1
|
Köbler P, Vogel RT, Joraschky P, Söllner W. [Experiences of Burden and Coping Strategies and their Associations with Mental Health and Well-Being in COPD - a Mixed Methods Study]. Psychother Psychosom Med Psychol 2024; 74:183-191. [PMID: 38492567 DOI: 10.1055/a-2255-8695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
Understanding trigger and maintaining factors regarding psychiatric comorbidities in COPD is of great importance. In the presented mixed-methods study, qualitative interview data on burden experience and coping were related to psychiatric comorbidity (using PHQ-D) and quality of live (Positive Affect Negative Affect Schedulde, PANAS and Satisfaction with Life Scale, SWLS) and extended by the Freiburg Questionnaire on Coping with Illness (FKV-LIS). The two interview questions prompting narrative were 1.) "What is currently bothering you most?"; 2.) "How do you cope with your chronic disease in everyday life?" A total of 62 patients who were hospitalized due to COPD participated. The severity of physical impairment was assessed using GOLD stage and the Charlson Comorbidity Index (CCI). The interviews conducted were content analyzed and then quantified. The collected data were then compared between two groups with regard to mental distress. 13 themes of burden and 11 coping strategies were identified by content analysis. A total of 42 patients showed signs of mental distress, while 20 patients did not show signs of distress. There were no significant differences between the two groups in terms of sociodemographic characteristics and the severity of their physical symptoms. In the first interview question, the stressed group more frequently addressed issues related to death (35.7% versus 15.0%) and social stress (21.4% versus 0.0%). With respect to the second interview question, the nonstressed group was significantly more likely to mention strategies for consciously emphasizing positive emotions (70.0% versus 31.0%). In addition, higher scores on the FKV scales for depressive coping and trivialization and wishful thinking were evident in the stressed group. Quality of life and mental distress should be considered in clinical care for COPD. Interventions to influence illness perception and related coping styles are important, especially with regard to the development of a realistic and optimistic perspective on life and disease burden, as well as the inclusion of group and family therapeutic interventions.
Collapse
Affiliation(s)
- Paul Köbler
- Universitätsklinik für Psychosomatische Medizin und Psychotherapie, Paracelsus Medizinische Privatuniversität - Nürnberg
| | - Ralf T Vogel
- Praxis für Psychotherapie und Supervision, Ingolstadt
| | | | - Wolfgang Söllner
- Universitätsklinik für Psychosomatische Medizin und Psychotherapie, Paracelsus Medizinische Privatuniversität - Nürnberg
| |
Collapse
|
2
|
Aravantinou-Karlatou A, Bouloukaki I, Christodoulakis A, Tsiligianni I. The Influence of Social Support in PROMs of Patients with COPD in Primary Care: A Scoping Review. Healthcare (Basel) 2023; 11:3141. [PMID: 38132031 PMCID: PMC10742576 DOI: 10.3390/healthcare11243141] [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: 12/10/2023] [Indexed: 12/23/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a prevalent and multidimensional disease with symptoms that greatly influence patients' health. Healthcare professionals utilize patient-reported outcome measures (PROMs) to classify and better manage the disease. Despite the value of PROMs, they inadequately represent some important dimensions of COPD, like social support and healthcare access/utilization. This is important, especially for social support, since it can positively influence PROMs results and the overall health of patients with COPD. Therefore, a scoping review was conducted to determine how social support affects PROMs of patients with COPD in primary care. The PRISMA-Scoping approach was adopted, and we sought articles published in MEDLINE and COHRANE. We screened 2038 articles for inclusion and finally included a total of 10 articles. Most of the articles were conducted in the U.S. and Norway. Social support had a strong positive impact on PROMs. Additionally, different types of social support were observed. Moreover, higher levels of social support were linked to better quality of life, mental health, self-care behaviors, self-management, functionality, and less severe COPD. Consequently, this scoping review highlights the value of social support in patients with COPD and its underrepresentation and misrepresentation in PROMs literature.
Collapse
Affiliation(s)
- Antonia Aravantinou-Karlatou
- Department of Social Medicine, School of Medicine, University of Crete, Voutes-Stavrakia, 71003 Heraklion, Greece; (I.B.); (A.C.); (I.T.)
| | - Izolde Bouloukaki
- Department of Social Medicine, School of Medicine, University of Crete, Voutes-Stavrakia, 71003 Heraklion, Greece; (I.B.); (A.C.); (I.T.)
| | - Antonios Christodoulakis
- Department of Social Medicine, School of Medicine, University of Crete, Voutes-Stavrakia, 71003 Heraklion, Greece; (I.B.); (A.C.); (I.T.)
