1
|
Jaltuszewska S, Chojnacka-Szawlowska G, Majkowicz M, Zdonczyk S, Homenda W, Hebel K. Illness Perception and the Severity of Depression and Anxiety Symptoms in Patients with Multimorbidity: Observational Cohort Studies. J Clin Med 2023; 13:69. [PMID: 38202075 PMCID: PMC10780102 DOI: 10.3390/jcm13010069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/05/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Many studies have shown a correlation between the patient's engagement in treatment and their perception of the illness. AIM The aim of this study has been to explore the link between the patient's perception of their illness with anxiety and depression, and to leverage this link to promote health education. MATERIALS AND METHODS The study was carried out using the following tools: the Hospital Anxiety and Depression Scale and the Illness Perception Questionnaire-Revised. The study participants included N = 143 patients. RESULTS The participants' age was statistically significantly associated with the expected duration of the illness (p < 0.01), the conviction that the treatment was effective (p < 0.01), and the perception of the severity of the disease symptoms (p < 0.05). The employment status was statistically significantly associated with the illness perception (p < 0.01). Anxiety and depression levels were statistically significantly associated with the perceived impact of the illness on life (p < 0.001) and emotional status (p < 0.001), the perceived control over the illness (p < 0.01), the potential for recovery (p < 0.001), the concern about the illness (p < 0.001), and the impact of the illness on emotional well-being (p < 0.001). CONCLUSIONS Individuals who perceived a high severity of illness symptoms also assessed that the illness significantly impacted their life and emotional state. The authors demonstrate a strong link of a "negative" perception of the illness with depression and anxiety. A better understanding of the illness predicted a less severe depression and lower anxiety. IMPLICATIONS FOR PRACTICE The results suggest that the study of illness perception holds significant potential to contribute effectively to educational and psychotherapeutic practices.
Collapse
Affiliation(s)
- Sylwia Jaltuszewska
- Institute of Health Sciences, Pomeranian University in Slupsk, Westerplatte 64, 76-200 Slupsk, Poland; (S.J.); (M.M.); (W.H.)
- Provincial Specialist Hospital named after Janusz Korczak in Slupsk, Hubalczyków 1, 76-200 Slupsk, Poland
| | | | - Mikolaj Majkowicz
- Institute of Health Sciences, Pomeranian University in Slupsk, Westerplatte 64, 76-200 Slupsk, Poland; (S.J.); (M.M.); (W.H.)
| | - Sebastian Zdonczyk
- Institute of Pedagogy, Pomeranian University in Slupsk, Westerplatte 64, 76-200 Slupsk, Poland;
- Provincial Specialist Hospital named after Janusz Korczak in Slupsk, Hubalczyków 1, 76-200 Slupsk, Poland
| | - Wojciech Homenda
- Institute of Health Sciences, Pomeranian University in Slupsk, Westerplatte 64, 76-200 Slupsk, Poland; (S.J.); (M.M.); (W.H.)
- Provincial Specialist Hospital named after Janusz Korczak in Slupsk, Hubalczyków 1, 76-200 Slupsk, Poland
| | - Kazimiera Hebel
- Institute of Health Sciences, Pomeranian University in Slupsk, Westerplatte 64, 76-200 Slupsk, Poland; (S.J.); (M.M.); (W.H.)
| |
Collapse
|
2
|
Okanlawon Bankole A, Jiwani RB, Avorgbedor F, Wang J, Osokpo OH, Gill SL, Jo Braden C. Exploring illness perceptions of multimorbidity among community-dwelling older adults: a mixed methods study. AGING AND HEALTH RESEARCH 2023; 3:100158. [PMID: 38779434 PMCID: PMC11109937 DOI: 10.1016/j.ahr.2023.100158] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Background Illness perceptions are individual beliefs or experiences about the nature and treatment of their illness. Although extensive research exists about illness perceptions, little is known about illness perceptions of multimorbidity. Methods The purpose of this parallel-convergent mixed-methods study was to comprehensively explore illness perception of multimorbidity among community dwelling older adults. Data was collected using one-on-one semi-structured interviews (n=17) and the Multimorbidity Illness Perception Scale (MULTIPleS) (n=116). Qualitative data were analyzed using content analysis while quantitative data were analyzed with descriptive and inferential statistics. Both qualitative and quantitative findings were integrated to identify differences in illness perceptions of multimorbidity by participant's socio-demographic and illness-related characteristics. Results Overall, participants were mostly female (71%), self-reported as Hispanic (35%), Black (33%), White (27%), or Asian (5%). From the content analysis of the qualitative data, we described three themes pertaining to Illness perception of multimorbidity which were influenced by both participants' socio-demographic and illness-related characteristics: (1) inter-relationships between conditions (2) consequences and priorities and (3) impact of multimorbidity on wellbeing. While inferential analysis of quantitative data indicated statistically significant differences across only socio-demographic characteristics such as race/ethnicity (causal links, prioritization, summary scale) and educational attainment (prioritization subscale). Mixed analysis of qualitative and quantitative findings confirmed that illness perception of multimorbidity may not differ by the number of chronic conditions. Conclusions Illness perception of multimorbidity may not differ by the number of chronic conditions the participants had. Rather, participants prioritized the impact of multimorbidity on their overall wellbeing, placing less importance on the number of their chronic conditions. Additional studies are needed to further characterize illness perceptions of multimorbidity and develop interventions that extend beyond disease-focused interventions to address holistic needs of older adults with multimorbidity.
Collapse
Affiliation(s)
| | - Rozmin B Jiwani
- University of Texas Health Science Center, San Antonio School of Nursing, San Antonio, Texas
| | | | - Jing Wang
- University of New Hampshire, Durham, New Hampshire, USA
| | - Onome H. Osokpo
- University of Pennsylvania, New Courtland Center for Transitions and Health, Philadelphia, PA
| | - Sara L. Gill
- University of Texas Health Science Center, San Antonio School of Nursing, San Antonio, Texas
| | - Carrie Jo Braden
- University of Texas Health Science Center, San Antonio School of Nursing, San Antonio, Texas
| |
Collapse
|
3
|
Stewart SJF, Moon Z, Horne R. Medication nonadherence: health impact, prevalence, correlates and interventions. Psychol Health 2023; 38:726-765. [PMID: 36448201 DOI: 10.1080/08870446.2022.2144923] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 12/05/2022]
Abstract
Nonadherence to medicines is a global problem compromising health and economic outcomes for individuals and society. This article outlines how adherence is defined and measured, and examines the impact, prevalence and determinants of nonadherence. It also discusses how a psychosocial perspective can inform the development of interventions to optimise adherence and presents a series of recommendations for future research to overcome common limitations associated with the medication nonadherence literature. Nonadherence is best understood in terms of the interactions between an individual and a specific disease/treatment, within a social and environmental context. Adherence is a product of motivation and ability. Motivation comprises conscious decision-making processes but also from more 'instinctive', intuitive and habitual processes. Ability comprises the physical and psychological skills needed to adhere. Both motivation and ability are influenced by environmental and social factors which influence the opportunity to adhere as well as triggers or cues to actions which may be internal (e.g. experiencing symptoms) or external (e.g. receiving a reminder). Systematic reviews of adherence interventions show that effective solutions are elusive, partly because few have a strong theoretical basis. Adherence support targeted at the level of individuals will be more effective if it is tailored to address the specific perceptions (e.g. beliefs about illness and treatment) and practicalities (e.g. capability and resources) influencing individuals' motivation and ability to adhere.
