Among the 14 million persons living in the United States with current or remitted cancer, poor physical health-related quality of life (HRQL) is a significant concern. However, self-compassion (i.e., common humanity, mindfulness, self-kindness) may be a protective factor, either directly or indirectly, by allowing for a sense of empowerment and control over illness, and in turn, facilitating engagement in treatment and positive perceptions of health. Serial mediation analyses among persons living with current (n = 67) or remitted (n = 168) cancer lend support for a positive, direct association between self-compassion and physical HRQL, as well as indirect effects via internal perceived control and, to a lesser degree, treatment adherence. Mixed findings, especially among cancer patients, highlight limitations of resiliency traits while also supporting the notion that self-compassion interventions (e.g., Mindful Self-Compassion Training) may have positive implications for health-related control beliefs, behaviors, and quality of life in the cancer population.

Among persons living with, or recovering from, chronic illness, poor physical health-related quality of life is a concern, as current and residual illness symptoms and treatment side effects may deleteriously impact physical functioning and fulfillment of daily roles. Numerous cognitive, emotional, and behavioral factors may impact perceptions of health status. Optimism, for example, is conceptualized as belief in the occurrence of positive future outcomes, and is beneficially associated with physical health-related quality of life. Further, optimism may contribute to enhanced perceptions of control and efficacy over disease symptoms and general health, manifesting as proactive health behaviors (e.g., wellness behaviors; treatment adherence) and, in turn, improved health-related quality of life. Across independent samples of persons living with remitted cancer (N = 164) or fibromyalgia (N = 508), we examined the serial mediating effects of health-related self-efficacy and proactive health behaviors in the relation between dispositional optimism and physical health-related quality of life. Participants completed online self-report measures, including the Life Orientation Test – Revised, Control Beliefs Inventory, Multidimensional Health Profile – Health Functioning Index, Wellness Behaviors Inventory, Medical Outcomes Study General Treatment Adherence Scale, and the Short-Form Health Survey. Significant serial mediation was observed across samples; higher dispositional optimism was associated with greater health-related self-efficacy and, in turn, greater engagement in proactive health behaviors and better physical health-related quality of life. For persons with remitted cancer, absence of other specific indirect effects indicates a need to consider the potential impact of unique aspects of disease, such as late effects of treatment or fear of recurrence, that may limit the beneficial effects of optimism exclusively through health-related self-efficacy or wellness behaviors. For persons with fibromyalgia, we found specific indirect effects through each mediating variable, lending support for the decoupling of cognitive and behavioral factors, consistent with pathophysiological and psychosomatic explanations of illness symptoms and approaches to treatment. Interventions designed to enhance optimism (e.g., cognitive-behavioral therapy; best possible self exercise) or self-efficacy (e.g., exercise skills training) may have positive downstream effects on health behavior engagement and perceptions of physical health-related quality of life among individuals living with remitted cancer or fibromyalgia.