Do People’s Beliefs About Their Illness Affect Their Engagement in Daily Routine Activities?

PURPOSE: Illness perceptions are reported as possible psychological factors associated with health outcomes of individuals with chronic illness. Illness perceptions, defined as individuals’ beliefs about the causes, impact, and management of illnesses, are the core concepts of the Common-Sense Model. This model states that illness perceptions guide action planning, generate coping behaviors, and influence health outcomes. Several systematic reviews have examined the relationships between illness perceptions and various health outcomes including medical regimen adherence, rehabilitation attendance, body function, mood, quality of life, and work participation in individuals with chronic illness. However, none of these studies reviewed the relationships between illness perceptions and individuals’ engagement in daily routine activities.

Restrictions in the engagement of daily routine activities are common in individuals with chronic illness and physical disabilities. Accordingly, assisting and supporting these individuals to improve their activity engagement has become a primary goal of rehabilitation. In order to achieve this rehabilitation goal, one needs to identify the potential factors that are related to individuals’ activity engagement. The purpose of this systematic review is to examine the relationships between illness perceptions and individuals’ activity engagement. Knowledge of the relationships between illness perceptions and activity engagement offers additional explanations for these individuals’ dependence in daily life activities. Thus, the findings obtained from this study will assist clinicians in setting goals and planning interventions more effectively.

DESIGN: This study is a systematic review. Studies that contained information on the relationships between the engagement of daily routine activities and illness perceptions of individuals with chronic illness or physical disability were included in this systematic review. Two reviewers independently screened and selected the studies flowing the PRISMA protocol (Moher et al., 2015).

METHODS: Relevant literature databases, including PubMed, CINAHL, PsycINFO, and Web of Science were searched from inception through February 1, 2019, using multiple search terms for chronic illness, illness perceptions, and activity engagement, with the following constraints: English, humans, adults, and peer-reviewed journals. 30 out of 510 studies met the criteria and were included in the current review. Two reviewers independently assessed study quality using the Mixed Methods Appraisal Tool, and extracted results from included studies.

RESULTS: Authors located 22 cross-sectional studies. These studies identified positive relationships between illness perceptions and activity engagement. Specifically, strong beliefs in more symptoms, severe consequences, longer timeline, and negative emotional representations are associated with more difficulty and limitations in engaging in activities of daily living, role fulfillment, and social activities; whereas strong beliefs in personal control and better understanding of the illness is related to better ADL performance and work participation. In addition, similar results were found in other 7 longitudinal studies and one qualitative study.

CONCLUSIONS: In general, individuals’ illness perceptions are positively associated with activity engagement. During the rehabilitation process, healthcare professionals should pay attention to individuals’ illness perceptions in order to target interventions and assist individuals’ engagement in daily activities more effectively.

References

Foxwell, R., Morley, C., & Frizelle, D. (2013). Illness perceptions, mood and quality of life: A systematic review of coronary heart disease patients. Journal of Psychosomatic Research, 75, 211–222. https://doi.org/10.1016/j.jpsychores.2013.05.003

Leventhal, H., Phillips, L. A., & Burns, E. (2016). The Common-Sense Model of Self-Regulation (CSM): A dynamic framework for understanding illness self-management. Journal of Behavioral Medicine, 39, 935–946. https://doi.org/10.1007/s10865-016-9782-2

Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., … PRISMA-P Group. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4, 1. https://doi.org/10.1186/2046-4053-4-1

Pluye, P., & Hong, Q. N. (2014). Combining the power of stories and the power of numbers: Mixed methods research and mixed studies reviews. Annual Review of Public Health, 35, 29–45. https://doi.org/10.1146/annurev-publhealth-032013-182440