Collapse
Affiliation(s)
- Sarah-Jane F Stewart
- Centre for Behavioural Medicine, Research Department of Practice and Policy, UCL School of Pharmacy, University College London, London, UK
| | - Zoe Moon
- Centre for Behavioural Medicine, Research Department of Practice and Policy, UCL School of Pharmacy, University College London, London, UK
| | - Rob Horne
- Centre for Behavioural Medicine, Research Department of Practice and Policy, UCL School of Pharmacy, University College London, London, UK
| |
Collapse
|
4
|
Bankole AO, Gill SL, McSharry J, White CL, Aniemeke C, Wallington SF, Addo-Mensah DE, Braden CJ. Self-regulatory coping among community dwelling older adults with multiple chronic conditions. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231207538. [PMID: 37867622 PMCID: PMC10588418 DOI: 10.1177/26335565231207538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/27/2023] [Indexed: 10/24/2023]
Abstract
Objectives Many older adults with multiple chronic conditions (MCC) frequently experience hospitalizations, functional limitations, and poor quality of life. Outcomes may be improved by promoting self-regulation, which may individuals respond to health threats and manage their health conditions. The aim of this study was to describe self-regulatory coping among older adults with MCC. Methods A qualitative descriptive study using semi-structured interviews and content analysis and guided by the Common-Sense Self-Regulation Model. Seventeen community-dwelling older adults with two or more chronic conditions participated in our study. Results Three themes were developed from the analysis: (1) "I don't think about it unless something happens": coping in the absence of a health event, (2) "doing what I am supposed to do": coping during a health event, and (3) "How do I know if what I did works?": appraisal of coping success. Discussion Self-regulatory coping was influenced by individual beliefs and experiences (illness representations), context, self-efficacy and availability of support and resources to cope with MCC. These findings suggest implications for clinical practice and future self-regulation interventions for older adults with MCC.
Collapse
Affiliation(s)
| | - Sara L. Gill
- San Antonio School of Nursing, University of Texas Health Science Center, San Antonio, TX, USA
| | - Jenny McSharry
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
| | - Carole L. White
- San Antonio School of Nursing, University of Texas Health Science Center, San Antonio, TX, USA
| | - Chidinma Aniemeke
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
| | - Sherrie Flynt Wallington
- School of Nursing and the Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | - Carrie Jo Braden
- San Antonio School of Nursing, University of Texas Health Science Center, San Antonio, TX, USA
| |
Collapse
|
5
|
Geuens S, Leyen K, Raymaekers K, Prikken S, Willen J, Goemans N, De Waele L, Lemiere J, Luyckx K. Illness Perceptions and Illness Identity in Adolescents and Emerging Adults With Neuromuscular Disorders. Clin Child Psychol Psychiatry 2022:13591045221125631. [PMID: 36112900 DOI: 10.1177/13591045221125631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Neuromuscular disorders (NMD) are intrusive medical conditions with implications for psychosocial development. OBJECTIVES This paper explores illness perceptions and illness identity dimensions of youth with NMD. First, we compare illness identity outcomes and illness perceptions of NMD patients with a comparison group of adolescents with type 1 diabetes mellitus (DM). Second, we report about the relationships between NMD-related variables and illness perceptions and illness identity. METHODS Scores on the Brief Illness Perception Questionnaire and the Illness Identity Questionnaire were compared between a group of NMD patients (N = 59; 12-22 years) and an age- and gender-matched group of DM patients (N = 118). NMD-related variables included time since diagnosis, prognosis, wheelchair use, and physical limitations. RESULTS Youth with NMD scored significantly higher on two of the four illness identity dimensions than youth with DM. NMD patients reported significantly less positive illness perceptions, experienced more physical symptoms, and had a lower score on understanding of their illness. Within the NMD group, wheelchair-users have a better understanding of their disease than those who are not wheelchair-bound. CONCLUSIONS The present study is the first to investigate illness identity and illness perceptions in NMD. More research is needed to provide insight in the identity formation process of the growing group of adolescents with NMDs.
Collapse
Affiliation(s)
- Sam Geuens
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, 26657KU Leuven, Leuven, Belgium
| | - Kathelijne Leyen
- School Psychology and Development in Context, 26657KU Leuven, Leuven, Belgium
| | - Koen Raymaekers
- School Psychology and Development in Context, 26657KU Leuven, Leuven, Belgium.,60182FWO Vlaanderen (Research Foundation Flanders), Leuven, Belgium
| | - Sofie Prikken
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium.,School Psychology and Development in Context, 26657KU Leuven, Leuven, Belgium.,60182FWO Vlaanderen (Research Foundation Flanders), Leuven, Belgium
| | - Joanna Willen
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium
| | - Nathalie Goemans
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, 26657KU Leuven, Leuven, Belgium
| | - Liesbeth De Waele
- Child Neurology, 60182University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, 26657KU Leuven, Leuven, Belgium
| | - Jurgen Lemiere
- Child Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Koen Luyckx
- School Psychology and Development in Context, 26657KU Leuven, Leuven, Belgium.,UNIBS, 60182University of the Free State, Bloemfontein, South Africa
| |
Collapse
|
6
|
Schönenberg A, Prell T. Factors Influencing Self-Reported Medication Use in the Survey of Health Aging and Retirement in Europe (SHARE) Dataset. Healthcare (Basel) 2021; 9:healthcare9121752. [PMID: 34946478 PMCID: PMC8701040 DOI: 10.3390/healthcare9121752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022] Open
Abstract
The validity of self-reported medication use in epidemiological studies is an important issue in healthcare research. Here we investigated factors influencing self-reported medication use for multiple diagnoses in the seventh wave of the Survey of Health Aging and Retirement in Europe (SHARE) dataset in n = 77,261 participants (ages: mean = 68.47, standard deviation = 10.03 years). The influence of mental, physical, and sociodemographic parameters on medication self-report was analyzed with logistic regressions and mediation models. Depression, memory function, and polypharmacy influenced the self-report of medication use in distinct disorders to varying degrees. In addition, sociodemographic factors, knowledge about diagnosis, the presence of several chronic illnesses, and restrictions of daily instrumental activities explained the largest proportion of variance. In the mediation model, polypharmacy had an indirect effect via depression and memory on self-reported medication use. Factors influencing medication self-report vary between different diagnoses, highlighting the complexity of medication knowledge. Therefore, it is essential to assess the individual parameters and their effect on medication behavior. Relying solely on medication self-reports is insufficient, as there is no way to gage their reliability. Thus, self-reported medication intake should be used with caution to indicate the actual medication knowledge and use.
Collapse
|
7
|
Seydi M, Akhbari B, Ghasem Abad SK, Jaberzadeh S, Saeedi A, Ashrafi A, Shakoorianfard MA. Psychometric properties of the Persian version of the brief illness questionnaire in Iranian with non-specific chronic neck pain. J Bodyw Mov Ther 2021; 28:323-331. [PMID: 34776159 DOI: 10.1016/j.jbmt.2021.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 04/19/2021] [Accepted: 06/08/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The Brief Illness Perception Questionnaire (BIPQ) is an instrument for assessing the illness perception. Illness perception varies between individuals based on their health status. There is no study that assess the psychometric properties of the Persian version of BIPQ in neck pain patients. The goal of this study was to evaluate the reliability, construct validity, and exploratory factor analysis of the Persian BIPQ in individuals with non-specific chronic neck pain. METHODS This is a cross-sectional study in which 123 individuals with non-specific chronic neck pain participated. 60 participants examined after 7 days for testing reliability. Reliability was assessed by intra-class correlation coefficient, standard error of measurement, and minimal detectable change. For assessing construct validity and item-total correlation, correlation tests were used. Also, exploratory factor analysis was done to assess the factor structure of the BIPQ. RESULTS Exploratory factor analysis' results showed that there were 2 factors with Eigenvalues >1. Factor 1 included "identity", "consequence", "timeline", and "emotional response". Factor 2 consisted of "coherence" and "treatment control". The intra-class correlation coefficient and the cronbach's alpha for the total score was 0.8 and 0.86 respectively. Results of correlation tests showed an acceptable construct validity except with SF-12 mental component. Item-total correlation tests demonstrated that the correlations were above 0.3 for all subscales except for "treatment control" and "coherence". CONCLUSION BIPQ has an acceptable properties to assess illness perception in individuals with non-specific chronic neck pain. The results of exploratory factor analysis and item-total correlation confirmed that 2-subscale version is more acceptable.
