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Geriatrics 2018, 3(3), 45; https://doi.org/10.3390/geriatrics3030045

Illness Representation and Self-Care Ability in Older Adults with Chronic Disease

1
Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA
2
Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA
3
Department of Nursing, Mayo Clinic, Rochester, MN 55905, USA
*
Author to whom correspondence should be addressed.
Received: 22 June 2018 / Revised: 24 July 2018 / Accepted: 26 July 2018 / Published: 31 July 2018
(This article belongs to the Special Issue Chronic Disease Self-Management in Older Adult Populations)
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Abstract

Chronic illness affects >50% of adults in the United States and accounts for >80% of healthcare spending. The purpose of this study was to determine whether beliefs about one’s chronic disease (illness representation) are associated with self-care activation, emergency department (ED) visits, or hospitalizations. Using a cross-sectional design, we recruited older adults with heart failure, chronic obstructive pulmonary disease (COPD), and chronic kidney disease. The Revised Illness Perception Questionnaire (IPQ-R) measured perceptions about disease. The Patient Activation Measure measured self-care activation. ED visits and hospitalizations were measured by self-report. IPQ-R scores were analyzed using latent profile analysis to identify subgroups. Participants included 187 adults (mean age 65 years, 54% female, 74% Black). We found three subgroups (stable, overwhelmed, and confident). Groups did not differ demographically or by disease. The stable group (few consequences, non-fluctuating pattern) had the fewest hospitalizations. The overwhelmed group (many consequences, fluctuating pattern, high negative emotion) had high hospitalizations and low self-care ability. The confident group (high disease control, well-understood) had the highest self-care ability, but also high hospitalizations. ED visits did not differ by group. We found three subgroups that differ in their illness representation and health outcomes. Findings suggest that assessing patients’ illness representations may have important implications for subgroup-specific interventions. View Full-Text
Keywords: illness representation; chronic disease; heart failure; chronic obstructive pulmonary disease; chronic kidney disease; aged illness representation; chronic disease; heart failure; chronic obstructive pulmonary disease; chronic kidney disease; aged
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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.

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