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The patients' illness perceptions and the use of primary health care.

https://arctichealth.org/en/permalink/ahliterature70485
Source
Psychosom Med. 2005 Nov-Dec;67(6):997-1005
Publication Type
Article
Author
Lisbeth Frostholm
Per Fink
Kaj S Christensen
Tomas Toft
Eva Oernboel
Frede Olesen
John Weinman
Author Affiliation
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark. frost@as.aaa.dk
Source
Psychosom Med. 2005 Nov-Dec;67(6):997-1005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Attitude to Health
Chronic Disease - epidemiology
Comparative Study
Denmark - epidemiology
Female
Follow-Up Studies
Health status
Humans
Life Style
Linear Models
Male
Middle Aged
Patient Acceptance of Health Care
Patients - psychology - statistics & numerical data
Personality Inventory
Primary Health Care - utilization
Questionnaires
Research Support, Non-U.S. Gov't
Sick Role
Somatoform Disorders - diagnosis - epidemiology - psychology
Stress, Psychological - epidemiology - psychology
Abstract
OBJECTIVE: To investigate if primary care patients' perceptions of a current health problem were associated with use of health care. METHOD: One thousand seven hundred eighty-five patients presenting a new health problem to 1 of 38 physicians from 28 general practices in Aarhus County, Denmark. Patients completed a questionnaire on their illness perceptions and emotional distress before the consultation. The physicians completed a questionnaire for each patient on diagnostics and prognostics. Register data on primary health care utilization 3 years before and 2 years after baseline were obtained. Odds ratios were estimated to examine associations between previous health care use and illness perceptions. Linear regression analysis was performed to examine if illness perceptions predicted later health care use. RESULTS: Previous use: Higher use was associated with psychosocial, stress, and lifestyle attributions. Accident/chance attributions were associated with higher use for patients with a chronic disorder but with lower use for patients without a chronic disorder. A strong illness identity (number of self-reported symptoms), illness worry, a long timeline perspective, a belief that the symptoms would have serious consequences, and all emotional distress variables were associated with higher use. Use during follow-up: Infection/lowered immunity attributions were associated with higher use for patients with a chronic disorder, whereas psychosocial and lifestyle attributions were associated with higher use for all patients. Illness worry and all emotional distress variables predicted higher health care use. A strong illness identity, a long timeline perspective, a belief in serious consequences, and stress and accident/chance attributions were among the strongest predictors of health care use in a multivariate model including all variables. CONCLUSIONS: Patients' perceptions of a current health problem are associated with health care use and may offer an obvious starting point for a biopsychosocial approach in primary care.
PubMed ID
16314606 View in PubMed
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Sociodemographic differences in myocardial infarction risk perceptions among people with coronary heart disease.

https://arctichealth.org/en/permalink/ahliterature165272
Source
J Health Psychol. 2007 Mar;12(2):316-29
Publication Type
Article
Date
Mar-2007
Author
Anna-Mari Aalto
John Weinman
David P French
Arja R Aro
Kristiina Manderbacka
Ilmo Keskimäki
Author Affiliation
STAKES, Helsinki, Finland. anna-mari.aalto@stakes.fi
Source
J Health Psychol. 2007 Mar;12(2):316-29
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
Aged
Attitude to Health
Coronary Disease - complications - psychology
Demography
Female
Finland
Humans
Male
Middle Aged
Myocardial Infarction - etiology - prevention & control
Psychology, Social
Questionnaires
Risk assessment
Abstract
This study examines sociodemographic differences in myocardial infarction (MI) risk perceptions among people with coronary heart disease (CHD) (N = 3130). Two variables for comparative risk perceptions were computed: (1) own risk compared to that of an average person; and (2) own risk compared to that of an average person with CHD. Comparative optimism in MI risk perceptions was common, particularly among men and those with higher education. CHD severity and psychosocial resources mediated these sociodemographic differences. These results suggest challenges for secondary prevention in CHD, particularly regarding psychosocial interventions for communicating risk information and supporting lifestyle adjustments.
PubMed ID
17284495 View in PubMed
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Sociodemographic, disease status, and illness perceptions predictors of global self-ratings of health and quality of life among those with coronary heart disease--one year follow-up study.