Collapse
Affiliation(s)
- Mahsa Seydi
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Behnam Akhbari
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Sarvenaz Karimi Ghasem Abad
- Department of Anatomy, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran; Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Shapour Jaberzadeh
- Department of Physiotherapy, Non-invasive Brain Stimulation & Neuroplasticity Laboratory, Monash University, Victoria, 3199, Australia.
| | - Ahmad Saeedi
- Department of Statistical Research and Information Technology, Institute for Research and Planning in Higher Education, Tehran, Iran.
| | - Atefe Ashrafi
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Mohammad Ali Shakoorianfard
- Rehabilitation Research Center, Department of Physical Therapy, Rehabilitation Faculty, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
8
|
Foley L, Hynes L, Murphy AW, Molloy GJ. 'Just keep taking them, keep hoping they'll work': A qualitative study of adhering to medications for multimorbidity. Br J Health Psychol 2021; 27:691-715. [PMID: 34719079 DOI: 10.1111/bjhp.12568] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/26/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Compared to single diseases, health psychology reflects many areas of medical research by affording relatively less attention to the experiences of people self-managing multiple co-occurring conditions and, in particular, the experience of managing the associated complex medication regimens. This study aimed to explore the experience of self-managing multimorbidity among older adults, with a focus on medication adherence. DESIGN A qualitative approach was taken, using individual semi-structured interviews. METHODS Sixteen people with complex multimorbidity aged 65 years or older were recruited through general practice to take part in semi-structured interviews. Data were analysed following guidelines for reflexive thematic analysis. RESULTS Two themes were generated, with each theme comprising three subthemes. Theme one represents the amplified burden arising from multimorbidity that leads to unique challenges for self-management, such as integrating multiple medications into daily life, accumulating new symptoms and treatments, and managing evolving medication regimens. Theme two represents pathways towards relief that reduce this burden and promote medication adherence, such as prioritising certain conditions and treatments, resigning to the need for multiple medications, and identifying and utilising adherence supports. CONCLUSIONS We identified factors relevant to medication adherence for older adults with multimorbidity that go beyond single-disease influences and account for the amplified experience of chronic disease that multimorbidity can produce for some people. While evidence of single-disease influences remains fundamental to tailoring behavioural interventions to individuals, the impact of multimorbidity on medication adherence should be accounted for in research and practice.
Collapse
Affiliation(s)
- Louise Foley
- School of Psychology, National University of Ireland Galway, Ireland
| | - Lisa Hynes
- Croí Heart and Stroke Centre, Galway, Ireland
| | - Andrew W Murphy
- Discipline of General Practice, National University of Ireland Galway, Ireland.,HRB Primary Care Clinical Trials Network Ireland, National University of Ireland Galway, Ireland
| | - Gerard J Molloy
- School of Psychology, National University of Ireland Galway, Ireland
| |
Collapse
|
9
|
Foley L, Larkin J, Lombard-Vance R, Murphy AW, Hynes L, Galvin E, Molloy GJ. Prevalence and predictors of medication non-adherence among people living with multimorbidity: a systematic review and meta-analysis. BMJ Open 2021; 11:e044987. [PMID: 34475141 PMCID: PMC8413882 DOI: 10.1136/bmjopen-2020-044987] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES This systematic review aimed to describe medication non-adherence among people living with multimorbidity according to the current literature, and synthesise predictors of non-adherence in this population. METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses. PubMed, EMBASE, CINAHL and PsycINFO were searched for relevant articles published in English language between January 2009 and April 2019. Quantitative studies reporting medication non-adherence and/or predictors of non-adherence among people with two or more chronic conditions were included in the review. A meta-analysis was conducted with a subgroup of studies that used an inclusive definition of multimorbidity to recruit participants, rather than seeking people with specific conditions. Remaining studies reporting prevalence and predictors of non-adherence were narratively synthesised. RESULTS The database search produced 10 998 records and a further 75 were identified through other sources. Following full-text screening, 178 studies were included in the review. The range of reported non-adherence differed by measurement method, at 76.5% for self-report, 69.4% for pharmacy data, and 44.1% for electronic monitoring. A meta-analysis was conducted with eight studies (n=8949) that used an inclusive definition of multimorbidity to recruit participants. The pooled prevalence of non-adherence was 42.6% (95% CI: 34.0 - 51.3%, k=8, I2=97%, p<0.01). The overall range of non-adherence was 7.0%-83.5%. Frequently reported correlates of non-adherence included previous non-adherence and treatment-related beliefs. CONCLUSIONS The review identified a heterogeneous literature in terms of conditions studied, and definitions and measures of non-adherence used. Results suggest that future attempts to improve adherence among people with multimorbidity should determine for which conditions individuals require most support. The variable levels of medication non-adherence highlight the need for more attention to be paid by healthcare providers to the impact of multimorbidity on chronic disease self-management. PROSPERO REGISTRATION NUMBER CRD42019133849.
Collapse
Affiliation(s)
- Louise Foley
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - James Larkin
- HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Richard Lombard-Vance
- Department of Psychology, National University of Ireland Maynooth, Maynooth, Ireland
| | - Andrew W Murphy
- Discipline of General Practice, National University of Ireland Galway, Galway, Ireland
- HRB Primary Care Clinical Trials Network Ireland, National University of Ireland Galway, Galway, Ireland
| | - Lisa Hynes
- Health Programmes, Croí Heart & Stroke Centre, Galway, Ireland
| | - Emer Galvin
- School of Pharmacy & Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gerard J Molloy
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| |
Collapse
|
10
|
Ishida N, Tokumoto Y, Suga Y, Noguchi-Shinohara M, Abe C, Yuki-Nozaki S, Mori A, Horimoto M, Hayashi K, Iwasa K, Yokogawa M, Ishimiya M, Nakamura H, Komai K, Matsushita R, Ishizaki J, Yamada M. [Factors Associated with Self-reported Medication Adherence in Japanese Community-dwelling Elderly Individuals: The Nakajima Study]. YAKUGAKU ZASSHI 2021; 141:751-759. [PMID: 33952759 DOI: 10.1248/yakushi.20-00254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Medication non-adherence in the elderly population is a major problem, preventing them from obtaining optimal therapeutic effects. Identifying the factors affecting medication adherence is crucial for improving and maintaining health among the elderly population and enhance healthcare economy. The purpose of this study was to examine the prevalence of self-reported medication adherence, and identify the associated factors and the influence of health-related quality of life (HRQOL) in the Japanese community-dwelling elderly population. This cross-sectional study was part of the Nakajima study and targeted inhabitants aged ≥60 years who underwent health examinations in 2017. Data regarding medication adherence were acquired through interviews and self-administered questionnaires. Medication adherence were assessed using a visual analog scale, and HRQOL was assessed by EuroQol five-dimensional questionnaire with 3 levels. Among the 455 participants, low and high medication adherence were seen in 9.7% and 66.2% of the participants, respectively (visual analog scores <80% and ≥95%, respectively). Medication adherence was significantly lower in participants taking medications ≥3 times daily than in those taking medications once or twice daily; a regimen involving drug administration ≥3 times daily had significantly lower odds of medication adherence. The use of a drug profile book and HRQOL had significant positive association with medication adherence. Our results suggest that low dosing frequency and using a drug profile book was positively associated with medication adherence among elderly persons, which in turn could enhance their QOL.