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Ioanna Tsiligianni
- Department of Social Medicine, School of Medicine, University of Crete, Voutes-Stavrakia, 71003 Heraklion, Greece; (I.B.); (A.C.); (I.T.)
| |
Collapse
|
3
|
Henning C, Schroeder S, Steins-Loeber S, Wolstein J. Gender and Emotional Representation Matter: Own Illness Beliefs and Their Relationship to Obesity. Front Nutr 2022; 9:799831. [PMID: 35211498 PMCID: PMC8863172 DOI: 10.3389/fnut.2022.799831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/05/2022] [Indexed: 12/19/2022] Open
Abstract
Background Current treatments of obesity often fail to consider gender and psychological aspects, which are essential for weight loss and weight maintenance. The aim of our study was to analyze subjective illness representations (SIRs) of adults with obesity according to the Common-Sense Self-Regulation Model (CSM) by assessing their associations with weight-related variables and gender. Methods Data was collected via online self-assessment between April 2017 and March 2018. SIRs were operationalized by the revised Illness Perception Questionnaire (IPQ-R) and illness outcomes according to the CSM were defined as BMI, eating behaviour, physical wellbeing, bodyweight satisfaction, and shape concerns. The sample consisted of 427 adults (M = 42.2 years, SD = 10.9; 82% female) with obesity (BMI: M = 42.3 kg/m2, SD = 9.0). Student's t-tests and multiple hierarchical regression analyses were conducted with the control variables (age and BMI) and subjective illness representations and gender as independent variables. Results The explanation of outcome variances was moderate to high (21-43%) except for restraint eating behaviour (10%). Subjective illness representations showed several significant associations with weight-related variables, especially timeline and emotional representations. Female gender was significantly associated with more restraint eating behaviour [F(1, 400) = 4.19, p < 0.001] and females had unfavourable values of the weight-related variables as well as a more cyclic [t(425) = 3.68, p < 0.001], and more emotional representation [t(100) = 5.17, p < 0.001] of their obesity. Conclusion The results of this study indicate that gender and subjective illness representations, especially the emotional representation, play an important role for weight-related variables. Therefore, the assessment of SIRs may constitute an economic tool to identify specific individual deficits of self-regulation.
Collapse
Affiliation(s)
- Carmen Henning
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
- *Correspondence: Carmen Henning
| | | | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - Joerg Wolstein
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| |
Collapse
|
4
|
Whitehall L, Rush R, Górska S, Forsyth K. The General Self-Efficacy of Older Adults Receiving Care: A Systematic Review and Meta-Analysis. THE GERONTOLOGIST 2021; 61:e302-e317. [PMID: 32373938 PMCID: PMC8361502 DOI: 10.1093/geront/gnaa036] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Indexed: 12/14/2022] Open
Abstract
Background and Objectives General self-efficacy (GSE) encourages health-promoting behaviors in older adults. It is unsurprising then that older adults receiving health care services are reported to have a greater risk of low GSE than older adults who are not. Despite this, there is currently limited evidence investigating whether the effect differs based on the environment in which care is received. This review aims to determine whether the GSE of older adults is affected by the receipt of health care services and whether GSE varies based on the setting in which care is received. Research Design and Methods In accordance with PRISMA guidelines (PROSPERO registration number CRD42018092191), a systematic search was undertaken across 7 databases. Standardized mean differences (SMD) and mean General Self-Efficacy Scale scores, with 95% confidence intervals (CI), were pooled for meta-analysis. Results A total of 40 studies were identified, they consisted of 33 population cohorts that were included in the meta-analysis. Older adults receiving health care services were found to be at greater risk of having lower GSE than those who do not (SMD = −0.62; 95% CI: −0.96 to −0.27, p < .0001). Following identification of sources of heterogeneity, older adults receiving acute inpatient care were more likely to have lower GSE than those receiving care in other health care settings. Discussion and Implications Older adults receiving inpatient care have a greater risk of lower GSE, and consequently, poorer health-promoting behaviors. Further research is recommended that focuses on the GSE of older adults and health outcomes following discharge from inpatient care.
