Illness Representation and Self-Care Ability in Older Adults with Chronic Disease
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Sample Characteristics
3.2. Latent Profile Analysis
3.3. Group Differences
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Subscale | Definition | High Score Indicates | Number of Items |
---|---|---|---|
Timeline | Whether an individual perceives their disease to be acute or chronic in nature | A more chronic disease perception | 6 |
Consequences | The extent of perceived consequences of the disease | More disease consequences | 6 |
Personal Control | The amount of perceived control a person has over their disease | More control | 6 |
Treatment Control | The amount of perceived control the medical treatments have over the disease | More control | 5 |
Coherence | The perceived level of understanding of their disease | More understanding | 5 |
Cyclical Timeline | Whether an individual perceives their disease to have a stable or unstable pattern from day today | More unstable disease pattern | 4 |
Emotion | Amount of negative emotion an individual attribute to their disease | More negative emotion | 6 |
Variables | Entire Sample n = 187 | Groups Derived from Latent Profile Analysis | Chi-Square or ANOVA | ||
---|---|---|---|---|---|
Overwhelmed n = 80 | Stable n = 61 | Confident n = 46 | |||
Chronic Disease | 5.228 | ||||
HF | 63 (33.7%) | 29 (36.3%) | 16 (26.2%) | 18 (39.1%) | |
CKD | 65 (34.8%) | 24 (30.0%) | 28 (45.9%) | 13 (28.3%) | |
COPD | 59 (31.6%) | 27 (33.8%) | 17 (27.9%) | 15 (32.6%) | |
Age | 64.9 (SD = 8.9) | 64.5 (8.5) | 66.8 (8.8) | 63.1 (9.6) | 2.468 |
Range: 50–88 | |||||
Gender | 1.704 | ||||
Female | 100 (53.8%) | 46 (57.5%) | 33 (55.0%) | 21 (45.7%) | |
Male | 86 (46.2%) | 34 (42.5%) | 27 (45.0%) | 25 (54.3%) | |
Race/ethnicity | 9.201 | ||||
Black | 137 (73.7%) | 53 (66.3%) | 45 (75.0%) | 39 (84.8%) | |
Hispanic | 15 (8.1%) | 7 (8.8%) | 5 (8.3%) | 3 (6.5%) | |
White | 30 (16.1%) | 16 (20.0%) | 10 (16.7%) | 4 (8.7%) | |
Asian | 4 (2.2%) | 4 (5.0%) | 0 (0.0%) | 0 (0.0%) | |
Education | 0.798 | ||||
≤High school | 96 (51.9%) | 38 (48.1%) | 33 (55.0%) | 25 (54.3%) | |
>High school | 89 (48.1%) | 41 (51.9%) | 27 (45.0%) | 21 (45.7%) | |
Severity variables | |||||
Years with disease | 6.9 (SD = 8.6) | 5.3 (5.2) a | 10.3 (12.0) b | 5.3 (6.9) a | 6.550 ** |
Range: 1–55 | |||||
Complications | 1.68 (SD = 1.0) | 1.84 (1.0) a | 1.38 (1.0) b | 1.80 (1.1) ab | 3.965 * |
Range: 0–4 | |||||
Comorbid conditions | 3.2 (SD = 1.7) | 1.32 | |||
Range: 0–8 | 3.3 (1.8) | 2.9 (1.4) | 3.3 (1.6) | ||
Severity | 8.713 | ||||
Mild | 56 (31.3%) | 19 (24.7%) | 24 (42.1%) | 13 (28.9%) | |
Moderate | 82 (45.8%) | 34 (44.2%) | 23 (40.4%) | 25 (55.6%) | |
Severe | 41 (22.9%) | 24 (31.2%) | 10 (17.5%) | 7 (15.6%) | |
Illness representation variables | |||||
Timeline | 3.57 (SD = 0.87) | 3.82 (0.76) a | 3.58 (0.81) a | 3.11 (0.98) b | 10.750 *** |
Range: 1.2–5 | |||||