Collapse
Affiliation(s)
- Natsuko Ishida
- Clinical Pharmacy and Healthcare Sciences, Faculty of Pharmacy, Institute of Medical, Pharmaceutical & Health Science, Kanazawa University
| | - Yurina Tokumoto
- Clinical Pharmacy and Healthcare Sciences, Faculty of Pharmacy, Institute of Medical, Pharmaceutical & Health Science, Kanazawa University
| | - Yukio Suga
- Clinical Pharmacy and Healthcare Sciences, Faculty of Pharmacy, Institute of Medical, Pharmaceutical & Health Science, Kanazawa University
| | - Moeko Noguchi-Shinohara
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences
| | - Chiemi Abe
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences
| | - Sohshi Yuki-Nozaki
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences
| | - Ayaka Mori
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences
| | - Mai Horimoto
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences
| | - Koji Hayashi
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences
| | - Kazuo Iwasa
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences
| | - Masami Yokogawa
- Department of Physical Therapy, Division of Health Sciences, Kanazawa University Graduate School of Medical Sciences
| | - Mai Ishimiya
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Sciences
| | - Hiroyuki Nakamura
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Sciences
| | - Kiyonobu Komai
- Department of Neurology, Hokuriku Brain and Neuromuscular Disease Center, Iou Hospital, National Hospital Organization
| | - Ryo Matsushita
- Clinical Pharmacy and Healthcare Sciences, Faculty of Pharmacy, Institute of Medical, Pharmaceutical & Health Science, Kanazawa University
| | - Junko Ishizaki
- Clinical Pharmacy and Healthcare Sciences, Faculty of Pharmacy, Institute of Medical, Pharmaceutical & Health Science, Kanazawa University
| | - Masahito Yamada
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences
| |
Collapse
|
11
|
Rijken M, Valderas JM, Heins M, Schellevis F, Korevaar J. Identifying high-need patients with multimorbidity from their illness perceptions and personal resources to manage their health and care: a longitudinal study. BMC FAMILY PRACTICE 2020; 21:75. [PMID: 32349683 PMCID: PMC7191697 DOI: 10.1186/s12875-020-01148-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 04/22/2020] [Indexed: 01/15/2023]
Abstract
Background A proactive person-centred care process is advocated for people with multimorbidity. To that aim, general practitioners may benefit from support in the identification of high-need patients, i.e. patients who are high or suboptimal users of health services and/or have a poor quality of life. To develop such support, we examined whether knowledge about patients’ illness perceptions and personal resources to manage their health and care is useful to identify high-need patients among multimorbid general practice populations. Methods Survey data, collected in 2016 and 2017, of 601 patients with two or more chronic diseases (e.g. COPD, diabetes, Parkinson’s disease) registered with 40 general practices in the Netherlands were analysed by logistic regression analysis to predict frequent contact with the general practice, contact with general practice out-of-office services, unplanned hospitalisations and poor health related quality of life. Patients’ illness perceptions and personal resources (education, health literacy, mastery, mental health status, financial resources, social support) were included as predictors. Results The four outcomes were only weakly associated among themselves (Phi .07–.19). Patients’ illness perceptions and personal resources were of limited value to predict potentially suboptimal health service use, but they were important predictors of health related quality of life. Patients with a poor health related quality of life could be identified by their previously reported illness perceptions (attributing many symptoms to their chronic conditions (B = 1.479, P < .001), a high level of concern (B = 0.844, P = .002) and little perceived control over their illness (B = -0.728, P = .006)) combined with an experienced lack of social support (B = -0.527, P = .042) and a poor mental health status (B = -0.966, P = .001) (sensitivity 80.7%; specificity 68.1%). Conclusions Multimorbid patients who frequently contact the general practice, use general practice out-of-office services, have unplanned hospitalisations or a poor health related quality of life are largely distinct high-need subgroups. Multimorbid patients at risk of developing a poor quality of life can be identified from specific illness beliefs, a poor mental health status and unmet social needs.
Collapse
Affiliation(s)
- Mieke Rijken
- Nivel (Netherlands Institute for Health Services Research), PO Box 1568, 3500, BN, Utrecht, The Netherlands. .,Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland.
| | - José Maria Valderas
- Health Services & Policy Research, Exeter Collaboration for Academic Primary Care (APEx), NIHR PenCLAHRC, University of Exeter, Exeter, UK
| | - Marianne Heins
- Nivel (Netherlands Institute for Health Services Research), PO Box 1568, 3500, BN, Utrecht, The Netherlands
| | - Francois Schellevis
- Nivel (Netherlands Institute for Health Services Research), PO Box 1568, 3500, BN, Utrecht, The Netherlands.,Department of General Practice and Elderly Care Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Joke Korevaar
- Nivel (Netherlands Institute for Health Services Research), PO Box 1568, 3500, BN, Utrecht, The Netherlands
| |
Collapse
|
12
|
Alrabiah Z, Wajid S, Alsulaihim I, Alghadeer S, Alhossan A, Babelghaith SD, Al-Arifi M. Adherence to prophylactic dual antiplatelet therapy in patients with acute coronary syndrome - A study conducted at a Saudi university hospital. Saudi Pharm J 2020; 28:369-373. [PMID: 32194339 PMCID: PMC7078558 DOI: 10.1016/j.jsps.2020.01.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 01/29/2020] [Indexed: 11/26/2022] Open
Abstract
Objectives The aim of this study was to evaluate patients’ self-reported adherence to dual antiplatelet therapy (DAPT) and determine the factors associated with premature discontinuation of DAPT. Methods The cross-sectional interview-based study was conducted among adult outpatients who visited the outpatient department of King Khalid University Hospital, Cardiac Center in Riyadh, Saudi Arabia, over a period of 3 months from May to July of 2016. Medication adherence was assessed using the Self-efficacy for Appropriate Medication Use Scale (SEAMS), which is composed of 13 items with a 3-point Likert scale. Results A total of 192 patients participated in the study. The majority of the participants were male (82.1%), and the mean age was 55.66 ± 10.80 years. More than 84% (84.4%) of the patients reported that they were “confident” in taking several medications each day. The minimum and maximum SEAMS scores were 22 and 39, respectively, with the mean score being 30.8 ± 3.5. Almost all patients had moderate scores and adherence; only one patient got a score of 39. Among sociodemographic characteristics, only health insurance and income were significantly associated with the medication adherence score (p < 0.05). Conclusions Study results concluded that patients had a moderate level of adherence towards DAPT in Saudi Arabia, however Patient education on DAPT is essential to improve adherence to medication treatment. More effective intentions and education methods should be developed to improve long-term DAPT adherence.
