PURPOSE:We investigated illness perceptions of critically ill patients and their caregivers during their ICU admission. We hypothesized that these perceptions would vary by selected demographics, illness severity measures, survival status, and personal measures.
METHODS:This was a cross-sectional, descriptive investigation. Illness perception was measured using the Illness Perception Questionnaire-Revised (IPQ-R), a self-administered survey. The IPQ-R uses a five-point Likert response scale to measure five perception domains: timeline, consequences, control, illness coherence, and emotional representation. Respondents were sequential MICU patients and/or their surrogate on MICU day 3 (n=100). Demographics, illness severity, and survival status were obtained from the medical record and/or respondent self-report.
RESULTS:Significant differences were identified in several subgroups particularly among African Americans (n=43) compared with Caucasians (n=57). African Americans tended to perceive the critical illness as less chronic (p<.0001), less serious (p<.0021), as having more personal control (p=.0002), more confidence in treatments (p=.005), and less emotional impact (p=.002) compared to Caucasian respondents. African Americans, however, tended to report lower illness comprehension compared to Caucasians (p=.002). Respondents for patients that died while in the MICU (n=31) reported stronger perceptions of chronic illness (p=.01), more serious consequences (p=.009), and greater self-reported illness comprehension (p=.06) compared to surviving MICU patients (n=69). Finally, religiosity as measured by self-report of strongly agreeing/agreeing to “being active in faith/church” was associated with a perception of less serious consequences (p=.02), more confidence in treatments (p=.008), and less emotional impact of critical illness (p=.03).
CONCLUSION:Significant differences exist between African Americans’ illness perceptions of critical illness as compared to Caucasians’ perceptions of critical illness in four of five domains measured by the IPQ-R. Other differences were identified by deceased vs. surviving MICU patients and respondents active in their faith/church.
CLINICAL IMPLICATIONS:Critical care clinicians should be aware of different perceptions of illness between African Americans and Caucasians and those active in their faith and use this knowledge.
DISCLOSURE:Dee Ford, None.