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Monday, 16 October 2006
18

RELATIONSHIPS BETWEEN ILLNESS REPRESENTATIONS AND UTILITIES IN ADOLESCENTS WITH INFLAMMATORY BOWEL DISEASE

Michael S. Yi, M.D.1, M. Susan Moyer, MD2, Maria T. Britto, MD, MPH2, Uma R. Kotagal, MBBS, MSc2, Susan N. Sherman, DPA1, Laura A. Nabors, PhD1, Frank W. Putnam, MD2, and Joel Tsevat, MD, MPH1. (1) University of Cincinnati, Cincinnati, OH, (2) Cincinnati Children's Hospital Medical Center, Cincinnati, OH

PURPOSE: Health perceptions have been shown to influence outcomes and medical decision-making. We examined the relationship between illness perceptions and utilities in adolescents with inflammatory bowel disease (IBD).

METHODS: Teens 12-18 years of age with IBD were interviewed as part of an ongoing study at a large Midwestern medical center. We collected socio-demographic data and time since diagnosis. We used the short version of the Illness Perception Questionnaire (IPQ), which is based on a theoretical model of how one cognitively processes health threats. The IPQ assesses the following domains of patients' representations of IBD (range of each scale 0-10): Identity (higher scores represent less IBD symptoms), Cause (higher scores represent greater understanding of IBD), Timeline (higher scores represent shorter anticipated duration of IBD), Consequences (higher scores represent less perceived impact of IBD), Personal Control (higher scores represent greater personal control of IBD), Treatment Control (higher scores represent greater treatment control of IBD), and Emotional (higher scores represent less emotional impact of IBD). The rating scale (RS), time tradeoff (TTO) and standard gamble (SG) techniques were assessed using a computer software package. We performed linear regression to analyze data.

RESULTS:  We analyzed data from 30 subjects with IBD. Their mean (SD) age was 15.4 (2.0), 13 (43%) were male, and 27 (90%) were Caucasian. The mean (SD) health value and IPQ scores are in the table.

RS

TTO

SG

Identity

Cause

 79.0 (15.7)

0.90 (0.21)

0.98 (0.03)

5.9 (2.5)

6.9 (2.2)

 

Timeline

Consequences

Personal Control

Treatment Control

Emotional

2.8 (2.3)

6.1 (2.7)

5.5 (2.7)

7.8 (2.2)

5.5 ( 2.9)

Results from stepwise regression analysis indicated that higher RS scores were significantly associated with being male, non-Caucasian, in a higher grade, and having greater personal control of IBD, and less emotional impact of IBD (R2=0.73); higher TTO scores were associated with being Caucasian, and having greater treatment control of IBD (R2=0.43); and higher SG scores were associated with having greater personal control over IBD (R2=0.16).

CONCLUSION: Aspects of patients' illness representations were related to their utilities. Greater perceived personal control and treatment control of IBD, and less emotional impact from IBD were related to higher scores, although not in a consistent manner. Illness representations may be a potential target for improving health values in youth with IBD.


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See more of The 28th Annual Meeting of the Society for Medical Decision Making (October 15-18, 2006)