Can we identify patients with different illness schema following an acute exacerbation of COPD: A cluster analysis
Summary Introduction Pulmonary Rehabilitation (PR) reduces hospital admissions following an acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) but adherence is known to be poor. Patients' illness perceptions may affect adherence to disease-management strategies but to date have...
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| Veröffentlicht in: | Respiratory medicine 2014-02, Vol.108 (2), p.319-328 |
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| creator | Harrison, S.L Robertson, N Graham, C.D Williams, J Steiner, M.C Morgan, M.D.L Singh, S.J |
| description | Summary Introduction Pulmonary Rehabilitation (PR) reduces hospital admissions following an acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) but adherence is known to be poor. Patients' illness perceptions may affect adherence to disease-management strategies but to date have not been explored following an exacerbation. The study aim is two-fold; firstly to prospectively explore acceptance and uptake of post-exacerbation PR and secondly to identify possible clusters of patients' illness perceptions following hospitalisation for an exacerbation of COPD. Methods Patients admitted to hospital with an exacerbation of COPD were recruited to a prospective observational study. Self-reported illness perceptions, mood, health status and self-efficacy were assessed. Acceptance and uptake of PR were recorded at six months. Cluster analysis of Illness Perceptions Questionnaire-Revised data was used to establish groups of patients holding distinct beliefs. Results 128 patients were recruited. Acceptance and uptake of PR following an acute exacerbation was poor with only 9% ( n = 11) completing the programme. Cluster analysis revealed three distinct groups: Cluster 1 ‘in control’ ( n = 52), Cluster 2 ‘disengaged’ ( n = 36) and Cluster 3 ‘distressed’ ( n = 40). Significant between-cluster differences were observed in mood, health status and self-efficacy ( p |
| doi_str_mv | 10.1016/j.rmed.2013.10.016 |
| format | Article |
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Patients' illness perceptions may affect adherence to disease-management strategies but to date have not been explored following an exacerbation. The study aim is two-fold; firstly to prospectively explore acceptance and uptake of post-exacerbation PR and secondly to identify possible clusters of patients' illness perceptions following hospitalisation for an exacerbation of COPD. Methods Patients admitted to hospital with an exacerbation of COPD were recruited to a prospective observational study. Self-reported illness perceptions, mood, health status and self-efficacy were assessed. Acceptance and uptake of PR were recorded at six months. Cluster analysis of Illness Perceptions Questionnaire-Revised data was used to establish groups of patients holding distinct beliefs. Results 128 patients were recruited. Acceptance and uptake of PR following an acute exacerbation was poor with only 9% ( n = 11) completing the programme. Cluster analysis revealed three distinct groups: Cluster 1 ‘in control’ ( n = 52), Cluster 2 ‘disengaged’ ( n = 36) and Cluster 3 ‘distressed’ ( n = 40). Significant between-cluster differences were observed in mood, health status and self-efficacy ( p < 0.01). Acceptance and uptake of PR did not differ between clusters. Conclusions Acceptance/uptake of post-exacerbation PR was found to be poor. Three distinct illness schema exist in patients following an acute exacerbation. This information may be useful in developing novel psychologically-informed interventions designed to reduce feelings of distress and perhaps facilitate a PR intervention for this vulnerable population.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2013.10.016</identifier><identifier>PMID: 24238773</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Acute Disease ; Aged ; Anxiety - etiology ; Chronic illnesses ; Chronic obstructive pulmonary disease ; Chronic obstructive pulmonary disease (COPD) ; Cluster Analysis ; Depression - etiology ; Ethics ; Exacerbations ; Female ; Health Status ; Heart attacks ; Hospitals ; Humans ; Illness perceptions ; Male ; Patient Acceptance of Health Care - statistics & numerical data ; Prospective Studies ; Psychological interventions ; Pulmonary Disease, Chronic Obstructive - psychology ; Pulmonary Disease, Chronic Obstructive - rehabilitation ; Pulmonary rehabilitation (PR) ; Pulmonary/Respiratory ; Questionnaires ; Referral and Consultation - statistics & numerical data ; Self Efficacy ; Studies</subject><ispartof>Respiratory medicine, 2014-02, Vol.108 (2), p.319-328</ispartof><rights>Elsevier Ltd</rights><rights>2013 Elsevier Ltd</rights><rights>Copyright © 2013 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited Feb 