Association between illness representation and psychological distress in stroke patients: A systematic review and meta-analysis
Section snippets
What is already known about the topic?
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Patients’ perceptions of health threats determine their coping and behavior, based on patients’ illness representation.
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Patients conceptualize their illness and how it influences their physical recovery, psychological well-being, and social functioning.
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An early meta-analysis on chronic illness indicated that illness consequences, timelines, and identity had significant positive relationships with distress.
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Research indicates that the control representation of patients with chronic illness is
What this paper adds
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Meta analysis shows that stroke patients’ negative illness representation is positively related to psychological distress (depression and anxiety).
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Of the stroke patients’ positive illness representation dimensions, only illness coherence was significantly related to depression and overall distress.
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Stroke patients’ personal control and treatment control did not show a significant relationship with any distress outcome.
Literature search
An electronic literature search was conducted using the CINAHL, MEDLINE, PubMed, Cochrane library, and Google Scholar databases. Search strategies were title (stroke or cerebrovascular accident or CVA or cerebral vascular event or CVA or transient ischemic attack or TIA) and keyword (disease or illness) and keyword (perceptions or attitudes or opinion or experience or view or reflection or beliefs). The literature search covered the period of January1990 to October 2018.
The selection criteria
Results
As shown in Table 1, of the seven studies included, the total number of participants included in the meta-analysis was 507. The mean sample size of studies was 72.43 (SD = 47.59), ranging from 40 to 176.
Discussion
This study aimed to examine the relationships between the illness representation dimensions and psychological outcomes across available studies from the related health literature database. This is the first meta-analysis to provide evidence of the association between illness representation and distress in stroke patients. Meta-analysis techniques were used to correct the average relationships between illness representations dimensions and psychological outcomes across seven studies that
Limitations
We performed both a comprehensive systematic review and a meta-analysis. All seven empirical research studies, however, were either cross-sectional or follow-up research. Thus, in this study, there are some limitations that need to be addressed. First, the findings need to be confirmed, and any causal relationship between illness representation and stroke patients need to be further explored in a randomized controlled trial. Second, illness belief may be influenced by changes over time. Thus, a
Conclusions
The current evidence on the Common Sense Model, that a negative illness representation is positively related to psychological distress (depression and anxiety), was supported by this study. In regard to the positive illness representation dimensions that are negatively related to psychological distress (depression and anxiety) for stroke patients, only illness coherence was significantly related to depression and overall distress, whereas personal control and treatment control did not show a
Ethical approval
The study was approved by the institutional review board of Chung-Shan Medical University Hospital (CSMUH No: CS2-18011).
Funding
This research was funded by the Ministry of Science and Technology for funding this study (MOST 107-2314-B-040-002).
Conflicts of interest
The authors declare no conflicts of interest.
Acknowledgements
We thank the Ministry of Science and Technology for funding this study (MOST 107-2314-B-040-002).
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