Collapse
Affiliation(s)
- Lucy Whitehall
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Robert Rush
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Sylwia Górska
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Kirsty Forsyth
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| |
Collapse
|
5
|
Frith P, Sladek R, Woodman R, Effing T, Bradley S, van Asten S, Jones T, Hnin K, Luszcz M, Cafarella P, Eckermann S, Rowett D, Phillips PA. Pragmatic randomised controlled trial of a personalised intervention for carers of people requiring home oxygen therapy. Chron Respir Dis 2020; 17:1479973119897277. [PMID: 31903773 PMCID: PMC6945457 DOI: 10.1177/1479973119897277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We used a pragmatic randomised controlled trial to evaluate a behavioural change strategy targeting carers of chronically hypoxaemic patients using long-term home oxygen therapy. Intervention group carers participated in personalised educational sessions focusing on motivating carers to take actions to assist patients. All patients received usual care. Effectiveness was measured through a composite event of patient survival to hospitalisation, residential care admission or death to 12 months. Secondary outcomes at baseline, 3, 6 and 12 months included carer and patient emotional and physical well-being. No difference between intervention (n = 100) and control (n = 97) patients was found for the composite outcome (hazard ratio (HR) 1.22, 95% confidence interval (CI) = 0.89, 1.68; p = 0.22). Improved fatigue, mastery, vitality and general health occurred in intervention group patients (all p values < 0.05). No benefits were seen in carer outcomes. Mortality was significantly higher in intervention patients (HR = 2.01, 95% CI = 1.00, 4.14; p = 0.05; adjusted for Australia-modified Karnofsky Performance Status), with a significant diagnosis-intervention interaction (p = 0.028) showing higher mortality in patients with COPD (HR 4.26; 95% CI = 1.60, 11.35) but not those with interstitial lung disease (HR 0.83; 95% CI = 0.28, 2.46). No difference was detected in the primary outcome, but patient mortality was higher when carers had received the intervention, especially in the most disabled patients. Trials examining behavioural change interventions in severe disease should stratify for functionality, and both risks and benefits should be independently monitored. Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12607000177459).
Collapse
Affiliation(s)
- Peter Frith
- College of Medicine & Public Health, Flinders University, Adelaide, Australia.,Health and Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Ruth Sladek
- College of Medicine & Public Health, Flinders University, Adelaide, Australia.,Prideaux Centre for Research in Health Professions Education, College of Medicine & Public Health, Flinders University, Adelaide, Australia
| | - Richard Woodman
- Flinders Centre for Epidemiology and Biostatistics, College of Medicine & Public Health, Flinders University, Adelaide, Australia
| | - Tanja Effing
- College of Medicine & Public Health, Flinders University, Adelaide, Australia.,Department of Respiratory and Sleep Medicine, Southern Adelaide Local Health Network, Adelaide, Australia
| | - Sandra Bradley
- College of Nursing & Health Sciences, Flinders University, Adelaide, Australia
| | - Suzanne van Asten
- Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Tina Jones
- Department for Health and Well-being, SA Health, Adelaide, Australia
| | - Khin Hnin
- Adelaide Sleep Health, Southern Adelaide Local Health Network, Adelaide, Australia.,Adelaide Institute for Sleep Health, College of Medicine & Public Health, Flinders University, Adelaide, Australia
| | - Mary Luszcz
- Department of Psychology, College of Education, Psychology & Social Work, Flinders University, Adelaide, Australia
| | - Paul Cafarella
- College of Medicine & Public Health, Flinders University, Adelaide, Australia.,Department of Respiratory and Sleep Medicine, Southern Adelaide Local Health Network, Adelaide, Australia
| | - Simon Eckermann
- Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Debra Rowett
- Drug and Therapeutics Information Service, Southern Adelaide Local Health Network, Adelaide, Australia.,School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Paddy A Phillips
- College of Medicine & Public Health, Flinders University, Adelaide, Australia.,Department for Health and Well-being, SA Health, Adelaide, Australia
| |
Collapse
|
6
|
Contribution of the self-regulation model to understanding the health related quality of life of rheumatoid arthritis patients. Qual Life Res 2019; 29:403-412. [PMID: 31576485 DOI: 10.1007/s11136-019-02315-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2019] [Indexed: 01/19/2023]
Abstract
PURPOSE This study examined a comprehensive model that integrates the interrelationships among health-related-quality-of-life (HRQoL), disease duration, disease severity, illness representations, and coping resources regarding patients with Rheumatoid arthritis (RA), based on the Self-regulation model. METHOD A convenience sample of 164 patients with RA completed measures of disease's characteristics (disease duration, disease status), illness representations (timeline, consequences, self-control, treatment control, symptom burden, concern about RA, understanding RA, emotional representations), coping resources (resilience, social support), HRQoL, and socio-demographic questionnaires. The research model was assessed through path analysis. RESULTS Perceptions of higher treatment control, lower consequences of RA and lower symptom burden were directly related to HRQoL. The perceptions of higher self-control, higher treatment control, less concern about RA, and lower emotional representations were associated with higher resilience, which in turn was associated with higher HRQoL. The perceptions of higher treatment control, greater understanding of RA, and lower emotional representations were associated with higher perceived social support; however, social support was not associated with HRQoL. CONCLUSIONS This study contributes to a better understanding of the determinants of HRQoL among RA patients. The findings indicate that clinical interventions targeting RA patients' illness representations and resilience may assist patients with RA to improve their HRQoL.