Collapse
Affiliation(s)
- Ziyad Alrabiah
- Clinical Pharmacy Department, College of Pharmacy King Saud University, Saudi Arabia
| | - Syed Wajid
- Clinical Pharmacy Department, College of Pharmacy King Saud University, Saudi Arabia
| | - Ibrahim Alsulaihim
- Clinical Pharmacy Department, College of Pharmacy King Saud University, Saudi Arabia
| | - Sultan Alghadeer
- Clinical Pharmacy Department, College of Pharmacy King Saud University, Saudi Arabia
| | - Abdulaziz Alhossan
- Clinical Pharmacy Department, College of Pharmacy King Saud University, Saudi Arabia
| | - Salmeen D Babelghaith
- Clinical Pharmacy Department, College of Pharmacy King Saud University, Saudi Arabia
| | - Mohamed Al-Arifi
- Clinical Pharmacy Department, College of Pharmacy King Saud University, Saudi Arabia
| |
Collapse
|
13
|
Cheng C, Yang C, Inder K, Chan SWC. Illness Perceptions, Coping Strategies, and Quality of Life in People With Multiple Chronic Conditions. J Nurs Scholarsh 2020; 52:145-154. [DOI: 10.1111/jnu.12540] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Cheng Cheng
- PhD candidate, School of Nursing and Midwifery, the University of Newcastle, Callaghan, Australia; Lecturer, Department of Nursing Bengbu Medical College Bengbu China
| | - Cong‐Yan Yang
- Head nurse, Department of Nursing the First Affiliated Hospital of Bengbu Medical College Bengbu China
| | - Kerry Inder
- Associate Professor, School of Nursing and Midwifery the University of Newcastle Callaghan Australia
| | | |
Collapse
|
14
|
Emilsson M, Berndtsson I, Gustafsson PA, Horne R, Marteinsdottir I. Reliability and validation of Swedish translation of Beliefs about Medication Specific (BMQ-Specific) and Brief Illness Perception Questionnaire (B-IPQ) for use in adolescents with attention-deficit hyperactivity disorder. Nord J Psychiatry 2020; 74:89-95. [PMID: 31596161 DOI: 10.1080/08039488.2019.1674376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: The purpose of this study was to assess the reliability and validity of Swedish translations of the Beliefs about Medicines Questionnaire-Specific (BMQ-Specific) and Brief Illness Perception Questionnaire (B-IPQ) for use in adolescents with ADHD.Methods: Forward and backward translations of the BMQ-Specific and B-IPQ scales to Swedish were conducted and reviewed by adolescents with ADHD and professionals. The validity and reliability of both questionnaires were investigated in a cross-sectional study of 101 adolescents (13-17 years) on a long-term prescription of ADHD medication recruited from two child and adolescent psychiatric outpatient clinics in Sweden.Results: Regarding the BMQ-Specific, principal component analysis (PCA) loadings confirmed the previously defined components of Specific-Necessity and Specific-Concern. The PCA for B-IPQ revealed two components, the first one, B-IPQ Consequences, captured questions regarding perceptions of the implication of having ADHD (items 1, 2, 5, 6 and 8) and the second one, B-IPQ-Control, the perceptions of the capability to manage the ADHD disorder (items 3, 4 and 7). The Cronbach alpha coefficients for BMQ-Specific-Necessity scale was α = 0.80, for BMQ-Specific-Concern scale α = 0.75, B-IPQ Consequences α = 0.74 and for B-IPQ-Control α = 0.44.Conclusions: The present results prove the Swedish translation of BMQ-Specific and B-IPQ to be valid and reliable for utilization in adolescents with ADHD. The PCA confirmed the original components for BMQ-Specific and the recent findings of two main B-IPQ components describing emotional and cognitive implications versus the capability for self-care maintenance of ADHD.
Collapse
Affiliation(s)
- Maria Emilsson
- Department of Health Science, Section of Nursing Graduate Level, University West, Trollhättan, Sweden
| | - Ina Berndtsson
- Department of Health Science, Section of Nursing Graduate Level, University West, Trollhättan, Sweden
| | - Per A Gustafsson
- Department of Clinical and Experimental Medicine and Department of Child and Adolescent Psychiatry, Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Robert Horne
- Centre for Behavioural Medicine, UCL School of Pharmacy, University College London, London, UK
| | - Ina Marteinsdottir
- Department of Medicine and Optometry Faculty of Health and Life Sciences, Linnæus University, Kalmar, Sweden
| |
Collapse
|
15
|
Nelson S, Albert JM, Liu Y, Selvaraj D, Curtan S, Ryan K, Pinto A, Ejaz F, Milgrom P, Riedy C. The psychometric properties of a new oral health illness perception measure for adults aged 62 years and older. PLoS One 2019; 14:e0214082. [PMID: 30970021 PMCID: PMC6457485 DOI: 10.1371/journal.pone.0214082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 03/06/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Based on the Common-Sense Model of Self-Regulation (CSM), a new integrated Illness Perception Questionnaire Revised for Dental Use in Older/Elder Adults (IPQ-RDE) was developed for single and multiple dental conditions. This study describes psychometric properties of the IPQ-RDE for adults 62 years and older. METHODS Participants (n = 198) living in 16 subsidized housing facilities completed the IPQ-RDE and a questionnaire assessing their socio-demographics, frequency of dental visits, perceived condition of teeth/gums, depression, social support, and oral health quality of life (OHQOL). Participants received dental screening for presence/absence of teeth, coronal and root caries, and periodontitis. The 43-item IPQ-RDE was tested for internal (construct, discriminant) and external validity (concurrent, construct, discriminant, predictive) and reliability (internal consistency). RESULTS Confirmatory factor analysis demonstrated that a ten-factor model in accordance with the CSM framework (identity, consequences, control, timeline, illness coherence, treatment burden, prioritization, causal relationship, activity restriction, emotional representations) had good construct validity based on significant factor loadings and acceptable model fit (RMSEA = 0.065, CFI = 0.902). Edentulous participants had significantly higher mean factor scores (inaccurate perception) for overall IPQ-RDE and four constructs indicating concurrent validity. Discriminant validity was suggested by non-relationship with external measures (education, dental visit frequency). Predictive validity was indicated by the negative correlation of most constructs with OHQOL suggesting that inaccurate perception was related to lower quality of life. Internal consistency of eight IPQ-RDE constructs was excellent (Cronbach's alpha > 0.73). CONCLUSIONS The IPQ-RDE is a valid and reliable new measure for assessing older adult's perception of dental conditions. It can be an important tool for oral health behavioral research to restructure older adult's perception of dental conditions, and subsequently prevent tooth loss and improve oral health quality of life.
Collapse
Affiliation(s)
- Suchitra Nelson
- Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, United States of America
| | - Jeffrey M. Albert
- Case Western Reserve University School of Medicine, Cleveland, Ohio, United States of America
| | - Yiying Liu
- Case Western Reserve University School of Medicine, Cleveland, Ohio, United States of America
| | - David Selvaraj
- Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, United States of America
| | - Shelley Curtan
- Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, United States of America
| | - Kelli Ryan
- Case Western Reserve University School of Medicine, Cleveland, Ohio, United States of America
| | - Andres Pinto
- Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, United States of America
| | - Farida Ejaz
- Benjamin Rose Institute on Aging, Cleveland, Ohio, United States of America
| | - Peter Milgrom
- University of Washington School of Dentistry, Seattle, Washington, United States of America
| | - Christine Riedy
- Harvard School of Dental Medicine, Boston, Massachusetts, United States of America
| |
Collapse
|
16
|
Pednekar PP, Ágh T, Malmenäs M, Raval AD, Bennett BM, Borah BJ, Hutchins DS, Manias E, Williams AF, Hiligsmann M, Turcu-Stiolica A, Zeber JE, Abrahamyan L, Bunz TJ, Peterson AM. Methods for Measuring Multiple Medication Adherence: A Systematic Review-Report of the ISPOR Medication Adherence and Persistence Special Interest Group. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:139-156. [PMID: 30711058 DOI: 10.1016/j.jval.2018.08.006] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 06/29/2018] [Accepted: 08/20/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND A broad literature base exists for measuring medication adherence to monotherapeutic regimens, but publications are less extensive for measuring adherence to multiple medications. OBJECTIVES To identify and characterize the multiple medication adherence (MMA) methods used in the literature. METHODS A literature search was conducted using PubMed, PsycINFO, the International Pharmaceutical Abstracts, the Cumulative Index to Nursing and Allied Health Literature and the Cochrane Library databases on methods used to measure MMA published between January 1973 and May 2015. A two-step screening process was used; all abstracts were screened by pairs of researchers independently, followed by a full-text review identifying the method for calculating MMA. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to conduct this systematic review. For studies that met the eligibility criteria, general study and adherence-specific characteristics and the number and type of MMA measurement methods were summarized. RESULTS The 147 studies that were included originated from 32 countries, in 13 disease states. Of these studies, 26 used proportion of days covered, 23 used medication possession ratio, and 72 used self-reported questionnaires (e.g., the Morisky Scale) to assess MMA. About 50% of the studies included more than one method for measuring MMA, and different variations of medication possession ratio and proportion of days covered were used for measuring MMA. CONCLUSIONS There appears to be no standardized method to measure MMA. With an increasing prevalence of polypharmacy, more efforts should be directed toward constructing robust measures suitable to evaluate adherence to complex regimens. Future research to understand the validity and reliability of MMA measures and their effects on objective clinical outcomes is also needed.
