Characterization of CKD Illness Representation Profiles Using Patient-level Factors

Overview

Journal J Nephrol

Publisher Springer

Specialty Nephrology

Date 2024 May 10

PMID 38727894

Authors

Eleanor Rivera

Nathan Tintle

Raymond R Townsend

Mahboob Rahman

Sarah J Schrauben

Maya N Clark-Cutaia

Mary Hannan

James P Lash

Katherine Wolfrum

Celestin Missikpode

Karen B Hirschman

Affiliations

Soon will be listed here.

Abstract

Background: Illness perceptions are the unique perspective individuals have on their illness, based on their context and experiences, and are associated with patient outcomes including coping and adherence. The purpose of this study was to explore characteristics that may be driving membership in illness perceptions cluster groups for adults with chronic kidney disease (CKD).

Methods: This study was conducted within the multicenter longitudinal Chronic Renal Insufficiency Cohort (CRIC) Study. Cross-sectional data were collected and combined with CRIC data. Illness perceptions were measured using the Revised Illness Perception Questionnaire. Clustering analysis was conducted in R, and bivariate analysis including linear regression was performed in STATA 16.

Results: The sample (n = 197) had a mean age of 68, was 52% women, 53% non-White, and mean estimated glomerular filtration rate (eGFR) 56 ml/min/1.73 m. Three cluster groups were identified, labeled as "Disengaged" (n = 20), "Well-Resourced" (n = 108), and "Distressed" (n = 69). The "Disengaged" group was characterized by low CKD knowledge, many recent hospitalization days, and the lowest perceived CKD burden. The "Well-Resourced" group was characterized by the highest levels of education, CKD knowledge, optimism, and medication adherence. The "Distressed" group was characterized by the highest levels of depression scores, comorbidity burden, CKD burden, CKD symptoms, and lowest optimism. Group membership significantly predicted the number of hospitalization days in adjusted analyses.

Conclusions: Illness perceptions groups are associated with number of hospitalization days but are independent of many patient characteristics. Illness perceptions data could be used to tailor care for specific patients at risk for poor health outcomes.

References

Gunarathne T, Tang L, Lim S, Nanayakkara N, Damayanthi H, Abdullah K . Factors Associated with Symptom Burden in Adults with Chronic Kidney Disease Undergoing Hemodialysis: A Prospective Study. Int J Environ Res Public Health. 2022; 19(9). PMC: 9105408. DOI: 10.3390/ijerph19095540. View

Grover S, Fitzpatrick A, Azim F, Ariza-Vega P, Bellwood P, Burns J . Defining and implementing patient-centered care: An umbrella review. Patient Educ Couns. 2021; 105(7):1679-1688. DOI: 10.1016/j.pec.2021.11.004. View

Nahlen Bose C, Elfstrom M, Bjorling G, Persson H, Saboonchi F . Patterns and the mediating role of avoidant coping style and illness perception on anxiety and depression in patients with chronic heart failure. Scand J Caring Sci. 2016; 30(4):704-713. DOI: 10.1111/scs.12297. View

Muscat P, Weinman J, Farrugia E, Camilleri L, Chilcot J . Illness perceptions predict mortality in patients with predialysis chronic kidney disease: a prospective observational study. BMC Nephrol. 2020; 21(1):537. PMC: 7727218. DOI: 10.1186/s12882-020-02189-7. View

Rivera E, Corte C, Steffen A, DeVon H, Collins E, McCabe P . Illness Representation and Self-Care Ability in Older Adults with Chronic Disease. Geriatrics (Basel). 2019; 3(3). PMC: 6319205. DOI: 10.3390/geriatrics3030045. View

Denker M, Boyle S, Anderson A, Appel L, Chen J, Fink J . Chronic Renal Insufficiency Cohort Study (CRIC): Overview and Summary of Selected Findings. Clin J Am Soc Nephrol. 2015; 10(11):2073-83. PMC: 4633788. DOI: 10.2215/CJN.04260415. View

Teng E, Chui H . The Modified Mini-Mental State (3MS) examination. J Clin Psychiatry. 1987; 48(8):314-8. View

Islam S, Elaiho C, Arniella G, Rivera S, Vangeepuram N . A Pilot Study to Examine the Feasibility and Acceptability of a Virtual Adaptation of an In-Person Adolescent Diabetes Prevention Program. Int J Environ Res Public Health. 2022; 19(19). PMC: 9564467. DOI: 10.3390/ijerph191912286. View

Rivera E, Clark-Cutaia M, Schrauben S, Townsend R, Lash J, Hannan M . Treatment Adherence in CKD and Support From Health care Providers: A Qualitative Study. Kidney Med. 2022; 4(11):100545. PMC: 9630784. DOI: 10.1016/j.xkme.2022.100545. View

10.

Devins G, Binik Y, Mandin H, Letourneau P, Hollomby D, Barre P . The Kidney Disease Questionnaire: a test for measuring patient knowledge about end-stage renal disease. J Clin Epidemiol. 1990; 43(3):297-307. DOI: 10.1016/0895-4356(90)90010-m. View

11.

Scheier M, Carver C, Bridges M . Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test. J Pers Soc Psychol. 1994; 67(6):1063-78. DOI: 10.1037//0022-3514.67.6.1063. View

12.

Cedillo-Couvert E, Ricardo A, Chen J, Cohan J, Fischer M, Krousel-Wood M . Self-reported Medication Adherence and CKD Progression. Kidney Int Rep. 2018; 3(3):645-651. PMC: 5976857. DOI: 10.1016/j.ekir.2018.01.007. View

13.

Beck A, Ward C, Mendelson M, Mock J, ERBAUGH J . An inventory for measuring depression. Arch Gen Psychiatry. 1961; 4:561-71. DOI: 10.1001/archpsyc.1961.01710120031004. View

14.

Charlson M, Pompei P, Ales K, MacKenzie C . A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40(5):373-83. DOI: 10.1016/0021-9681(87)90171-8. View

15.

Baker D, Williams M, Parker R, Gazmararian J, Nurss J . Development of a brief test to measure functional health literacy. Patient Educ Couns. 2003; 38(1):33-42. DOI: 10.1016/s0738-3991(98)00116-5. View

16.

Scrucca L, Fop M, Murphy T, Raftery A . mclust 5: Clustering, Classification and Density Estimation Using Gaussian Finite Mixture Models. R J. 2016; 8(1):289-317. PMC: 5096736. View

17.

Li J, Qiu X, Yang X, Zhou J, Zhu X, Zhao E . Relationship between Illness Perception and Depressive Symptoms among Type 2 Diabetes Mellitus Patients in China: A Mediating Role of Coping Style. J Diabetes Res. 2020; 2020:3142495. PMC: 7585654. DOI: 10.1155/2020/3142495. View

18.

Baiardini I, Rogliani P, Santus P, Corsico A, Contoli M, Scichilone N . Disease awareness in patients with COPD: measurement and extent. Int J Chron Obstruct Pulmon Dis. 2018; 14:1-11. PMC: 6301728. DOI: 10.2147/COPD.S179784. View

19.

Hurt C, Burn D, Hindle J, Samuel M, Wilson K, Brown R . Thinking positively about chronic illness: An exploration of optimism, illness perceptions and well-being in patients with Parkinson's disease. Br J Health Psychol. 2013; 19(2):363-79. DOI: 10.1111/bjhp.12043. View

20.

Meuleman Y, Chilcot J, Dekker F, Halbesma N, van Dijk S . Health-related quality of life trajectories during predialysis care and associated illness perceptions. Health Psychol. 2017; 36(11):1083-1091. DOI: 10.1037/hea0000504. View