Collapse
|
7
|
Sawyer AT, Harris SL, Koenig HG. Illness perception and high readmission health outcomes. Health Psychol Open 2019; 6:2055102919844504. [PMID: 31041109 PMCID: PMC6482662 DOI: 10.1177/2055102919844504] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This review identified associations between illness perception and health outcomes of patients with a medical diagnosis included in the Hospital Readmissions Reduction Program. Inclusion criteria were English language, use of quantitative methodology, health outcomes specified, and identifiable effect size and statistical significance of the relationship. Most of the 31 studies in this review showed that favorable illness perception has been associated with better health outcomes, while unfavorable illness perception has been associated with worse outcomes. A multifaceted approach might include behavioral, clinical, educational, and psychosocial components to improve one’s illness perception through educative, cognitive-behavioral, or psychodynamic counseling.
Collapse
|
8
|
Tabar NA, Alshraideh JA. Correlates and Predictors of Health-Related Quality of Life among Patients with COPD: An Integrative Review. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/ojn.2019.912088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
9
|
Bonsaksen T, Grimholt TK, Skogstad L, Lerdal A, Ekeberg Ø, Heir T, Schou-Bredal I. Self-diagnosed depression in the Norwegian general population - associations with neuroticism, extraversion, optimism, and general self-efficacy. BMC Public Health 2018; 18:1076. [PMID: 30157827 PMCID: PMC6116443 DOI: 10.1186/s12889-018-5990-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 08/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multi-item rating scales for depression informs about the level of depression, but does not allow individuals to state by self-evaluation whether they feel depressed or not. The insider perspective on depression is rarely assessed. This study investigated the prevalence of self-diagnosed depression in the Norwegian general population, and associations with sociodemographic and psychological factors. METHODS As part of a national survey, the General Self-Efficacy Scale, the Life Orientation Test-Revised, a short version of the Eysenck Personality Questionnaire and a one-item measure of self-diagnosed depression was administered to 5.500 persons in the general Norwegian population. Of the 4961 eligible participants ≥ 18 years of age, 1.787 (response rate 36%) participated in the survey, and 1.684 of these had valid scores on the relevant scales. The associations between sociodemographic factors and self-diagnosed depression were examined using univariate and multivariate logistic regression analyses. RESULTS One hundred and thirty-six participants (8.1%) reported depression during the preceding month. When adjusting for sociodemographic and psychological variables, higher age (OR = 0.82), being in work (OR = 0.57), and higher levels of general self-efficacy (OR = 0.67) and optimism (OR = 0.52) were associated with lower risk of self-diagnosed depression, whereas higher levels of neuroticism (OR = 1.97) was associated with higher risk. CONCLUSIONS The prevalence of self-diagnosed depression in the adult Norwegian population was higher for women than for men. Higher age, being in work and having higher levels of psychological resources appear to reduce the risk of self-diagnosed depression, whereas neuroticism increases the risk.
