Prospective Impact of Illness Uncertainty on Outcomes in Chronic Lung Disease

Karin F Hoth; Frederick S Wamboldt; Matthew Strand; Dee W Ford; Robert A Sandhaus; Charlie Strange; David B Bekelman; Kristen E Holm

doi:10.1037/a0032721

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Prospective Impact of Illness Uncertainty on Outcomes in Chronic Lung Disease

Journal article

Open access

Peer reviewed

Prospective Impact of Illness Uncertainty on Outcomes in Chronic Lung Disease

Karin F Hoth, Frederick S Wamboldt, Matthew Strand, Dee W Ford, Robert A Sandhaus, Charlie Strange, David B Bekelman and Kristen E Holm

Health psychology, Vol.32(11), pp.1170-1174

11/2013

DOI: 10.1037/a0032721

PMCID: PMC3966193

PMID: 23772888

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http://doi.org/10.1037/a0032721View

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Abstract

Objective: To determine which aspect of illness uncertainty (i.e., ambiguity or complexity) has a stronger association with psychological and clinical outcomes over a 2-year period among individuals with a genetic subtype of chronic obstructive pulmonary disease (COPD). Ambiguity reflects uncertainty about physical cues and symptoms, and complexity reflects uncertainty about treatment and the medical system. Method: Four-hundred and 7 individuals with alpha-1 antitrypsin deficiency-associated COPD completed questionnaires at baseline, 1- and 2-year follow-up. Uncertainty was measured using the Mishel Uncertainty in Illness Scale. Outcomes were measured using the Hospital Anxiety and Depression Scale, St. George's Respiratory Questionnaire, and MMRC Dyspnea Scale. Ambiguity and complexity were examined as predictors of depressive symptoms, anxiety, quality of life, and breathlessness using linear mixed models adjusting for demographic and health characteristics. Results: Ambiguity was associated with more depressive symptoms (b = 0.09, SE = 0.02, p < .001) and anxiety (b = 0.13, SE = 0.02, p < .001), worse quality of life (b = 0.57, SE = 0.10, p < .001), and more breathlessness (b = 0.02, SE = 0.006, p < .001). Complexity did not have an independent effect on any outcome. Interactions between ambiguity and time since diagnosis were not statistically significant. Conclusions: Ambiguity was prospectively associated with worse mood, quality of life, and breathlessness. Thus, ambiguity should be targeted in psychosocial interventions. Time since diagnosis did not affect the association between ambiguity and outcomes, suggesting that the impact of ambiguity is equally strong throughout the course of COPD.

Mishel Uncertainty in Illness Scale (MUIS)

Alpha One Antitrypsin Deficiency (AATD)

uncertainty

Chronic Obstructive Pulmonary Disease (COPD)

Details

Title: Subtitle: Prospective Impact of Illness Uncertainty on Outcomes in Chronic Lung Disease
Creators: Karin F Hoth - Department of Psychiatry, University of Iowa Carver College of Medicine, Department of Medicine, National Jewish Health, Denver, Colorado, and Department of Psychiatry and Department of Neurology, University of Colorado School of Medicine at the Anschutz Medical Campus
Frederick S Wamboldt - Department of Medicine, National Jewish Health, Denver, Colorado, and Department of Psychiatry, University of Colorado School of Medicine at the Anschutz Medical Campus
Matthew Strand - Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, Colorado and Department of Biostatistics, Colorado School of Public Health
Dee W Ford - Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina
Robert A Sandhaus - National Jewish Health, Denver, Colorado and Department of Medicine, and Clinical Director, Alpha-1 Foundation, Miami, Florida
Charlie Strange - Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina
David B Bekelman - Department of Medicine, National Jewish Health, Denver, Colorado, Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, Colorado, and Department of Medicine, University of Colorado School of Medicine at the Anschutz Medical Campus
Kristen E Holm - Department of Medicine, National Jewish Health, Denver, Colorado and Department of Community and Behavioral Health, Colorado School of Public Health
Contributors: Anne E Kazak (Editor)
Resource Type: Journal article
Publication Details: Health psychology, Vol.32(11), pp.1170-1174
DOI: 10.1037/a0032721
PMID: 23772888
PMCID: PMC3966193
NLM abbreviation: Health Psychol
ISSN: 0278-6133
eISSN: 1930-7810
Publisher: American Psychological Association
Grant note: DOI: 10.13039/100001448, name: Alpha-1 Foundation; DOI: 10.13039/100000002, name: National Institutes of Health, award: F32 HL083687, K23 HL091049, K23 HL095658; DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences, award: UL1 TR000154
Alternative title: BRIEF REPORT
Language: English
Date published: 11/2013
Academic Unit: Psychiatry; Iowa Neuroscience Institute
Record Identifier: 9984003913702771

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