Illness appraisal mediates the relationship between gratitude and quality of life among cancer patients

Introduction
The level of gratitude may explain an increase in quality of life. Illness appraisal is a valid factor that modifies coping with stress of cancer. The aim of the research was to investigate the role of illness appraisal and gratitude for the quality of life of cancer patients. It was hypothesized that appraisal of the disease mediates the relationship between gratitude and quality of life in oncological patients with a moderating effect of gender.

Material and methods
The participants comprised 96 Polish cancer patients, with breast or prostate cancer, hospitalized during 5–7 weeks of radiotherapy, and aged 31–79 years. A gratitude questionnaire, the disease-related appraisals scale, and the sense of quality of life questionnaire were used.

Results
The appraisal of the disease in the category of harm was a variable mediating the relationship between the sense of gratitude in the all measured dimensions of quality of life: global, psychophysical, psychosocial, subjective and metaphysical. Mediation moderated by gender occurred in the relationship between gratitude and the metaphysical dimension of quality of life, and the appraisal of the disease as harm serves as a variable mediating this relationship.

Conclusions
The mediating variable in the relationship between gratitude and the metaphysical dimension of quality of life was the appraisal of illness as harm. The above mediation relationship turned out to be moderated by gender. The appraisal of the disease in the category of harm turned out to be a variable mediating the influence of gratitude on the metaphysical quality of life only in women.