Collapse
Affiliation(s)
- Tore Bonsaksen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs Plass, 0130 Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Sandnes, Norway
| | - Tine K. Grimholt
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Laila Skogstad
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Anners Lerdal
- Department for Patient Safety and Research, Lovisenberg Diakonale Hospital, Oslo, Norway
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øivind Ekeberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
| | - Trond Heir
- Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Inger Schou-Bredal
- Institute of Health and Society, University of Oslo, Oslo, Norway
- Department for Cancer, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
10
|
Weldam SW, Schuurmans MJ, Zanen P, Heijmans MJ, Sachs AP, Lammers JWJ. The effectiveness of a nurse-led illness perception intervention in COPD patients: a cluster randomised trial in primary care. ERJ Open Res 2017; 3:00115-2016. [PMID: 29250529 PMCID: PMC5722077 DOI: 10.1183/23120541.00115-2016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 09/30/2017] [Indexed: 11/27/2022] Open
Abstract
The new COPD-GRIP (Chronic Obstructive Pulmonary Disease - Guidance, Research on Illness Perception) intervention translates evidence regarding illness perceptions and health-related quality of life (HRQoL) into a nurse intervention to guide COPD patients and to improve health outcomes. It describes how to assess and discuss illness perceptions in a structured way. This study aimed to assess the effectiveness of the intervention in primary care. A cluster randomised controlled trial was conducted within 30 general practices and five home-care centres, including 204 COPD patients. 103 patients were randomly assigned to the intervention group and 101 patients to the usual-care group. To assess differences, repeated multilevel linear mixed modelling analyses were used. Primary outcome was change in health status on the Clinical COPD Questionnaire (CCQ) at 9 months. Secondary outcomes were HRQoL, daily activities, health education impact and changes in illness perceptions. There was no significant difference between the groups in the CCQ at 9 months. We found a significant increase in health-directed behaviour at 6 weeks (p=0.024) and in personal control (p=0.005) at 9 months in favour of the intervention group. The COPD-GRIP intervention, practised by nurses, did not improve health status in COPD patients in primary care. However, the intervention has benefits in improving the ability to control the disease and health-related behaviours in the short term. Therefore, taking illness perceptions into account when stimulating healthy behaviours in COPD patients should be considered. Further study on influencing the health status and HRQoL is needed.
Collapse
Affiliation(s)
- Saskia W.M. Weldam
- Dept of Respiratory Diseases, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Marieke J. Schuurmans
- Dept of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Pieter Zanen
- Dept of Respiratory Diseases, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | | | - Alfred P.E. Sachs
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Jan-Willem J. Lammers
- Dept of Respiratory Diseases, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| |
Collapse
|
11
|
Goldman RE, Mennillo L, Stebbins P, Parker DR. How do patients conceptualize chronic obstructive pulmonary disease? Chron Respir Dis 2016; 14:245-255. [PMID: 28774206 DOI: 10.1177/1479972316680845] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a leading cause of death in the United States, yet even at risk or diagnosed patients misunderstand COPD and its consequences for their quality of life and mortality. This study explored how patients conceptualize the causes, symptoms, consequences, treatment, and risk for developing COPD. The study consisted of six focus groups: 39 participants who were adults > 40 and current smoker or have COPD symptoms, family history, or exposures. Although many participants had some familiarity with the breathing, lung function, physical, emotional, and social consequences of COPD, confusion and misunderstanding prevailed. Few knew that COPD, chronic bronchitis, and emphysema are synonymous. Some participants claimed that they "only" had bronchitis and/or emphysema and not COPD. Some participants described behavioral adaptations to decrease symptom impact and others expressed strong interest in learning how to increase daily functioning. Insufficient knowledge and persisting misconceptions about COPD can prevent patients from accessing life-enhancing strategies. Patients can benefit from (1) providers clarifying COPD's connection to chronic bronchitis and emphysema to aid them in recognizing the need for mitigating action; (2) encouraging smoking cessation, specifically to stem worsening of disease; and (3) explaining lifestyle adaptations for easing daily life despite decreased lung function.