Collapse
Affiliation(s)
- Priti P Pednekar
- Mayes College of Healthcare Business and Policy, University of the Sciences, Philadelphia, PA, USA.
| | - Tamás Ágh
- Syreon Research Institute, Budapest, Hungary
| | - Maria Malmenäs
- Real World Strategy & Analytics, Mapi Group, Stockholm, Sweden
| | | | | | - Bijan J Borah
- Division of Health Care Policy and Research, Mayo Clinic College of Medicine, Rochester, MN, USA
| | | | - Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Deakin University, Burwood, Victoria, Australia
| | - Allison F Williams
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Mickaël Hiligsmann
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Adina Turcu-Stiolica
- Department of Pharmaceutical Marketing and Management, University of Medicine and Pharmacy, Craiova, Romania
| | - John E Zeber
- Central Texas Veterans Health Care System, Scott & White Healthcare, Center for Applied Health Research, Temple, TX, USA
| | | | | | - Andrew M Peterson
- Mayes College of Healthcare Business and Policy, University of the Sciences, Philadelphia, PA, USA
| |
Collapse
|
17
|
Heyduck-Weides K, Bengel J, Farin E, Glattacker M. Measuring illness perceptions in the family context: psychometric properties of the IPQ-R adapted for adolescent-caregiver dyads. Psychol Health 2019; 34:1-23. [PMID: 30632795 DOI: 10.1080/08870446.2018.1494830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Given the lack of validated measures assessing illness perceptions in families, the aim of our study was the development and psychometric testing of an adapted version of the Illness Perceptions Questionnaire-Revised (IPQ-R) allowing for Common Sense Model-based dyadic assessment of adolescents' and caregivers' perceptions of a chronic illness in adolescence. METHODS Using a cross-sectional survey design, factor structure, reliability and validity of the adapted measure You-IPQ-R were tested in a sample of adolescents with asthma (N = 155) and their primary caregivers (N = 132). Analysis included a dyadic methodology (dyadic confirmatory factor analyses) and examination of the suitability of the measure for different age groups. RESULTS Both the adolescent and the caregiver versions of the You-IPQ-R revealed good overall validity and reliability. For all Common Sense Model dimensions except for timeline cyclical in the caregiver version, unidimensional scales aligning with the original IPQ-R structure could be confirmed. Age-specific analyses revealed good to excellent measurement properties in adolescents aged 14 years or older, but considerably poorer indices in younger adolescents. CONCLUSION The dyadically validated You-IPQ-R will enable researchers and clinicians to compare illness perceptions in adolescent-caregiver dyads and to assess the effects of family illness perceptions' congruence upon medical, psychosocial and behavioural outcomes.
Collapse
Affiliation(s)
- Katja Heyduck-Weides
- a Faculty of Medicine , Section of Health Care Research and Rehabilitation Research, Medical Center , University of Freiburg , Freiburg, Germany
| | - Jürgen Bengel
- b Department of Rehabilitation Psychology and Psychotherapy , University of Freiburg , Freiburg, Germany
| | - Erik Farin
- a Faculty of Medicine , Section of Health Care Research and Rehabilitation Research, Medical Center , University of Freiburg , Freiburg, Germany
| | - Manuela Glattacker
- a Faculty of Medicine , Section of Health Care Research and Rehabilitation Research, Medical Center , University of Freiburg , Freiburg, Germany
| |
Collapse
|
18
|
Groeneveld IF, van der Pas SL, Meesters JJL, Schuurman JM, van Meijeren-Pont W, Jagersma E, Goossens PH, Kaptein AA, Vliet Vlieland TPM. Illness perceptions of stroke survivors: Predictors and changes over time - A 1 year follow-up study. J Psychosom Res 2019; 116:54-61. [PMID: 30654994 DOI: 10.1016/j.jpsychores.2018.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/11/2018] [Accepted: 10/31/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To describe the illness perceptions (IP) of stroke patients in the first year post stroke; to identify patient clusters with comparable IP trajectories and determine their associations with health. METHODS This prospective study included consecutive stroke patients after medical rehabilitation. Three and 12 months post stroke they completed the Brief Illness Perception Questionnaire (B-IPQ) and questionnaires on physical and mental health. All eight IP and their changes over time were described. Clusters of patients with comparable IP trajectories were constructed by k-means clustering, with subsequent comparison of patient characteristics. Multivariable logistic regression analyses were conducted to determine the association between IP clusters and 12-month mental health. RESULTS Hundred-and-eighty-four patients were included (men n = 107 [58.2%]; mean age 61.1 [SD 12.7] years). At 3 months, the scores of the IP coherence (mean 3.0, SD 2.3) and treatment control (mean 3.2, SD 2.5) were lowest (best), and consequences (mean 6.1, SD 2.8) and anticipated timeline (mean 6.0, SD 2.7) were highest (worst). At 12 months, the timeline and treatment control scores had significantly worsened. Three clusters of the trajectories of IP were identified, and designated as 'favourable', 'average', and 'unfavourable'. The unfavourable cluster was significantly associated with worse physical and mental health at 3 months (unadjusted) and depressive symptoms at 12 months. CONCLUSION Stroke patients' IP partly changed between 3 and 12 months post stroke. Patients with an unfavourable IP trajectory had a higher chance of depressive symptoms at 12 months. Illness perceptions could be considered as an additional target of treatment.
Collapse
Affiliation(s)
- I F Groeneveld
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands.
| | - S L van der Pas
- Medical Statistics, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands; Mathematical Institute, Leiden University, the Netherlands
| | - J J L Meesters
- Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | | | - W van Meijeren-Pont
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | - E Jagersma
- Sophia Rehabilitation, The Hague, the Netherlands
| | - P H Goossens
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | - A A Kaptein
- Department of Medical Psychology, Leiden University Medical Center, Leiden, the Netherlands
| | - T P M Vliet Vlieland
- Rijnlands Rehabilitation Centre, Leiden, the Netherlands; Sophia Rehabilitation, The Hague, the Netherlands; Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | | |
Collapse
|
19
|
Abstract
BACKGROUND The majority of people with anxiety tend to seek help in primary care. Patients' illness perception regarding their own anxiety can influence the assessment, treatment processes, and outcomes. This cross-sectional study explored possible relationships between patients' illness perception of their anxiety and the severity of their anxiety. MATERIALS AND METHODS Ninety-five patients with anxiety were recruited at two primary care clinics in Singapore. Their responses to the generalized anxiety disorder-7 (GAD-7) and illness perception questionnaire mental health (IPQ-MH) were examined with Spearman's rho correlation coefficients and multiple regression analyses. RESULTS Four illness perception subscales, i.e., consequences (rs = 0.23), personal control (rs = -0.27), coherence (rs = -0.22), and biological (rs = 0.34) significantly correlated to anxiety (P < 0.05). A multiple regression analysis identified that attribution to biological factors (β = 0.348, P =0.001) and attribution to personal control (β = -0.262, P =0.008) were significantly associated with anxiety. CONCLUSIONS Interventions for anxiety reduction in primary care can be enhanced with methods that promote (1) patients' awareness of the reasons for their anxiety beyond mostly bodily ones to include psychosocial ones and (2) patients' confidence in their own capacity to influence their recovery.
