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Johnston KN, Burgess R, Kochovska S, Williams MT. Exploring the Experience of Breathlessness with the Common-Sense Model of Self-Regulation (CSM). Healthcare (Basel) 2023; 11:1686. [PMID: 37372804 DOI: 10.3390/healthcare11121686] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/26/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Chronic breathlessness is a multidimensional, unpleasant symptom common to many health conditions. The Common-Sense Model of Self-Regulation (CSM) was developed to help understand how individuals make sense of their illness. This model has been underused in the study of breathlessness, especially in considering how information sources are integrated within an individual's cognitive and emotional representations of breathlessness. This descriptive qualitative study explored breathlessness beliefs, expectations, and language preferences of people experiencing chronic breathlessness using the CSM. Twenty-one community-dwelling individuals living with varying levels of breathlessness-related impairment were purposively recruited. Semi-structured interviews were conducted with questions reflecting components of the CSM. Interview transcripts were synthesized using deductive and inductive content analysis. Nineteen analytical categories emerged describing a range of cognitive and emotional breathlessness representations. Representations were developed through participants' personal experience and information from external sources including health professionals and the internet. Specific words and phrases about breathlessness with helpful or nonhelpful connotations were identified as contributors to breathlessness representations. The CSM aligns with current multidimensional models of breathlessness and provides health professionals with a robust theoretical framework for exploring breathlessness beliefs and expectations.
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Affiliation(s)
- Kylie N Johnston
- Allied Health and Human Performance, Innovation, IMPlementation and Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, SA 5001, Australia
| | - Rebecca Burgess
- Allied Health and Human Performance, Innovation, IMPlementation and Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, SA 5001, Australia
| | - Slavica Kochovska
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Marie T Williams
- Allied Health and Human Performance, Innovation, IMPlementation and Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, SA 5001, Australia
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Al-Smadi AM, Tawalbeh LI, Ashour A, Hweidi IM, Gharaibeh B, Slater P, Fitzsimons D. The influence of treatment modality on illness perception and secondary prevention outcomes among patients with acute myocardial infarction. Int J Nurs Sci 2017; 4:271-277. [PMID: 31406752 PMCID: PMC6626236 DOI: 10.1016/j.ijnss.2017.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 06/10/2017] [Accepted: 06/22/2017] [Indexed: 11/30/2022] Open
Abstract
Objectives This study aims to determine if patients with acute myocardial infarction differ in illness perception and secondary prevention outcomes depending on the treatment they received. Methods A repeated measures design was used to compare patients with acute myocardial infarction receiving three different treatment modalities: ST-elevation myocardial infarction treated by primary percutaneous coronary intervention, ST-elevation myocardial infarction treated by thrombolytic therapy, and non ST-elevation myocardial infarction treated by medication. A convenient sampling technique was used to recruit 206 patients with acute myocardial infarction who agreed to participate in the current study. Patients' illness perception, physical activity, and demographical and clinical data were collected during hospital admission and again at 6 months. Results A total of 186 patients completed the study. Results showed that the primary percutaneous coronary intervention group perceived their illness as acute rather than chronic (P = 0.034) and has lower personal control (P = 0.032), higher treatment control (P = 0.025), and higher perception of illness coherence (P = 0.022) compared with patients receiving thrombolytic therapy and treated after non-ST segment infarction. Moreover, they report low control of their blood pressure (P = 0.013) and less physical activity (P = 0.001). Conclusion The results of this study revealed that patients' treated with primary percutaneous coronary intervention had negative illness perception and limited behavioral changes 6 months after hospitalization in comparison with other treatment modalities such as percutaneous coronary intervention and thrombolytic treatment. Further research is recommended to confirm this association with longer follow-up study and among different cultures.