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c516t-1964f2ab0d8c17cd4655377a64d87671741c8996c5bb85e756890d534ce5b4c83</citedby><cites>FETCH-LOGICAL-c516t-1964f2ab0d8c17cd4655377a64d87671741c8996c5bb85e756890d534ce5b4c83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0954611113004319$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24238773$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Harrison, S.L</creatorcontrib><creatorcontrib>Robertson, N</creatorcontrib><creatorcontrib>Graham, C.D</creatorcontrib><creatorcontrib>Williams, J</creatorcontrib><creatorcontrib>Steiner, M.C</creatorcontrib><creatorcontrib>Morgan, M.D.L</creatorcontrib><creatorcontrib>Singh, S.J</creatorcontrib><title>Can we identify patients with different illness schema following an acute exacerbation of COPD: A cluster analysis</title><title>Respiratory medicine</title><addtitle>Respir Med</addtitle><description>Summary Introduction Pulmonary Rehabilitation (PR) reduces hospital admissions following an acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) but adherence is known to be poor. Patients' illness perceptions may affect adherence to disease-management strategies but to date have not been explored following an exacerbation. The study aim is two-fold; firstly to prospectively explore acceptance and uptake of post-exacerbation PR and secondly to identify possible clusters of patients' illness perceptions following hospitalisation for an exacerbation of COPD. Methods Patients admitted to hospital with an exacerbation of COPD were recruited to a prospective observational study. Self-reported illness perceptions, mood, health status and self-efficacy were assessed. Acceptance and uptake of PR were recorded at six months. Cluster analysis of Illness Perceptions Questionnaire-Revised data was used to establish groups of patients holding distinct beliefs. Results 128 patients were recruited. Acceptance and uptake of PR following an acute exacerbation was poor with only 9% ( n = 11) completing the programme. Cluster analysis revealed three distinct groups: Cluster 1 ‘in control’ ( n = 52), Cluster 2 ‘disengaged’ ( n = 36) and Cluster 3 ‘distressed’ ( n = 40). Significant between-cluster differences were observed in mood, health status and self-efficacy ( p < 0.01). Acceptance and uptake of PR did not differ between clusters. Conclusions Acceptance/uptake of post-exacerbation PR was found to be poor. Three distinct illness schema exist in patients following an acute exacerbation. This information may be useful in developing novel psychologically-informed interventions designed to reduce feelings of distress and perhaps facilitate a PR intervention for this vulnerable population.</description><subject>Acute Disease</subject><subject>Aged</subject><subject>Anxiety - etiology</subject><subject>Chronic illnesses</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Chronic obstructive pulmonary disease (COPD)</subject><subject>Cluster Analysis</subject><subject>Depression - etiology</subject><subject>Ethics</subject><subject>Exacerbations</subject><subject>Female</subject><subject>Health Status</subject><subject>Heart attacks</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Illness perceptions</subject><subject>Male</subject><subject>Patient Acceptance of Health Care - statistics & numerical data</subject><subject>Prospective Studies</subject><subject>Psychological interventions</subject><subject>Pulmonary Disease, Chronic Obstructive - psychology</subject><subject>Pulmonary Disease, Chronic Obstructive - rehabilitation</subject><subject>Pulmonary rehabilitation (PR)</subject><subject>Pulmonary/Respiratory</subject><subject>Questionnaires</subject><subject>Referral and Consultation - statistics & numerical data</subject><subject>Self Efficacy</subject><subject>Studies</subject><issn>0954-6111</issn><issn>1532-3064</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkk2LFDEQhoMo7rj6BzxIwIuXHlOdzxYRlvETFlZQzyGdrnYzZrrHpNtx_r1pZhdhD3pKUnneF6reIuQpsDUwUC-367TDbl0z4KWwLqV7ZAWS1xVnStwnK9ZIUSkAOCOPct4yxhoh2ENyVouaG635iqSNG-gBaehwmEJ_pHs3hXLN9BCma9qFvsdU3jTEOGDONPtr3DnajzGOhzB8p0Xv_Dwhxd_OY2qLfhzo2NPN1ee3r-gF9XHOE6YCunjMIT8mD3oXMz65Oc_Jt_fvvm4-VpdXHz5tLi4rL0FNFTRK9LVrWWc8aN8JJSXX2inRGa00aAHeNI3ysm2NRC2VaVgnufAoW-ENPycvTr77NP6cMU92F7LHGN2A45wtKDAGlIDm_6hoGuBcMV3Q53fQ7Tin0tpiKITWkilZqPpE-TTmnLC3-xR2Lh0tMLuEZ7d2Cc8u4S21UiqiZzfWc7v83Upu0yrA6xOAZWy_AiabfQnLYxcS-sl2Y_i3_5s7ch_DELyLP_CI-W8fNteW2S_L-izbA5wxwcuY_gBIk74X</recordid><startdate>20140201</startdate><enddate>20140201</enddate><creator>Harrison, S.L</creator><creator>Robertson, N</creator><creator>Graham, C.D</creator><creator>Williams, J</creator><creator>Steiner, M.C</creator><creator>Morgan, M.D.L</creator><creator>Singh, S.J</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>ASE</scope><scope>FPQ</scope><scope>H94</scope><scope>K6X</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20140201</creationdate><title>Can we identify patients with different illness schema following an acute exacerbation of COPD: A cluster