Collapse
Affiliation(s)
| | - Mei Yin Wong
- National Healthcare Group Polyclinics, Singapore
| | | |
Collapse
|
20
|
de Rooij BH, Thong MS, van Roij J, Bonhof CS, Husson O, Ezendam NPM. Optimistic, realistic, and pessimistic illness perceptions; quality of life; and survival among 2457 cancer survivors: the population-based PROFILES registry. Cancer 2018; 124:3609-3617. [DOI: 10.1002/cncr.31634] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/29/2018] [Accepted: 06/01/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Belle H. de Rooij
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology; Tilburg University; Tilburg the Netherlands
- The Netherlands Comprehensive Cancer Organisation; Utrecht the Netherlands
| | - Melissa S.Y. Thong
- Department of Medical Psychology, Academic Medical Center; University of Amsterdam, Amsterdam Public Health Research Institute; Amsterdam the Netherlands
| | - Janneke van Roij
- The Netherlands Comprehensive Cancer Organisation; Utrecht the Netherlands
| | - Cynthia S. Bonhof
- The Netherlands Comprehensive Cancer Organisation; Utrecht the Netherlands
| | - Olga Husson
- The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust; London United Kingdom
| | - Nicole P. M. Ezendam
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology; Tilburg University; Tilburg the Netherlands
- The Netherlands Comprehensive Cancer Organisation; Utrecht the Netherlands
| |
Collapse
|
21
|
Heid AR, Pruchno R, Wilson-Genderson M. Illness Representations of Multiple Chronic Conditions and Self-Management Behaviors in Older Adults: A Pilot Study. Int J Aging Hum Dev 2018; 87:90-106. [PMID: 29737195 DOI: 10.1177/0091415018771327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article explores the intraindividual variability in illness representations of people with multiple chronic conditions and examines how representations of hypertension and arthritis are associated with self-management. Intraclass correlations determined the proportion of within-person variability in illness representations including Timeline, Consequences, Personal Control, and Timeline-Cyclical for 25 adults aged 64 and older. Within-person consistency across illnesses was present for Timeline and Timeline-Cyclical, but variability across illnesses in Personal Control and Consequences. Correlations revealed associations of diet, exercise, and sleep with illness representations of people with arthritis and hypertension. Representations of hypertension (Personal Control, Timeline-Cyclical, and Consequences) were associated with adherence to a reduced fat diet, walking, and total sleep time. Representations of arthritis were not associated with health behaviors. Findings demonstrate that clinical practice must consider the illness representations patients have about each of their chronic illnesses to begin to sustain positive self-management behaviors.
Collapse
Affiliation(s)
- Allison R Heid
- 1 New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Rachel Pruchno
- 1 New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | | |
Collapse
|
22
|
Lamarche L, Tejpal A, Mangin D. Self-efficacy for medication management: a systematic review of instruments. Patient Prefer Adherence 2018; 12:1279-1287. [PMID: 30050290 PMCID: PMC6056165 DOI: 10.2147/ppa.s165749] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Medication self-efficacy is a potentially important construct in research around optimal use of prescription medications. A number of medication self-efficacy measures are available; however, there is no systematic review of existing instruments and cataloguing of their theoretical underpinnings or psychometric properties, strengths, and weaknesses. The aim of the study was to identify instruments that measure self-efficacy for medication management. The study also aimed to examine the quality, theoretical grounding, and psychometric evaluation of existing measures of self-efficacy for medication management. The study was a systematic review. METHODS Data were extracted from PubMed, OVID, and MEDLINE using a predefined search strategy. Citations were included if they reported the development and/or psychometric evaluation of an instrument to measure self-efficacy for medication management and were in English. Abstracts were screened for studies potentially meeting eligibility criteria. Full articles of these studies were then reviewed in depth. The review was carried out independently by two members of the research team. RESULTS The search identified 158 citations of which 12 were included after screening. Full review identified 3 articles fitting inclusion criteria for the review. Generally, development was theoretically grounded and included patients and experts in the field. Psychometric testing showed evidence of internal consistency (2/3 instruments) and test-retest reliability (1/3 instruments). All instruments showed some validity; however, assessment of all forms of validity for each instrument was lacking. CONCLUSION Although our analysis would recommend the use of the Self-Efficacy for Appropriate Medication Use Scale because of the current evidence of validity and reliability, more psychometric evaluation is required, particularly in terms of responsiveness to change as self-efficacy is a malleable patient-level factor. Three measures of self-efficacy for medication management were identified. Overall, some evidence of reliability and/or validity was demonstrated for all instruments; however, other forms of validity were not tested (ie, responsiveness to change). Use of a well-validated measure of self-efficacy medication management is essential in order to understand relationships between medication self-efficacy and other patient-reported outcomes such as patient-centeredness, patient enablement, and burden of treatment, an important area of research that is currently lacking.
Collapse
Affiliation(s)
- Larkin Lamarche
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada,
| | - Ambika Tejpal
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada,
| | - Dee Mangin
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada,
| |
Collapse
|
23
|
Illness perceptions in patients with heart failure and an implantable cardioverter defibrillator: Dimensional structure, validity, and correlates of the brief illness perception questionnaire in Dutch, French and German patients. J Psychosom Res 2017; 97:1-8. [PMID: 28606488 DOI: 10.1016/j.jpsychores.2017.03.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 03/17/2017] [Accepted: 03/19/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Patients' illness perceptions are associated with psychological wellbeing and can be measured with the Brief Illness Perception Questionnaire (B-IPQ). However, little is known about illness perceptions in patients with heart failure. We examined the dimensional structure, validity and clinical and psychological correlates of the B-IPQ in Dutch, French and German patients with heart failure and an implantable cardioverter defibrillator (ICD). METHOD European heart failure patients (n=585) participating in the REMOTE-CIED study completed a set of questionnaires 1-2weeks post ICD-implantation, including the B-IPQ. Information on clinical data was captured from patients' medical records. RESULTS A two-factor structure (I='Consequences'; II='Control') represented 7 out of 8 B-IPQ items in the total sample and Dutch, German and French subgroups. The total B-IPQ had a Cronbach's α of 0.69, with the 'Consequences' subscale being more internally consistent (α=0.80). Both the B-IPQ and its 'Consequences' subscale were significantly correlated with a number of psychological characteristics, but not with clinical characteristics. Multivariable logistic regression analysis indicated that threatening illness perceptions as measured with the total B-IPQ were associated with poor health status (OR=2.66, 95%CI=1.72-4.11), anxiety (OR=1.79, 95%CI=1.001-3.19), depression (OR=2.81, 95%CI=1.65-4.77), negative affectivity (OR=1.93, 95%CI=1.21-3.09) and poor ICD acceptance (OR=2.68, 95%CI=1.70-4.22). CONCLUSION The B-IPQ demonstrated good psychometric properties in Dutch, French and German patients with heart failure. Psychological factors were the most important correlates of patients' perceptions of heart failure, emphasizing the importance of targeting maladaptive illness perceptions in this population, due to their impact on patients' wellbeing and quality of life.
Collapse
|
24
|
Richardson EM, Scott JL, Schüz N, Sanderson K, Schüz B. 'It was all intertwined': Illness representations and self-management in patients with cancer and anxiety/depression. Psychol Health 2017; 32:1082-1108. [PMID: 28511605 DOI: 10.1080/08870446.2017.1324970] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Cancer and anxiety/depression frequently co-occur, leading to poorer outcomes for these illnesses. However, the majority of existing research investigates how participants view single illnesses alone. This study aimed to explore the content of individuals' multimorbid representations and how these relate to their coping behaviours and self-management strategies for cancer and anxiety/depression. DESIGN A semi-structured qualitative research design with theoretical thematic analysis. MAIN OUTCOME MEASURES Multimorbid illness representations, coping behaviours, and self-management strategies. RESULTS In interviews with 21 participants multimorbid representations varied, three participants viewed cancer and anxiety/depression as unrelated, five participants were uncertain about the relationship between cancer and anxiety/depression, and the majority of participants perceived cancer and anxiety/depression as related. This third group of participants often described relationships as causal, with representations having both positive and negative influences on coping behaviours and self-management strategies. Representations were shown to change over the course of the cancer experience, with fear of cancer recurrence and the influence of participants' most challenging illness also discussed. CONCLUSIONS People hold multimorbid illness representations that can influence self-management. An awareness of these representations by researchers, health professionals, and patients is important for the creation of future interventions that aim to improve and maintain patient wellbeing.