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Affiliation(s)
| | - Loai Issa Tawalbeh
- Faculty of Nursing, Al-AlBayt University, P. O. Box: 130040, Al-Mafraq 25113, Jordan
| | - Ala Ashour
- Faculty of Nursing, The Hashemite University, Al-Zarqa, Jordan
| | - Issa M Hweidi
- Jordan University of Science and Technology, Irbid, Jordan
| | | | - Paul Slater
- University of Ulster, School of Nursing, United Kingdom
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Pietrabissa G, Manzoni GM, Rossi A, Castelnuovo G. The MOTIV-HEART Study: A Prospective, Randomized, Single-Blind Pilot Study of Brief Strategic Therapy and Motivational Interviewing among Cardiac Rehabilitation Patients. Front Psychol 2017; 8:83. [PMID: 28223950 PMCID: PMC5293749 DOI: 10.3389/fpsyg.2017.00083] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 01/13/2017] [Indexed: 01/09/2023] Open
Abstract
Background: Psychological distress, biomedical parameters, and unhealthy lifestyles contribute to a poorer prognosis for cardiac disease. Public health's challenge is to motivate patients to utilize self-care. Objective: This prospective, randomized, single-blind pilot study aimed at testing the incremental efficacy of Brief Strategic Therapy (BST) combined with Motivational Interviewing (MI) in improving selected biomedical and psychological outcomes over and beyond those of the stand-alone BST in a residential Cardiac Rehabilitation (CR) program. Method: Fourty-two inpatients (17 females), enrolled in a 1-month CR program, were randomly allocated into two conditions: (a) Three sessions of BST and (b) Three sessions of BST plus MI. Data were collected at baseline, discharge, and after 3 months through phone interviews. Results: At discharge, no significant between-group difference was found in any outcome variable. Changes from pre- to post-treatment within each condition showed significant improvements only in the BST group, where the level of external regulation diminished, and both the participants' self-regulation (Relative Autonomous Motivation Index, RAI) and willingness to change improved. At the 3-month follow-up, within-group analyses on responders (BST = 9; BST + MI = 11) showed a statistically significant improvement in the level of systolic blood pressure in both groups. Discussion: Findings showed no evidence of the incremental efficacy of combining BST and MI over and beyond BST alone on either selected biomedical or psychological outcomes among CR patients. Conclusions: Ends and limitations from the present pilot study should be considered and addressed in future investigations.
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Affiliation(s)
- Giada Pietrabissa
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCSS Istituto Auxologico Italiano IRCCSVerbania, Italy; Department of Psychology, Catholic University of MilanMilan, Italy
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCSS Istituto Auxologico Italiano IRCCSVerbania, Italy; Faculty of Psychology, eCampus UniversityNovedrate, Italy
| | - Alessandro Rossi
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCSS Istituto Auxologico Italiano IRCCS Verbania, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCSS Istituto Auxologico Italiano IRCCSVerbania, Italy; Department of Psychology, Catholic University of MilanMilan, Italy
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Janelle C, O’Connor K, Dupuis G. Evaluating illness representations in heart transplant patients. J Health Psychol 2016; 21:1850-9. [DOI: 10.1177/1359105314567210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim was to see whether qualitative analysis improved quantitative measurement of illness perception after heart transplant. Two methods of evaluating illness representations were compared: one quantitative (administration of the Illness Perception Questionnaire-Revised) and one qualitative (phenomenological reduction). The qualitative analysis provided greater insight into the idiosyncratic and dynamic nature of the concept of illness representations. Adjustments to the Illness Perception Questionnaire-Revised are suggested to improve the evaluation of illness perception in terms of dispersion of scores, emotional impact, coping strategies and treatment, and social support, and ultimately to enhance interventions designed to promote treatment compliance.
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Wottrich SH, Quintana AM, Camargo VP, Beck CLC. “Manifestos do Coração”: Significados Atribuídos à Doença por Pacientes Cardíacos Pré-cirúrgicos. PSICOLOGIA: TEORIA E PESQUISA 2015. [DOI: 10.1590/0102-37722015021127213219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Este estudo objetivou explorar os significados atribuídos à doença cardíaca por pacientes cardíacos pré-cirúrgicos em tratamento ambulatorial no sul do Brasil. É um estudo clínico-qualitativo, de caráter exploratório e descritivo, cuja coleta de dados aconteceu por meio de entrevistas semiestruturadas e da autofotografia, propostas a 15 indivíduos. Foi realizada análise de conteúdo temática, emergindo as categorias: Confrontação com a doença: os saberes em questão, Negação da doença, Doença e trabalho e Sexualidade rompida. Os resultados destacaram as dificuldades dos participantes relacionadas à apropriação do quadro da doença e à aceitação dessa condição. Salienta-se a premência de ações de saúde, que possam ser coadjuvantes na reestruturação das possibilidades de vida para os pacientes cardíacos pré-cirúrgicos.