Collapse
Affiliation(s)
- R E Goldman
- 1 Department of Family Medicine, Alpert Medical School of Brown University, Providence, RI, USA.,2 Brown Center for Primary Care and Prevention, Memorial Hospital of RI, Pawtucket, RI, USA
| | - L Mennillo
- 3 Department of Family Medicine, Memorial Hospital of RI, Pawtucket, RI, USA
| | - P Stebbins
- 1 Department of Family Medicine, Alpert Medical School of Brown University, Providence, RI, USA
| | - D R Parker
- 1 Department of Family Medicine, Alpert Medical School of Brown University, Providence, RI, USA.,2 Brown Center for Primary Care and Prevention, Memorial Hospital of RI, Pawtucket, RI, USA.,4 Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|
12
|
Tiemensma J, Gaab E, Voorhaar M, Asijee G, Kaptein AA. Illness perceptions and coping determine quality of life in COPD patients. Int J Chron Obstruct Pulmon Dis 2016; 11:2001-7. [PMID: 27601893 PMCID: PMC5003510 DOI: 10.2147/copd.s109227] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background A key goal of chronic obstructive pulmonary disease (COPD) care is to improve patients’ quality of life (QoL). For outcomes such as QoL, illness perceptions and coping are important determinants. Aim The primary aim was to assess the associations between illness perceptions, coping and QoL in COPD patients. A secondary aim was to compare illness perceptions and coping of patients with reference values derived from the literature. Patients and methods A total of 100 patients were included in the study. Patients were asked to complete the Brief Illness Perception Questionnaire (B-IPQ), the Utrecht Proactive Coping Competence scale (UPCC), and a QoL item. Correlations and linear regression models were used to analyze the data. Student’s t-tests were used to compare patients with COPD with reference values derived from the literature. Results Patients with better understanding of COPD utilized more proactive coping strategies (P=0.04). A more intense emotional response to COPD was related to less proactive coping (P=0.02). Patients who reported using more proactive coping techniques also reported to have a better QoL (P<0.01). Illness perceptions were also related to QoL: more positive illness perceptions were related to a better QoL (all P<0.05). Patients with COPD reported more negative illness perceptions than people with a common cold or patients with asthma (all P<0.01), but reported similar perceptions compared with patients with diabetes. Conclusion Patients with COPD reported a moderate QoL, but appeared to be proficient in proactive coping. Illness perceptions, coping, and QoL were all associated with each other. Patients reported more strongly affected illness perceptions compared to people with a cold and patients with asthma. We postulate that a self-management intervention targeting patients’ illness perceptions leads to improved QoL.
Collapse
Affiliation(s)
| | - Erin Gaab
- Health Sciences Research Institute, University of California, Merced, CA, USA
| | - Maarten Voorhaar
- Department of Family Medicine, Maastricht University, Care and Public Health Research Institute School for Public Health and Primary Care, Maastricht, the Netherlands; Boehringer Ingelheim, Alkmaar, the Netherlands
| | - Guus Asijee
- Department of Family Medicine, Maastricht University, Care and Public Health Research Institute School for Public Health and Primary Care, Maastricht, the Netherlands; Boehringer Ingelheim, Amsterdam, the Netherlands
| | - Adrian A Kaptein
- Department of Medical Psychology, Leiden University Medical Centre, Leiden, the Netherlands
| |
Collapse
|
13
|
Bonsaksen T, Lerdal A, Småstuen MC, Fagermoen MS. Differences and similarities in the trajectories of self-esteem and positive and negative affect in persons with chronic illness: an explorative longitudinal study. J Multidiscip Healthc 2016; 9:355-63. [PMID: 27574438 PMCID: PMC4993558 DOI: 10.2147/jmdh.s108891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Chronic illness is a risk factor for low self-esteem, and the research literature needs to include more studies of self-esteem and its development in chronic illness groups using longitudinal and comparative designs. The aim of this study was to explore the trajectories of self-esteem and of positive and negative affect in persons with morbid obesity and in persons with chronic obstructive pulmonary disease (COPD). METHODS Patient education course attendants in Norway having morbid obesity (n=139) or COPD (n=97) participated in the study. Data concerning self-esteem, positive and negative affect, and sociodemographic background were collected at the start and at the end of the patient education, with subsequent follow-ups at 3, 6, and 12 months. Data were analyzed using linear mixed models for repeated measures. RESULTS Taking all measurements into account, our data revealed a statistically significant increase in self-esteem for participants with morbid obesity but not for those with COPD. There were no significant differences in levels of negative and positive affect between the two groups, and the time-trajectories were also similar. However, participants in both groups achieved lower levels of negative affect for all the successive measurement points. CONCLUSION An increase in self-esteem during the first year after the patient education course was observed for persons with morbid obesity, but not for persons with COPD. Initial higher levels of self-esteem in the participants with COPD may indicate that they are less troubled with low self-esteem than people with morbid obesity are. The pattern of reduced negative affect for both groups during follow-up is promising.
