Characteristics and Outcomes Based on Perceived Illness Severity in SARS-CoV-2

Introduction: End-of-life (EOL) services, such as hospice and palliative care are often lacking even for the sickest heart failure (HF) patients. Use of these services have been hampered by the lack of availability, lack of referrals due to the unpredictable course in HF, and refusal of services by patients and caregivers due to a lack of understanding of the terminality of HF. The purpose of this study was to determine whether caregivers of HF patients with a predicted survival of less than 2 years, understood disease terminality prior to and after the patient’s death. Methods: As part of a longitudinal study of 100 patient-caregiver dyads, caregivers were interviewed monthly until the patient’s death and then twice post-death. Caregiver interviews immediately preceding and post-patient death were analyzed to determine caregivers’ perceptions of the terminality of heart failure. Results: There were 49 caregivers of patients who died. Patients died an average of 8 months after study enrollment. Most caregivers did not understand the severity of the patient’s disease and 51% (25/49) viewed the death as unexpected. When caregivers retrospectively reflected on the patient’s illness trajectory, they recounted downward trends in patient’s health, but were not aware of the terminality of the patient until after death occurred. Those few caregivers who perceived the illness severity prior to death came to this realization late in the disease trajectory. At the point of recognition, advanced treatments were limited or withdrawn and the short-term use of EOL services such as palliative care or hospice was instituted. Conclusions: The lack of perceived illness severity/terminality has profound implications for patients, caregivers, and healthcare providers. Patients and caregivers who do not understand the seriousness of the illness are less likely to accept EOL services, if offered. Clinicians need to understand the HF EOL trajectory and that EOL discussions and advance care planning help patients and caregivers make informed choices and receive quality care at EOL. We also need to educate all healthcare providers about having these discussions, so palliative care becomes a philosophy of care not merely a referral service immediately preceding death.

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Smoking, Cardiac Symptoms, and an Emergency Care Visit: A Mixed Methods Exploration of Cognitive and Emotional Reactions

Emergency Medicine International ◽

10.1155/2012/935139 ◽

2012 ◽

Vol 2012 ◽

pp. 1-12 ◽

Cited By ~ 2

Author(s):

Karyn A. Tappe ◽

Edwin D. Boudreaux ◽

Beth Bock ◽

Erin O'Hea ◽

Brigitte M. Baumann ◽

...

Keyword(s):

Smoking Cessation ◽

Causal Attribution ◽

Emotional Reactions ◽

Illness Severity ◽

Semistructured Interview ◽

Cardiac Symptoms ◽

Promote Smoking Cessation ◽

The Individual ◽

Perceived Illness ◽

Inpatient Units

Emergency departments and hospitals are being urged to implement onsite interventions to promote smoking cessation, yet little is known about the theoretical underpinnings of behavior change after a healthcare visit. This observational pilot study evaluated three factors that may predict smoking cessation after an acute health emergency: perceived illness severity, event-related emotions, and causal attribution. Fifty smokers who presented to a hospital because of suspected cardiac symptoms were interviewed, either in the emergency department (ED) or, for those who were admitted, on the cardiac inpatient units. Their data were analyzed using both qualitative and quantitative methodologies to capture the individual, first-hand experience and to evaluate trends over the illness chronology. Reported perceptions of the event during semistructured interview varied widely and related to the individual’s intentions regarding smoking cessation. No significant differences were found between those interviewed in the ED versus the inpatient unit. Although the typical profile was characterized by a peak in perceived illness severity and negative emotions at the time the patient presented in the ED, considerable pattern variation occurred. Our results suggest that future studies of event-related perceptions and emotional reactions should consider using multi-item and multidimensional assessment methods rated serially over the event chronology.

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Exposure to a severe illness prototype, perceptions of severity, and coping responses

Psychology: the Journal of the Hellenic Psychological Society ◽

10.12681/psy_hps.25598 ◽

2020 ◽

Vol 25 (2) ◽

pp. 186

Author(s):

Evangelos C. Karademas ◽

Christoforos Thomadakis

Keyword(s):

Lung Cancer ◽

Repeated Measures ◽

Active Coping ◽

Illness Severity ◽

Severe Illness ◽

Care Seeking ◽

Coping Responses ◽

And Coping ◽

Perceived Illness ◽

Illness Recognition

The aim of this experimental study was to examine the relationship of exposure to a lung cancer illness prototype to perceptions of illness severity, illness recognition, and coping responses. Two hundred and ten students were presented with Scenarios of a person suffering from lung cancer-related symptoms. Participants were randomly assigned in two groups: half were asked to think of themselves as the patient, and half of “someone else they know”. After each Scenario, participants were asked to respond to a set of questions regarding the perceived severity of symptoms, potential coping actions, and illness recognition. Repeated Measures MANOVAs, moderation analyses, correlations, and chi-square tests were used to analyse the data. According to the results, gradual exposure to more severe symptoms was related to increased perceived illness severity, increased possibility of using an active coping plan (e.g., care seeking), and more accurate illness recognition. Perceived illness severity was related to more active coping. Still, most participants inaccurately recognized an acute disorder in the majority of Scenarios. Participants in the other-person-group reported greater possibility of using active coping. The findings provide support to several of the Common Sense Model suggestions regarding the role of illness prototypes. They also indicate that illness prototypes are flexible, dynamic constructs that vary according to the specific aspects of the condition.

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Health status as a personal resource: Analyzing associations between perceived illness severity, burnout, and work engagement amongst employees with autoimmune diseases

10.31234/osf.io/vrw34 ◽

2021 ◽

Author(s):

Alexandra Cook ◽

Alexander Zill

Keyword(s):

Health Status ◽

Autoimmune Diseases ◽

Work Engagement ◽

Job Demands ◽

Epidemiological Data ◽

Illness Severity ◽

Chronic Illnesses ◽

Future Research ◽

Personal Resource ◽

Perceived Illness

Epidemiological data suggest that the prevalence of autoimmune diseases is increasing. Although evidence implies that people with chronic illnesses experience higher levels of burnout, there are few available insights for developing preventative interventions. This paper builds on the job-demands resources model (JD-R) to investigate the association between impaired health, burnout, and work engagement. In two longitudinal studies, we test the effects of job demands and resources among employed people with autoimmune diseases and identify individual health status as a personal resource within the JD-R model to investigate the incremental effects of autoimmune illness severity on burnout. Study 1 investigated the effects of illness severity amongst 87 employees with inflammatory bowel diseases. Controlling for job characteristics, perceived illness severity was the strongest predictor of e burnout and predicted the vigor subdimension of work engagement. In study 2, we analyzed the effects of illness severity amongst 129 employees with multiple sclerosis and found similar effects of illness severity on both outcomes. Our studies provide important insights for employees with chronic illnesses and the organizations in which they work and give indications for theory development, future research, and the development of interventions.

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