Abstract
Objective: To determine whether people’s beliefs about their illness, conceptualised by the common sense model (CSM), can prospectively predict adherence to self-management behaviours (including, attendance, medication, diet and exercise) in adults with acute and chronic physical illnesses.Design and Main Outcome Measures: Electronic databases were searched in September 2014, for papers specifying the use of the ‘CSM’ in relation to ‘self-management’, ‘rehabilitation’ and ‘adherence’ in the context of physical illness. Six hundred abstracts emerged. Data from 52 relevant studies were extracted. Twenty-one studies were meta-analysed, using correlation coefficients in random effects models. The remainder were descriptively synthesised.Results: The effect sizes for individual illness belief domains and adherence to self-management behaviours ranged from .04 to .13, indicating very weak, predictive relationships. Further analysis revealed that predictive relationships did not differ by the: type of self-management behaviour; acute or chronic illness; or duration of follow-up.Conclusion: Individual illness belief domains, outlined by the CSM, did not predict adherence to self-management behaviours in adults with physical illnesses. Prospective relationships, controlling for past behaviour, also did not emerge. Other factors, including patients’ treatment beliefs and inter-relationships between individual illness beliefs domains, may have influenced potential associations with adherence to self-management behaviours.
Highlights
Adherence to self-management is an integral feature of long-term illness (Bodenheimer, Lorig, Holman, & Grumbach, 2002; Lorig, Sobel, Ritter, Laurent, & Hobbs, 2001)
This paper reports on a meta-analysis and descriptive synthesis that was undertaken to determine whether individual illness belief domains, outlined by the Common Sense Model (CSM), prospectively predicted adherence to self-management behaviours in adults with physical illnesses
A further strength of our review was that we report on a sub-analysis of prospective relationships offering valuable information on causality in predictive relationships between individual illness belief domains and adherence to self-management behaviours
Summary
Adherence to self-management is an integral feature of long-term illness (Bodenheimer, Lorig, Holman, & Grumbach, 2002; Lorig, Sobel, Ritter, Laurent, & Hobbs, 2001) It plays a vital role in the management of acute illnesses; this includes rapid onset conditions that are self-limiting (such as, common cold) and acute presentations of existing major illnesses or new chronic diseases (for example, myocardial infarction or stroke) (Jones, White, Armstrong, Ashworth, & Peters, 2010). It has been reported that patients who self-manage effectively are three-times more likely to experience good health outcomes, than those who are non-adherent with selfmanagement behaviours (DiMatteo, Giordani, Lepper, & Croghan, 2002)
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