analysis</title><author>Harrison, S.L ; Robertson, N ; Graham, C.D ; Williams, J ; Steiner, M.C ; Morgan, M.D.L ; Singh, S.J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c516t-1964f2ab0d8c17cd4655377a64d87671741c8996c5bb85e756890d534ce5b4c83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Acute Disease</topic><topic>Aged</topic><topic>Anxiety - etiology</topic><topic>Chronic illnesses</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Chronic obstructive pulmonary disease (COPD)</topic><topic>Cluster Analysis</topic><topic>Depression - etiology</topic><topic>Ethics</topic><topic>Exacerbations</topic><topic>Female</topic><topic>Health Status</topic><topic>Heart attacks</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Illness perceptions</topic><topic>Male</topic><topic>Patient Acceptance of Health Care - statistics & numerical data</topic><topic>Prospective Studies</topic><topic>Psychological interventions</topic><topic>Pulmonary Disease, Chronic Obstructive - psychology</topic><topic>Pulmonary Disease, Chronic Obstructive - rehabilitation</topic><topic>Pulmonary rehabilitation (PR)</topic><topic>Pulmonary/Respiratory</topic><topic>Questionnaires</topic><topic>Referral and Consultation - statistics & numerical data</topic><topic>Self Efficacy</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harrison, S.L</creatorcontrib><creatorcontrib>Robertson, N</creatorcontrib><creatorcontrib>Graham, C.D</creatorcontrib><creatorcontrib>Williams, J</creatorcontrib><creatorcontrib>Steiner, M.C</creatorcontrib><creatorcontrib>Morgan, M.D.L</creatorcontrib><creatorcontrib>Singh, S.J</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harrison, S.L</au><au>Robertson, N</au><au>Graham, C.D</au><au>Williams, J</au><au>Steiner, M.C</au><au>Morgan, M.D.L</au><au>Singh, S.J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Can we identify patients with different illness schema following an acute exacerbation of COPD: A cluster analysis</atitle><jtitle>Respiratory medicine</jtitle><addtitle>Respir Med</addtitle><date>2014-02-01</date><risdate>2014</risdate><volume>108</volume><issue>2</issue><spage>319</spage><epage>328</epage><pages>319-328</pages><issn>0954-6111</issn><eissn>1532-3064</eissn><abstract>Summary Introduction Pulmonary Rehabilitation (PR) reduces hospital admissions following an acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) but adherence is known to be poor. Patients' illness perceptions may affect adherence to disease-management strategies but to date have not been explored following an exacerbation. The study aim is two-fold; firstly to prospectively explore acceptance and uptake of post-exacerbation PR and secondly to identify possible clusters of patients' illness perceptions following hospitalisation for an exacerbation of COPD. Methods Patients admitted to hospital with an exacerbation of COPD were recruited to a prospective observational study. Self-reported illness perceptions, mood, health status and self-efficacy were assessed. Acceptance and uptake of PR were recorded at six months. Cluster analysis of Illness Perceptions Questionnaire-Revised data was used to establish groups of patients holding distinct beliefs. Results 128 patients were recruited. Acceptance and uptake of PR following an acute exacerbation was poor with only 9% ( n = 11) completing the programme. Cluster analysis revealed three distinct groups: Cluster 1 ‘in control’ ( n = 52), Cluster 2 ‘disengaged’ ( n = 36) and Cluster 3 ‘distressed’ ( n = 40). Significant between-cluster differences were observed in mood, health status and self-efficacy ( p < 0.01). Acceptance and uptake of PR did not differ between clusters. Conclusions Acceptance/uptake of post-exacerbation PR was found to be poor. Three distinct illness schema exist in patients following an acute exacerbation. This information may be useful in developing novel psychologically-informed interventions designed to reduce feelings of distress and perhaps facilitate a PR intervention for this vulnerable population.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>24238773</pmid><doi>10.1016/j.rmed.2013.10.016</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Disease Aged Anxiety - etiology Chronic illnesses Chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) Cluster Analysis Depression - etiology Ethics Exacerbations Female Health Status Heart attacks Hospitals Humans Illness perceptions Male Patient Acceptance of Health Care - statistics & numerical data Prospective Studies Psychological interventions Pulmonary Disease, Chronic Obstructive - psychology Pulmonary Disease, Chronic Obstructive - rehabilitation Pulmonary rehabilitation (PR) Pulmonary/Respiratory Questionnaires Referral and Consultation - statistics & numerical data Self Efficacy Studies |
| title | Can we identify patients with different illness schema following an acute exacerbation of COPD: A cluster analysis |
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