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RNL Dissertation FINAL 3.pdf (602.27 KB)

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The Moderating Influence of Patient and Caregiver Illness Perceptions on Psychological and Physical Outcomes of Coping Skills Training among Patients with Chronic Obstructive Pulmonary Disease

Long, Risa Nicole
http://rave.ohiolink.edu/etdc/view?acc_num=osu1503056464182065

Abstract Details

2017, Doctor of Philosophy, Ohio State University, Psychology.
Chronic obstructive pulmonary disease (COPD) is a progressive, irreversible medical condition associated with decreased quality of life (QoL), psychological functioning, and exercise capacity. Research indicates that COPD patients with negative illness perceptions are more likely to report poorer psychological well-being and lower QoL. Caregivers of patients with COPD also may have an influence on psychological functioning and quality of life of patients. However, few studies have examined the impact of caregiver illness perceptions on patient outcomes, and no study has examined the influence of caregiver perceptions in the context of a behavioral intervention. Preliminary evidence suggests that illness perceptions among other patient groups are modifiable. This exploratory study evaluated changes in illness perceptions and the moderating effect of patient and caregiver illness perceptions on patient psychological and somatic QoL, and exercise capacity following a telephone-based coping skills training (CST) intervention. The current study included 39 COPD patients (84.6% Caucasian, 53.8% female, mean age = 64.1 years, mean FEV1% predicted = 43.1, caregiver identified = 82.1%) and 32 caregivers (81.3% Caucasian, 68.8% female, mean age = 58.4%). Participants were randomized to a 14-week telephone-based CST group (n = 20) or COPD education (COPD-ED) group (n = 19). Patient and caregiver illness perceptions, generic and disease specific QoL, depression, anxiety, perceived dyspnea, exercise capacity (as indicated by six-minute walk distance [6MWD]), and lung function were assessed at baseline and post-intervention. Repeated measures analysis of variance (ANOVA), regressions, and estimation of conditional effects were the primary modes of data analysis. Results indicated that perceived concern decreased in the CST group compared to COPD-ED. There was no difference between groups on the other dimensions of illness perceptions. Participants in CST exhibited no change in psychological or somatic QoL, but quality of life decreased in COPD-ED. Patterns of conditional effects revealed that CST was associated with better psychological QoL when patient perceived consequences, identity, and emotional representation was high. Patient emotional representation moderated the influence of CST on exercise capacity such that CST patients with lower emotional representation reported greater 6MWD. Patterns of conditional effects revealed that CST participants reported better psychological QoL when caregiver perception of consequences and emotional representation was low, and concern was high. Caregiver perceived consequences moderated the effect of treatment group on somatic QoL such that CST patients reported better somatic QoL when caregiver perception of consequences for the patient was low. Patient-caregiver discrepancies in concern and coherence moderated the effect of treatment group on patient exercise capacity such that greater discrepancy was associated with greater 6MWD in CST patients. Results suggest that patient and caregiver illness perceptions influence the effect of a CST intervention. However, further research is needed to investigate the mechanism by which illness perceptions may influence psychosocial outcomes. This study also suggests a need to examine illness perception trajectories among patients with COPD to determine the impact on patient outcomes and to identify further strategies for intervention.
Charles Emery, PhD (Advisor)
Julian Thayer, PhD (Committee Member)
Michael Vasey, PhD (Committee Member)
112 p.
Psychology
COPD; illness perceptions; quality of life; psychological functioning; exercise capacity; caregivers

Recommended Citations

Citations

  • Long, R. N. (2017). The Moderating Influence of Patient and Caregiver Illness Perceptions on Psychological and Physical Outcomes of Coping Skills Training among Patients with Chronic Obstructive Pulmonary Disease [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1503056464182065

    APA Style (7th edition)

  • Long, Risa. The Moderating Influence of Patient and Caregiver Illness Perceptions on Psychological and Physical Outcomes of Coping Skills Training among Patients with Chronic Obstructive Pulmonary Disease. 2017. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1503056464182065.

    MLA Style (8th edition)

  • Long, Risa. "The Moderating Influence of Patient and Caregiver Illness Perceptions on Psychological and Physical Outcomes of Coping Skills Training among Patients with Chronic Obstructive Pulmonary Disease." Doctoral dissertation, Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu1503056464182065

    Chicago Manual of Style (17th edition)

osu1503056464182065
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This open access ETD is published by The Ohio State University and OhioLINK.