Self-management in older adults with chronic illness: Do illness representations play a regulatory role?

Abstract

Background. A greater number of older adults now live with chronic illness. This poses a significant public health problem, because older adults are at high risk for chronic illness -related mortality and morbidity. Methods. In the project on older adult self care in chronic illness, we administered nine subscales (Illness Consequences, Illness Coherence, Illness Timeline—Cyclical, Personal Control, Treatment Control, Illness Representations, Illness Identity, and Causal Attributions) of the Illness Perception Questionnaire— Revised (IPQ-R). Multivariable linear regression analyses explored the associations between illness perception, wellness-focused coping, and illness-focused coping as measured by CPCI42. Results. Among the 76 respondents (39.47% women; mean age, 64.53±6.93 years), in multivariable regression models, either illness perception variables or coping strategies variables were associated with chronic illness. Higher scores on causal attributions were associated with coping strategies chosen scores. Higher scores on the causal attributions (β = 0.63), Illness Coherence (β = -0.50), illness representations(β = 0.66) and Personal Control scales(β = -0.53) were associated with several scores of coping strategies chosen by chronically ill older persons. Conclusion. Older adults with chronic illness report a high understanding of their disease, feel that chronic illness has significant illness representations consequences, and endorse both illness coherence and personal control over their coping strategies. Illness perceptions did not vary with increased age or worsening disease severity, suggesting that illness perceptions may develop during aging. The self-regulatory model may provide a useful guide for the development of effective interventions tailored to older adults.

 Keywords: Chronic Illness; Coping Strategies; Illness Perceptions; Older Adults; Self-Regulatory Model