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

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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.

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Lopes, A. C., Xavier, R. F., AC Pereira, A. C., Stelmach, R., Fernandes, F. L. A., Harrison, S. L., & Carvalho, C. R. F. (2019). Identifying COPD patients at risk for worse symptoms, HRQoL, and self-efficacy: A cluster analysis. Chronic Illness, 15(2), 138–148. https://doi.org/10.1177/1742395317753883

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