https://arctichealth.org/en/permalink/ahliterature168420
Source
Qual Life Res. 2006 Oct;15(8):1307-22
Publication Type
Article
Date
Oct-2006
Author
Anna-Mari Aalto
Arja R Aro
John Weinman
Monique Heijmans
Kristiina Manderbacka
Marko Elovainio
Author Affiliation
Health Services Research, STAKES (National research and development centre for welfare and health), Lintulahdenkuja 4, Helsinki, Finn-00531, Finland. anna-mari.aalto@stakes.fi
Source
Qual Life Res. 2006 Oct;15(8):1307-22
Date
Oct-2006
Language
English
Publication Type
Article
Keywords
Aged
Attitude to Health
Comorbidity
Coronary Disease - physiopathology - psychology
Demography
Female
Finland
Follow-Up Studies
Humans
Male
Middle Aged
Quality of Life
Questionnaires
Risk factors
Self Efficacy
Severity of Illness Index
Sickness Impact Profile
Social Class
Abstract
This one-year follow-up study (n = 130 at baseline, n =2745 at follow-up, aged 45-74 years) examined the relationship of patients' perceptions of coronary heart disease (CHD) and illness-related factors with global health status and global quality of life (QOL) ratings. The independent variables were CHD history (myocardial infarction, revascularisation), CHD severity (use of nitrates, CHD risk factors and co-morbidities) and illness perceptions. In multivariate regression analysis, CHD history and severity explained 13% of variance in global health status and 8% in global QOL ratings at the baseline. Illness perceptions increased the share of explained variance by 18% and 16% respectively. In the follow-up, illness perceptions explained a significant but modest share of variance in change in health status and QOL when baseline health status and QOL and CHD severity were adjusted for more symptoms being attributed to CHD, severe perceived consequences of CHD, as well as a weak belief in the controllability of CHD were related to poor global health status and QOL ratings. In structural path models associations of CHD severity factors were mediated by illness perceptions. The association of disease severity with dependent variables was weaker after controlling for illness perceptions. Cognitive representations of CHD contribute to both global health status and QOL ratings and they also mediate the associations between CHD severity and well-being. No gender differences were found in associations of illness perceptions with health status or QOL ratings.
PubMed ID
16826444 View in PubMed
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The uncertain consultation and patient satisfaction: the impact of patients' illness perceptions and a randomized controlled trial on the training of physicians' communication skills.

https://arctichealth.org/en/permalink/ahliterature70486
Source
Psychosom Med. 2005 Nov-Dec;67(6):897-905
Publication Type
Article
Author
Lisbeth Frostholm
Per Fink
Eva Oernboel
Kaj S Christensen
Tomas Toft
Frede Olesen
John Weinman
Author Affiliation
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus N, Denmark.
Source
Psychosom Med. 2005 Nov-Dec;67(6):897-905
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Attitude to Health
Communication
Comparative Study
Family Practice - education - methods - standards
Female
Follow-Up Studies
Health Services Research
Health status
Humans
Male
Middle Aged
Multivariate Analysis
Patient satisfaction
Personality Inventory
Physicians - psychology - standards
Prognosis
Psychiatric Status Rating Scales
Questionnaires
Referral and Consultation - standards
Regression Analysis
Research Support, Non-U.S. Gov't
Somatoform Disorders - diagnosis - psychology - therapy
Teaching
Abstract
OBJECTIVE: To identify predictors of patient satisfaction among a range of patient and practitioner variables. In particular, to focus on patients' illness perceptions and the impact of a randomized controlled trial on the training of physicians in general communication skills and how to treat patients presenting with poorly defined illness. METHODS: A randomized controlled follow-up study conducted in 28 general practices in Aarhus County, Denmark. Half of the physicians were randomized into an educational program on treatment of patients presenting with medically unexplained symptoms (somatization). One thousand seven hundred eighty-five general practice attenders presenting a new health problem completed questionnaires on illness perceptions, physical functioning, and mental distress before the consultation. After the consultation, a questionnaire including relational and communicative domains of patient satisfaction with the current consultation was completed. The physicians completed a questionnaire for each patient on diagnostics and prognostics. Predictors of patient satisfaction were determined by logistic regression. RESULTS: A large number of patient and practitioner variables predicted satisfaction in univariate logistic regression models. Results from a multivariate logistic model showed that the illness perceptions "uncertainty" (patient not knowing what is wrong) and "emotional representations" (the complaint making the patient feel worried, depressed, helpless, afraid, hopeless) predicted dissatisfaction at OR (CI) = 1.8 (1.3-2.4), p
PubMed ID
16314594 View in PubMed
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