psikolojik iyi oluşun yordayicilari olarak öz-yeterlik ve etkileşim kaygisi. Uluslararasi Eğitim Bilimleri Dergisi 13: 207-216. Go to original source...
    26. . Kiropoulos L, Ward N, Rozenblat V (2021). Self-concept, illness acceptance and depressive and anxiety symptoms in people with multiple sclerosis. J Health Psychol 26(8): 1197-1206. DOI: 10.1177/1359105319871639. Go to original source... Go to PubMed...
    27. . Ko³tuniuk A, Rosiñczuk J (2021). The levels of depression, anxiety, acceptance of illness, and medication adherence in patients with multiple sclerosis - Descriptive and correlational study. Int J Med Sci 18(1): 216-225. DOI: 10.7150/ijms.51172. Go to original source... Go to PubMed...
    28. . Kosty³a M, Taba³a K, Kocur J (2013). Illness acceptance degree versus intensity of psychopathological symptoms in patients with psoriasis. Postêpy Dermatol Alergol 30(3): 134-139. DOI: 10.5114/pdia.2013.35613. Go to original source... Go to PubMed...
    29. . Kulpa M, Kosowicz M, Stypu³a-Ciuba BJ, Kazalska D (2014). Anxiety and depression, cognitive coping strategies, and health locus of control in patients with digestive system cancer. Prz Gastroenterol 9(6): 329-335. DOI: 10.5114/pg.2014.47895. Go to original source... Go to PubMed...
    30. . Majchrowicz B, Kowalczuk K, Tomaszewska K (2025). Acceptance of illness and quality of life of patients under long-term home nursing care. Front Public Health 13: 1505164. DOI: 10.3389/fpubh.2025.1505164. Go to original source... Go to PubMed...
    31. . McLean CP, Asnaani A, Litz BT, Hofmann SG (2011). Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res 45(8): 1027-1035. DOI: 10.1016/j.jpsychires.2011.03.006 Go to original source... Go to PubMed...
    32. . Niemeyer H, Bieda A, Michalak J, Schneider S, Margraf J (2019). Education and mental health: Do psychosocial resources matter? SSM Popul Health 7: 100392. DOI: 10.1016/j.ssmph.2019.100392. Go to original source... Go to PubMed...
    33. . Özen Y (2017). Farkinda miyiz? bilişsel farkindalik ile psikolojik iyi oluşun içrelleşmesi. Kesit Akademi Dergisi 7: 167-189. Go to original source...
    34. . Piotrkowska R, Kruk A, Krzemiñska A, Mêdrzycka-Dħbrowska W, Kwiecieñ-Jaguĥ K (2023). Factors determining the level of acceptance of illness and satisfaction with life in patients with cancer. Healthcare 11(8): 1168. DOI: 10.3390/healthcare11081168. Go to original source... Go to PubMed...
    35. . Pompey CS, Ridwan MN, Zahra AN, Yona S (2019). Illness acceptance and quality of life among end stage renal disease patients undergoing hemodialysis. Enferm Clin 29: 128-133. DOI: 10.1016/j.enfcli.2019.04.020. Go to original source...
    36. . Purc-Stephenson RJ, Edwards R (2024). Finding meaning in chronic illness and its relationship to psychological well-being:A mixed-methods study. PLOS Mental Health 1(4): e0000121. DOI: 10.1371/journal.pmen.0000121 Go to original source...
    37. . Religioni U, Czerw A, Depta³a A (2015). Acceptance of cancer in patients diagnosed with lung, breast, colorectal and prostate carcinoma. Iran J Public Health 44(8): 1135.
    38. . Rogon I, Kasprzak Z, Szczeĥniak £ (2017). Perceived quality of life and acceptance of illness in people with type 2 diabetes mellitus. Prz Menopauzalny 16(3): 79-85. DOI: 10.5114/pm.2017.70583. Go to original source... Go to PubMed...
    39. . Ryff CD, Keyes CLM (1995). The structure of psychological well-being revisited. J Pers Soc Psychol 69(4): 719-727. DOI: 10.1037//0022-3514.69.4.719. Go to original source... Go to PubMed...
    40. . İrol J, Ballová Mikuıková E, Èavojová V (2021). When we are worried, what are we thinking? Anxiety, lack of control, and conspiracy beliefs amidst the COVID-19 pandemic. Appl Cogn Psychol 35(3): 720-729. DOI: 10.1002/acp.3798. Go to original source... Go to PubMed...
    41. . Telef BB (2013). Psikolojik İyi Oluş Ölçeği: Türkçeye uyarlama, geçerlik ve güvenirlik çalişmasi. Hacett Üniv Eğit Fak Derg 28(3): 374-384.
    42. . Thornton M, Bowers K (2024). Poverty in older adulthood: A health and social crisis. Online J Issues Nurs 29(1). DOI: 10.3912/ojin.vol29no01man03. Go to original source...
    43. . Türen S, Atakoğlu Yilmaz R, Gündoğdu Ş (2021). The relationship with acceptance of illness and medication adherence in type 2 diabetes mellitus patients. Int J Caring Sci 14(3): 1824.
    44. . Van Damme-Ostapowicz K, Krajewska-Ku³ak E, Nwosu PJ, Ku³ak W, Sobolewski M, Olszañski R (2014). Acceptance of illness and satisfaction with life among malaria patients in rivers state, Nigeria. BMC Health Serv Res 14: 202. DOI: 10.1186/1472-6963-14-202. Go to original source... Go to PubMed...
    45. . van Laarhoven HW, Schilderman J, Bleijenberg G, Donders R, Vissers KC, Verhagen CA, Prins JB (2011). Coping, quality of life, depression, and hopelessness in cancer patients in a curative and palliative, end-of-life care setting. Cancer Nurs 34(4): 302-314. DOI: 10.1097/NCC.0b013e3181f9a040. Go to original source... Go to PubMed...
    46. . WHO (2023). Mental health of older adults. [online] [cit. 2025-01-22]. Available from: https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults
    47. . WHO (2025). Constitution of the World Health Organization. [online] [cit. 2025-01-22]. Available from: https://www.who.int/about/governance/constitution
    48. . Yazicioğlu Y, Erdoğan S (2004). SPSS Uygulamali Bilimsel Araştirma Yöntemleri. Ankara: Detay Yayincilik, 267 p.
    49. . Yiğman F, Fidan S (2021). Transdiagnostik faktör olarak belirsizliğe tahammülsüzlük. Psikiyatr Güncel Yaklaşimlar 13(3): 573-587. DOI: 10.18863/pgy.827416 Go to original source...
    50. . Zalewska A, Miniszewska J, Chodkiewicz J, Narbutt J (2007). Acceptance of chronic illness in psoriasis vulgaris patients. J Eur Acad Dermatol Venereol 21(2): 235-242. DOI: 10.1111/j.1468-3083.2006.01912.x. Go to original source... Go to PubMed...

    This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return