Consequences | 3.44 (SD = 0.76) | 3.86 (0.61) a | 2.84 (0.60) b | 3.51 (0.65) c | 48.49 *** |
Range: 1.2–5 | |||||
Personal Control | 3.67 (SD = 0.65) | 3.57 (0.57) a | 3.38 (0.62) a | 4.23 (0.47) b | 32.49 *** |
Range: 2–5 | |||||
Treatment Control | 3.45 (SD = 0.64) | 3.26 (0.58) a | 3.23 (0.54) a | 4.06 (0.45) b | 39.12 *** |
Range: 1.8–5 | |||||
Coherence | 3.33 (SD = 0.85) | 2.97 (0.85) a | 3.40 (0.77) b | 3.88 (0.61) c | 20.80 *** |
Range: 1–5 | |||||
Cyclical | 3.13 (SD = 0.87) | 3.66 (0.67) a | 2.43 (0.63) b | 3.13 (0.80) c | 54.37 *** |
Range: 1–5 | |||||
Emotion | 3.00 (SD = 0.93) | 3.71 (0.72) a | 2.40 (0.62) b | 2.55 (0.74) b | 73.75 *** |
Range: 1–5 | |||||
Outcome variables | |||||
ED visits | 3.976 | ||||
0 | 83 (44.4%) | 29 (36.3%) | 32 (52.5%) | 22 (47.8%) | |
≥1 | 104 (55.6%) | 51 (63.8%) | 29 (47.5%) | 24 (52.2%) | |
Hospitalizations | 7.842 * | ||||
0 | 86 (46.0%) | 31 (38.8%) | 37 (60.7%) | 18 (39.1%) | |
≥1 | 101 (54.0%) | 49 (61.3%) a | 24 (39.3%) b | 28 (60.9%) a | |
PAM score | 5.783 | ||||
Low activation | 84 (44.9%) | 42 (52.5%) | 28 (45.9%) | 14 (30.4%) | |
High activation | 103 (55.1%) | 38 (47.5%) a | 33 (54.1%) ab | 32 (69.6%) b |
Variables | ED Visits (≥1) | Hospitalizations (≥1) | Self-Care Activation (High) | ||||||
---|---|---|---|---|---|---|---|---|---|
OR | Z | p | OR | Z | p | OR | Z | p | |
Model 1: Groups only (n = 187) | |||||||||
Stable = 0 Overwhelmed = 1 | 1.942 | −1.92 | 0.055 | 2.439 | −2.56 | 0.011 | 0.768 | 0.78 | 0.438 |
Confident = 0 Overwhelmed = 1 | 1.613 | −1.27 | 0.204 | 1.016 | −0.04 | 0.966 | 0.387 | 2.37 | 0.018 |
Stable = 0 Confident = 1 | 1.204 | 0.47 | 0.635 | 2.437 | 2.19 | 0.029 | 1.939 | 1.61 | 0.107 |
Model 2: Groups plus disease years and complications (n = 171) | |||||||||
Stable = 0 Overwhelmed = 1 | 1.848 | −1.56 | 0.118 | 1.701 | −1.37 | 0.171 | 0.938 | 0.17 | 0.866 |
Confident = 0 Overwhelmed = 1 | 1.730 | −1.38 | 0.169 | 0.975 | −0.06 | 0.949 | 0.352 | 2.52 | 0.012 |
Stable = 0 Confident = 1 | 1.068 | 0.15 | 0.879 | 1.751 | 1.28 | 0.200 | 2.662 | 2.15 | 0.031 |
Years since diagnosis | 1.016 | 0.78 | 0.437 | 0.995 | −0.27 | 0.786 | 1.030 | 1.41 | 0.159 |
Complications | 1.460 | 2.32 | 0.020 | 1.524 | 2.57 | 0.010 | 0.915 | −0.56 | 0.573 |
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Rivera, E.; Corte, C.; Steffen, A.; DeVon, H.A.; Collins, E.G.; McCabe, P.J. Illness Representation and Self-Care Ability in Older Adults with Chronic Disease. Geriatrics 2018, 3, 45. https://doi.org/10.3390/geriatrics3030045
Rivera E, Corte C, Steffen A, DeVon HA, Collins EG, McCabe PJ. Illness Representation and Self-Care Ability in Older Adults with Chronic Disease. Geriatrics. 2018; 3(3):45. https://doi.org/10.3390/geriatrics3030045
Chicago/Turabian StyleRivera, Eleanor, Colleen Corte, Alana Steffen, Holli A. DeVon, Eileen G. Collins, and Pamela J. McCabe. 2018. "Illness Representation and Self-Care Ability in Older Adults with Chronic Disease" Geriatrics 3, no. 3: 45. https://doi.org/10.3390/geriatrics3030045