Collapse
Affiliation(s)
- Emma M Richardson
- a Division of Psychology, School of Medicine , University of Tasmania , Hobart , Australia
| | - Jennifer L Scott
- a Division of Psychology, School of Medicine , University of Tasmania , Hobart , Australia
| | - Natalie Schüz
- b School of Medicine , University of Tasmania , Hobart , Australia
| | - Kristy Sanderson
- c School of Health Sciences , University of East Anglia , Norwich , England
| | - Benjamin Schüz
- a Division of Psychology, School of Medicine , University of Tasmania , Hobart , Australia
| |
Collapse
|
25
|
Aujla N, Walker M, Sprigg N, Abrams K, Massey A, Vedhara K. Can illness beliefs, from the common-sense model, prospectively predict adherence to self-management behaviours? A systematic review and meta-analysis. Psychol Health 2016; 31:931-58. [PMID: 26911306 DOI: 10.1080/08870446.2016.1153640] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To determine whether people's beliefs about their illness, conceptualised by the common sense model (CSM), can prospectively predict adherence to self-management behaviours (including, attendance, medication, diet and exercise) in adults with acute and chronic physical illnesses. DESIGN AND MAIN OUTCOME MEASURES Electronic databases were searched in September 2014, for papers specifying the use of the 'CSM' in relation to 'self-management', 'rehabilitation' and 'adherence' in the context of physical illness. Six hundred abstracts emerged. Data from 52 relevant studies were extracted. Twenty-one studies were meta-analysed, using correlation coefficients in random effects models. The remainder were descriptively synthesised. RESULTS The effect sizes for individual illness belief domains and adherence to self-management behaviours ranged from .04 to .13, indicating very weak, predictive relationships. Further analysis revealed that predictive relationships did not differ by the: type of self-management behaviour; acute or chronic illness; or duration of follow-up. CONCLUSION Individual illness belief domains, outlined by the CSM, did not predict adherence to self-management behaviours in adults with physical illnesses. Prospective relationships, controlling for past behaviour, also did not emerge. Other factors, including patients' treatment beliefs and inter-relationships between individual illness beliefs domains, may have influenced potential associations with adherence to self-management behaviours.
Collapse
Affiliation(s)
- N Aujla
- a Division of Primary Care, University of Nottingham , Nottingham , UK.,b Division of Rehabilitation and Ageing , University of Nottingham , Nottingham , UK.,d Division of Clinical Neurosciences, Stroke , University of Nottingham , Nottingham , UK
| | - M Walker
- b Division of Rehabilitation and Ageing , University of Nottingham , Nottingham , UK
| | - N Sprigg
- d Division of Clinical Neurosciences, Stroke , University of Nottingham , Nottingham , UK
| | - K Abrams
- e Department of Health Sciences , University of Leicester , Leicester , UK
| | - A Massey
- c School of Clinical Sciences , University of Nottingham , Nottingham , UK
| | - K Vedhara
- a Division of Primary Care, University of Nottingham , Nottingham , UK
| |
Collapse
|
26
|
Yap AF, Thirumoorthy T, Kwan YH. Systematic review of the barriers affecting medication adherence in older adults. Geriatr Gerontol Int 2015; 16:1093-1101. [PMID: 26482548 DOI: 10.1111/ggi.12616] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2015] [Indexed: 01/10/2023]
Abstract
Medication adherence is a crucial part in the management of chronic diseases. As older adults form a greater proportion of the population with chronic diseases and multiple morbidities, understanding medication adherence in older adults becomes important. In the present article, we aimed to systematically review the literature for the factors associated with medication adherence in the geriatric population. We carried out a literature search using electronic databases and related keywords. 17 391 articles were reviewed in total. 65 articles were found to be relevant to our objective. A total of 80 factors of five different categories were found to be associated with medication adherence in older adults. The factors, the types of studies and the number of studies that agreed or disagreed were presented. A flower model for medication adherence was also presented to allow clinicians to better understand the complex nature of medication adherence in this population. The 80 factors reviewed were categorized into five main categories; namely, patient factors, medication factors, physician factors, system-based factors and other factors as factors affecting poor medication adherence in older adults. Clinicians need to be mindful of the complex nature of factors affecting medication adherence in this population to optimize therapeutic outcomes. Clinicians have to be more skillful to discover and to optimize the medication adherence factors in geriatric patients. The flower model is presented as a framework for clinicians to better understand the various factors affecting medication adherence in older adults. Geriatr Gerontol Int 2016; 16: 1093-1101.
Collapse
|
27
|
Leahy D, Treacy K, Molloy GJ. Conscientiousness and adherence to the oral contraceptive pill: A prospective study. Psychol Health 2015; 30:1346-60. [PMID: 26087993 DOI: 10.1080/08870446.2015.1062095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE We assess the association between conscientiousness and adherence to the oral contraceptive pill (OCP), and examine if such a relationship is independent of a measure of prospective memory and a range of social cognitive variables. METHOD Data were collected from 150 OCP users at baseline, and 99 provided follow-up data four weeks later. Conscientiousness, a range of social cognitive predictors and prospective memory were assessed at baseline. OCP adherence was measured at baseline, and again at Time 2. Data were analysed using correlation and multiple linear regression. RESULTS Higher conscientiousness was associated with higher overall OCP adherence in both cross-sectional (r = -0.28, p < 0.01) and prospective analysis (r = -0.34, p < 0.01). Conscientiousness predicted OCP adherence at Time 2, adjusting for OCP adherence at Time 1 (R(2) change = 0.02, p = 0.04). The association was reduced to non-significance when social cognitive predictors and prospective memory were included in the multivariable model. Prospective memory was an independent predictor of OCP adherence at Time 2. DISCUSSION This is the first study to identify an association between conscientiousness and OCP adherence. The association is not independent from social cognitive predictors and prospective memory. Facet-level analysis of conscientiousness and formal mediation analyses are recommended in future replications.
Collapse
Affiliation(s)
- D Leahy
- a School of Psychology , National University of Ireland , Galway , Ireland
| | - K Treacy
- a School of Psychology , National University of Ireland , Galway , Ireland
| | - G J Molloy
- a School of Psychology , National University of Ireland , Galway , Ireland
| |
Collapse
|
28
|
District-level primary care supply buffers the negative impact of functional limitations on illness perceptions in older adults with multiple illnesses. Ann Behav Med 2014; 49:463-72. [PMID: 25416178 DOI: 10.1007/s12160-014-9671-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Illness perceptions predict important outcomes, e.g. coping, adherence and well-being. Less is known about the sources of illness perceptions, in particular the role of environmental factors such as primary care supply. PURPOSE This study examines whether and how primary care supply (on district level) affects individual illness perceptions. METHODS We conducted a longitudinal study in 271 adults 65 years and older with multiple illnesses. Functional limitations (SF-36 physical functioning subscale) at time 1 were tested as predictors of illness perceptions 6 months later. Primary care supply on district level was matched to individual data. RESULTS In multilevel models, functional limitations predicted illness perceptions. Primary care supply on district level moderated the impact of functional limitations on individual identity and emotional response perceptions, with better supply buffering detrimental effects of functional limitations. CONCLUSIONS Illness perceptions do not only depend on individual factors, but socio-structural factors also substantially contribute to individual illness perceptions.
Collapse
|