University of Illinois Chicago, Chicago, IL, USA.
University of Pennsylvania, Philadelphia, PA, USA.
J Nephrol. 2024 Apr;37(3):671-679. doi: 10.1007/s40620-024-01955-2. Epub 2024 May 9.
Illness perceptions are the unique perspective individuals have on their illness, based on their context and experiences, and are associated with patient outcomes including coping and adherence. The purpose of this study was to explore characteristics that may be driving membership in illness perceptions cluster groups for adults with chronic kidney disease (CKD).
This study was conducted within the multicenter longitudinal Chronic Renal Insufficiency Cohort (CRIC) Study. Cross-sectional data were collected and combined with CRIC data. Illness perceptions were measured using the Revised Illness Perception Questionnaire. Clustering analysis was conducted in R, and bivariate analysis including linear regression was performed in STATA 16.
The sample (n = 197) had a mean age of 68, was 52% women, 53% non-White, and mean estimated glomerular filtration rate (eGFR) 56 ml/min/1.73 m. Three cluster groups were identified, labeled as "Disengaged" (n = 20), "Well-Resourced" (n = 108), and "Distressed" (n = 69). The "Disengaged" group was characterized by low CKD knowledge, many recent hospitalization days, and the lowest perceived CKD burden. The "Well-Resourced" group was characterized by the highest levels of education, CKD knowledge, optimism, and medication adherence. The "Distressed" group was characterized by the highest levels of depression scores, comorbidity burden, CKD burden, CKD symptoms, and lowest optimism. Group membership significantly predicted the number of hospitalization days in adjusted analyses.
Illness perceptions groups are associated with number of hospitalization days but are independent of many patient characteristics. Illness perceptions data could be used to tailor care for specific patients at risk for poor health outcomes.
疾病感知是个体基于自身背景和经历对疾病的独特看法，与患者的结局相关，包括应对和依从性。本研究旨在探讨可能导致慢性肾脏病（CKD）成人疾病感知聚类组的特征。
本研究在多中心纵向慢性肾功能不全队列（CRIC）研究中进行。收集横断面数据并与 CRIC 数据相结合。使用修订后的疾病感知问卷测量疾病感知。在 R 中进行聚类分析，在 STATA 16 中进行包括线性回归在内的双变量分析。
样本（n=197）的平均年龄为 68 岁，52%为女性，53%为非白人，平均估计肾小球滤过率（eGFR）为 56ml/min/1.73m。确定了三个聚类组，分别标记为“脱轨”（n=20）、“资源丰富”（n=108）和“痛苦”（n=69）。“脱轨”组的特点是 CKD 知识水平低，最近住院天数多，CKD 负担最低。“资源丰富”组的特点是受教育程度最高、CKD 知识水平最高、乐观程度最高、药物依从性最高。“痛苦”组的特点是抑郁评分、合并症负担、CKD 负担、CKD 症状最高，乐观程度最低。在调整分析中，组别的归属显著预测了住院天数。
疾病感知组与住院天数相关，但与许多患者特征无关。疾病感知数据可用于针对特定有不良健康结局风险的患者定制护理。