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Panzaru GM, Holman A. Type of treatment of cardiac disorders – quality of life and heart-focused anxiety: The mediating role of illness perceptions. PSYCHOL HEALTH MED 2014; 20:551-9. [DOI: 10.1080/13548506.2014.989863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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McCorry NK, Scullion L, McMurray CM, Houghton R, Dempster M. Content validity of the illness perceptions questionnaire – revised among people with type 2 diabetes: A think-aloud study. Psychol Health 2013; 28:675-85. [DOI: 10.1080/08870446.2012.746690] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Impact of menthal representation of disease and wound-related subjective perception of disease on convalescence after surgical treatment. POLISH JOURNAL OF SURGERY 2011; 83:258-63. [PMID: 22166478 DOI: 10.2478/v10035-011-0040-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
UNLABELLED Compared to open surgery, laparoscopic treatment has been shown to have several advantages, including lower levels of postoperative pain, faster recovery, and better cosmetic results. Nevertheless, the advantages of laparoscopy are being debated as possibly not being merely related to biomedical factors. MATERIAL AND METHODS The study consisted of two sub-studies. In the first study, 150 healthy, previously unoperated volunteers, not employed in the health services, were included. Healthy volunteers, from the latter study, were given questionnaires that presented different sizes of post-operative wounds and examined their perception of the severity of the illnesses that were treated by surgery leading to these wounds. In the second study, data was collected from 65 laparoscopic cholecystectomy patients and 35 patients treated by the open approach cholecystectomy. Patients from the second study were examined prior to operation and 1 month after surgery with a questionnaire evaluating their subjective perception of the disease. RESULTS Subjective perception of the severity of disease (SPSD) was similar between the laparoscopy and the open approach cholecystectomy patients before the operation (respectively, 6.25±1.7 and 6.06±2.2; ns). At the follow-up, a significant decrease of SPSD among laparoscopy patients was observed (post-op score = 3.28±0.8, p<0.05 in paired t-Student test), but not in the open approach patients (6.42±1.7, ns in paired t-Student test). The volunteers perceived that the disease of the laparoscopically treated patients was less serious than the disease of those treated with open surgery. CONCLUSIONS The authors would like to emphasize that the study presents a new approach to the explanation of the so called "laparoscopy phenomenon", i.e. much faster and smoother recovery after relatively larger and more serious surgical procedures. We believe that the benefits observed among the videoscopy patients might be, apart from immunological and pain-related factors, attributed to the psychological influence of cognitive representations of the disease severity on pain, analgetics use, and recovery.
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McCABE PAMELAJ, BARNASON SUSANA, HOUFEK JULIA. Illness Beliefs in Patients with Recurrent Symptomatic Atrial Fibrillation. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2011; 34:810-20. [DOI: 10.1111/j.1540-8159.2011.03105.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dempster M, McCorry NK. The factor structure of the revised Illness Perception Questionnaire in a population of oesophageal cancer survivors. Psychooncology 2011; 21:524-30. [DOI: 10.1002/pon.1927] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 01/05/2011] [Accepted: 01/08/2011] [Indexed: 11/09/2022]
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Medication beliefs predict medication adherence in older adults with multiple illnesses. J Psychosom Res 2011; 70:179-87. [PMID: 21262421 DOI: 10.1016/j.jpsychores.2010.07.014] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Revised: 07/20/2010] [Accepted: 07/27/2010] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To examine factors preventing medication nonadherence in community-dwelling older adults with multiple illnesses (multimorbidity). Nonadherence threatens successful treatment of multimorbidity. Adherence problems can be intentional (e.g., deliberately choosing not to take medicines or to change medication dosage) or unintentional (e.g., forgetting to take medication) and might depend on a range of factors. This study focused in particular on the role of changes in beliefs about medication to explain changes in adherence. METHODS Longitudinal study with N = 309 individuals aged 65-85 years with two or more diseases at three measurement points over six months. Medication adherence and beliefs about medicines were assessed by questionnaire. Hierarchical weighted least squares regression analyses were used to predict individual intentional and unintentional nonadherence. RESULTS Changes in intentional nonadherence were predicted by changes in specific necessity beliefs (B = -.19, P<.01), after controlling for sociodemographic factors, health status and number of prescribed medicines. Changes in unintentional nonadherence were predicted by changes in general overuse beliefs (B = .26, P<.01), controlling for the same covariates. CONCLUSION Beliefs about medication affect both intentional and unintentional adherence to medication in multimorbid older adults. This points to the importance of addressing medication beliefs in patient education to improve adherence.