Collapse
Affiliation(s)
- Tore Bonsaksen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Anners Lerdal
- Research Department, Lovisenberg Diakonale Hospital, Oslo, Norway
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - May Solveig Fagermoen
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
14
|
Bonsaksen T, Fagermoen MS, Lerdal A. Trajectories of physical and mental health among persons with morbid obesity and persons with COPD: a longitudinal comparative study. J Multidiscip Healthc 2016; 9:191-200. [PMID: 27175082 PMCID: PMC4854263 DOI: 10.2147/jmdh.s102630] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Morbid obesity and chronic obstructive pulmonary disease (COPD) are prevalent diseases associated with impaired health-related quality of life (HRQoL). Research generally indicates that persons with morbid obesity increase their HRQoL following intervention, whereas evidence of increases in HRQoL in persons with COPD is mixed. Examining the patterns of change over time instead of merely examining whether HRQoL changes will add to the knowledge in this field. METHODS A sample of persons with morbid obesity and persons with COPD was recruited from learning and mastery courses and rehabilitation centers in Norway. The data were collected by self-report questionnaires at the start of patient education and at four subsequent time points during the 1-year follow-up. HRQoL was measured with the Short Form 12, version 2, and repeated measures analysis of variance was employed in the statistical analysis. RESULTS Participants with morbid obesity linearly increased their physical HRQoL during the 1-year follow-up, whereas participants with COPD showed no change. None of the groups changed their mental HRQoL during follow-up. In all subdomains of HRQoL, the participants with morbid obesity showed favorable, linearly increasing trajectories across the follow-up period. Among the participants with COPD, no change patterns occurred in the subdomains of HRQoL, except for a fluctuating pattern in the mental health domain. Age, sex, and work status did not influence the trajectories of HRQoL in any of the domains. CONCLUSION A more favorable trajectory of HRQoL was found for persons with morbid obesity than for persons with COPD, possibly due to the obese persons' better chances of recovery.
Collapse
Affiliation(s)
- Tore Bonsaksen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - May Solveig Fagermoen
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anners Lerdal
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department for Patient Safety and Development, Lovisenberg Diakonale Hospital, Oslo, Norway
| |
Collapse
|
15
|
Staniute M, Brozaitiene J, Burkauskas J, Kazukauskiene N, Mickuviene N, Bunevicius R. Type D personality, mental distress, social support and health-related quality of life in coronary artery disease patients with heart failure: a longitudinal observational study. Health Qual Life Outcomes 2015; 13:1. [PMID: 25608461 PMCID: PMC4311474 DOI: 10.1186/s12955-014-0204-2] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 12/26/2014] [Indexed: 12/21/2022] Open
Abstract
Background The relationship between Type D personality and health related quality of life (HRQoL) in coronary artery disease patients is becoming more established, however, the factors that may explain this association remain unclear. The objective of the study was to examine the mediating effects of mental distress and social support on the relationship between the Type D personality and HRQoL in CAD patients with heart failure. Methods A total of 855 CAD patients with heart failure were assessed on Type D personality, mental distress, perceived social support and HRQoL with the following self-administered questionnaires: the Type D personality scale - 14, the Hospital Anxiety and Depression scale, the Multidimensional Scale of Perceived Social Support and the Minnesota Living with Heart Failure Questionnaire. Results The prevalence of Type D personality within the study population was 33.5%. Type D personality, anxiety symptoms, depressive symptoms and social support were all found to be determinants of decreased HRQoL (p’s < 0.001), once age, gender, NYHA functional class and acute myocardial infarction were adjusted for. Anxiety, depressive symptoms and social support were found to mediate the relationship between Type D personality and HRQoL. Type D personality exerted a stable effect on HRQoL over 24 months follow-up period. Conclusions Type D personality has an independent significant effect on the HRQoL in CAD patients with heart failure, and this relation is mediated by anxiety and depressive symptoms, social support.
Collapse
Affiliation(s)
- Margarita Staniute
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
| | - Julija Brozaitiene
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
| | - Julius Burkauskas
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
| | - Nijole Kazukauskiene
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
| | - Narseta Mickuviene
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
| | - Robertas Bunevicius
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
| |
Collapse
|