OBJECTIVE: The aim of this study is to analyze how patients with chronic diseases from Shanghai interpret their disease, and how these interpretations infl uence patients’ life satisfaction, intention to escape from their illness and their ability to refl ect on the implications of their illness.METHODS: A cross-sectional study enrolling 142 patients(mean age(50 ± 16) years; 63% men, 37% women) with chronic diseases(60% cancer) was recruited in the Changhai Hospital of Traditional Chinese Medicine, Shanghai, China and surveyed using standardized questionnaires.RESULTS: Patients with chronic diseases from Shanghai interpreted their illness mostly as an Adverse Interruption of Life(55%), as a Threat/Enemy(50%), but also as a Challenge(49%), and only rarely as a Call for Help(18%) or as a Punishment(13%). Particularly fatalistic negative(i.e., Threat/Enemy, Adverse Interruption of Life) and strategy-associated disease interpretations(i.e., Relieving Break, Call for Help) were moderately associated with patients’ intention to escape from illness. In contrast, positive interpretations(i.e., something of Value, Challenge) and also the guilt-associated negative interpretation Failure were moderately related with patients’ ability to refl ect on their illness. However, life satisfaction was weakly associated only with the view that illness might be a Challenge. Interestingly, 58% of those who would see their illness as an Adverse Interruption(AI+) could see it also as a Challenge(Ch+). Detailed analyses showed that AI+Ch+ patients differ from their AI+Ch- counterparts signifi cantly with respect to their ability to refl ect life and implications of illness(F=9.1; P=0.004).CONCLUSION: The observed interpretations of illness, particularly the negative perceptions, could be used as indicators that patients require further psychological assistance to cope with their burden. Helping AI+ patients see their illness also as a Challenge, and thus develop a higher Refl ection on Life Concerns, would be greatly benefi cial, and encourages further research. OBJECTIVE: The aim of this study is to analyze how patients with chronic diseases from Shanghai interpret their disease, and how these interpretations infl uence patients’ life satisfaction, intention to escape from their illness and their ability to reflcton the implications of their illness 63% men, 37% women) with chronic diseases (60% cancer) was recruited in the Changhai Hospital of Traditional Chinese Medicine, Shanghai, China and surveyed using standardized disease rates (%), as a Threat / Enemy (50%), but also as a Challenge (49%), Particularly fatalistic negative (ie, Threat / Enemy, Adverse Interruption of Life) and strategy-associated disease interpretations (ie, Relieving Break, Call for (18%) or as a Punishment Help) were moderately associated with patients ’intention to escape from illness. In contrast, positive interpretations (ie, something of Value, Challenge) and also the guilt-associated negative interpretation Failure were moderately related with patients’ ability to refl ect on their illness. However, life 58% of those who would see their illness as an Adverse Interruption (AI +) could see it also as a Challenge (Ch +). Detailed analyzes show that AI + Ch + patients differ from their AI + Ch-counterparts signifi cantly with respect to their ability to refl ect life and implications of illness (F = 9.1; P = 0.004) .CONCLUSION: The observed interpretations of illness, particularly the negative perceptions, could be used as indicators that patients require further psychological assistance to cope with their burden. Helping AI + patients see their illness also as a Challenge, and thus develop a higher Reflction on Lif eConcerns, would be greatly beneficial, and encourages further research.