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Griva K, Jayasena D, Davenport A, Harrison M, Newman SP. Illness and treatment cognitions and health related quality of life in end stage renal disease. Br J Health Psychol 2011; 14:17-34. [DOI: 10.1348/135910708x292355] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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van Wilgen CP, van Ittersum MW, Kaptein AA, van Wijhe M. Illness perceptions in patients with fibromyalgia and their relationship to quality of life and catastrophizing. ACTA ACUST UNITED AC 2009; 58:3618-26. [PMID: 18975315 DOI: 10.1002/art.23959] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In the last decade, illness perceptions have been identified as important in the treatment of fibromyalgia (FM). The aim of the present study was to examine illness perceptions and use of the revised Illness Perception Questionnaire in patients with FM (IPQ-R-FM) and their relationship to quality of life and catastrophizing. METHODS A domain with specific causal attributions related to FM was added to the IPQ-R-FM. The psychometric properties of the IPQ-R-FM dimensions and attribution scales were examined. The causal domain, in which patients describe the most important perceived causes for their FM, was analyzed. To analyze the relationship with quality of life and catastrophizing, the Fibromyalgia Impact Questionnaire and the Pain Catastrophizing Scale were used. RESULTS Fifty-one outpatients completed the questionnaires on 2 occasions, 3 weeks apart. FM was considered to be chronic and to have serious consequences; patients perceived little personal control and did not expect medical treatment to be effective. The psychometric properties of the IPQ-R-FM were found to be adequate. Patients most frequently attributed the causes of FM to an external somatic source (58%). Quality of life was related to experiencing more consequences attributable to FM. Catastrophizing was related to a limited understanding of the symptoms of FM, the more cyclical nature of FM, and an emotional representation. CONCLUSION The IPQ-R-FM is a useful tool to assess illness perceptions in patients with FM. Illness perceptions are related to quality of life and catastrophizing; therefore, it seems important to assess and integrate illness perceptions into the management of patients with FM.
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Affiliation(s)
- C Paul van Wilgen
- University Medical Center Groningen, University of Groningen, and Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.
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McCabe PJ. Self-management of atrial fibrillation: a new frontier for nursing research. ACTA ACUST UNITED AC 2008; 23:37-40. [PMID: 18326995 DOI: 10.1111/j.1751-7117.2008.07351.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Abstract
PURPOSE OF REVIEW In this article we summarize recent investigations into the influence of illness perceptions on outcomes in patients with medical conditions. RECENT FINDINGS Developments in assessment include the publishing of a new brief scale to assess illness perceptions and the examination of the relationship between patient drawings of their illness and outcomes. Recent studies in primary care highlight the importance of patients' beliefs and emotional responses to their illness as being important in influencing their satisfaction with the consultation, reassurance following negative medical testing and future healthcare use. Recent research shows illness perceptions to have associations with a number of outcomes in chronic illness including self-management behaviours and quality of life. As yet, however, few interventions have been developed designed to change illness perceptions and improve illness outcomes. Emerging areas of research include the application of illness perceptions to mental illness and genetic and risk factor testing. SUMMARY Research on illness perceptions has confirmed that patients' beliefs are associated with important outcomes in a broadening range of illnesses and risk factor testing. New interventions based on this model have the potential to improve patient outcomes but have yet to be widely developed and applied.
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Affiliation(s)
- Keith J Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
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