Identifying COPD patients at risk for worse symptoms, HRQoL, and self-efficacy: A cluster analysis

Author(s)

Lopes, Aline C. ^[1] ; Xavier, Rafaella F. ^[1] ; Pereira, Ana Carolina A. C. ^[1] ; Stelmach, Rafael ^[2] ; Fernandes, Frederico L. A. ^[2] ; Harrison, Samantha L. ^[3] ; Carvalho, Celso R. F. ^[1]

Affiliation

^[1] Univ Sao Paulo, Med Sch, Dept Phys Therapy, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Med Sch, Clin Hosp, Pulm Div, Heart Inst InCor, Sao Paulo - Brazil

^[3] Teesside Univ, Sch Hlth & Social Care, Hlth & Social Care Inst, Middlesbrough, Cleveland - England

• Document type: Journal article
• Source: CHRONIC ILLNESS; v. 15, n. 2, p. 138-148, JUN 2019.
• Web of Science Citations: 0

Abstract

Objectives To identify clusters of chronic obstructive pulmonary disease (COPD) patients with distinct beliefs about their illness in terms of symptoms, health-related quality of life (HRQoL), self-efficacy, and daily life physical activity (DLPA). Methods This cross-sectional study included 150 COPD outpatients. The patients' illness perceptions, clinical control, HRQoL, self-efficacy, and DLPA (accelerometry) were evaluated. A cluster analysis was conducted using data from the Illness Perceptions Questionnaire - Revised to establish groups of patients with distinct illness perceptions. Differences between clusters were tested using a T-test or a Mann-Whitney U test. Results The cluster analysis revealed two groups: distressed (n = 95) and coping (n = 55). Despite the fact that both clusters presented similar pulmonary function, between-cluster differences were observed in their self-efficacy, dyspnea, HRQoL, clinical control (p < 0.001), and educational level (p = 0.002). The levels of DLPA did not differ between the clusters. Discussion We observed that clinically stable COPD patients who displayed higher emotional representations and less coherence had heightened symptoms, poorer HRQoL, worse self-efficacy, and lower educational levels. These results emphasize the need to routinely evaluate illness perceptions in COPD patients to target and tailor the proper treatment to improve these important health outcomes. (AU)

• FAPESP's process: 16/05968-1 - New approaches to evaluate patients with chronic obstructive respiratory diseases
• Grantee: Celso Ricardo Fernandes de Carvalho
• Support Opportunities: Regular Research Grants
• FAPESP's process: 13/20676-9 - Identification of phenotypes in COPD patients: influence of physical activity in daily life, body composition and skeletal muscle dysfunction
• Grantee: Rafaella Fagundes Xavier
• Support Opportunities: Scholarships in Brazil - Doctorate