A systematic review of illness representation clusters in chronic conditions.
Eleanor Rivera, Colleen Corte, Holli A DeVon and 2 others
PMID 32067248WHAT IT FOUND
Patients with chronic illness clustered into positive and negative illness perception profiles.
Fewer perceived consequences, fewer symptoms, and less negative emotion consistently tracked better health outcomes.
Key findings
01All studies identified at least one positive and one negative illness perception profile.
02Lower perceived illness consequences were reported in the better outcome cluster in all 12 studies.
03Where those subscales were used, clusters with better outcomes reported fewer symptoms and less negative emotion.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 12 studies, and 5 were rated low quality. Many studies did not report a priori power analysis, reliability data, or adjustment for confounding variables. Sample sizes ranged from 44 to 227, and the smallest sample mentioned was 49, which may be underpowered. Most included studies were cross-sectional, so they show what illness perception patterns go with better outcomes, not that changing beliefs causes better outcomes. Some studies omitted IPQ-R subscales, and the review compared only the best and worst clusters, not middling groups. The review did not pool scores across conditions, so findings are pattern-level, not a universal illness perception profile.
Declared interests
The authors declare that there are no conflicts of interest.
The easy way to misread this
Do not conclude that assessing and targeting illness perceptions will improve outcomes. The review compared belief patterns with outcomes in observational studies; it did not test an intervention that changed beliefs.