School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
College of Nursing, University of Illinois at Chicago, Chicago, Illinois.
Res Nurs Health. 2020 Jun;43(3):241-254. doi: 10.1002/nur.22013. Epub 2020 Feb 17.
A person's beliefs about their chronic condition (illness representations) influence health and treatment outcomes. Recently, researchers have used clustering approaches to identify subgroups with different patterns of beliefs about their illness, with some subgroups having more favorable health outcomes than others. To date, these findings have not been synthesized. The purpose of this systematic review of the literature was to synthesize results of studies that used clustering approaches to analyze illness representation in chronic disease populations, in order to characterize the clusters and their relationship to health outcomes. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines we searched CINAHL, PsycInfo, and PubMed. To be included, studies had to be (a) peer reviewed, (b) in English, (c) performing a cluster analysis (CA), latent class analysis (LCA), or latent profile analysis (LPA), (d) using only illness representation (IR) subscales to form clusters, (e) measuring illness representation with the Illness Perception Questionnaire (IPQ-R), (f) in a chronic condition sample, and (g) measuring health-related outcomes. Twelve studies were included. Across studies, the number of clusters found ranged from two to three. In all studies, an association was found between illness representation group and at least one of their health outcomes. Illness representation clusters associated with favorable outcomes usually included lower disease-related consequences, fewer symptoms, less negative emotion, and a more stable disease pattern. The results of this review indicate that the relationship between the patterns of the illness representation profiles and health outcomes transcend diseases. Additionally, some dimensions of illness representation may be more important drivers of group membership than others.
一个人对其慢性疾病（疾病表现）的信念（疾病认知）会影响健康和治疗结果。最近，研究人员使用聚类方法来识别具有不同疾病认知模式的亚组，其中一些亚组的健康结果比其他亚组更有利。迄今为止，这些发现尚未被综合。本系统评价文献的目的是综合使用聚类方法分析慢性疾病人群疾病认知的研究结果，以描述这些聚类及其与健康结果的关系。我们使用系统评价和荟萃分析的首选报告项目（PRISMA）指南，在 CINAHL、PsycInfo 和 PubMed 中进行了搜索。为了纳入研究，必须满足以下条件：(a) 同行评审，(b) 英语，(c) 进行聚类分析（CA）、潜在类别分析（LCA）或潜在剖面分析（LPA），(d) 仅使用疾病认知（IR）分量形成聚类，(e) 使用疾病认知问卷（IPQ-R）测量疾病认知，(f) 在慢性疾病样本中，以及 (g) 测量与健康相关的结果。共纳入了 12 项研究。在所有研究中，都发现疾病认知组与至少一种健康结果之间存在关联。与有利结果相关的疾病认知聚类通常包括较低的疾病相关后果、较少的症状、较少的负面情绪和更稳定的疾病模式。本综述的结果表明，疾病认知模式与健康结果之间的关系超越了疾病。此外，疾病认知的某些维度可能比其他维度更能驱动分组。
