common sense model of illness-partial printat

common sense model of illness-partial printat - Psychology...

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Psychology and Health , 2003, Vol. 18, No. 2, pp. 141–184 A META-ANALYTIC REVIEW OF THE COMMON-SENSE MODEL OF ILLNESS REPRESENTATIONS MARTIN S. HAGGER* and SHEINA ORBELL Department of Psychology, University of Essex, Wivenhoe Park, Colchester, Essex CO4 3SQ (Received 14 June 2001; In final form 18 December 2002) A meta-analysis of empirical studies ( N ¼ 45) adopting Leventhal, Meyer and Nerenz’s (1980) Common Sense Model (CSM) of illness representations is presented. The average corrected intercorrelation matrix for the sample of studies showed that the CSM illness cognition dimensions of consequences, control/cure, identity and timeline followed a logical pattern supporting their construct and discriminant validity across illness types. A content analysis classified coping strategies into seven distinctive categories and health outcomes into six categories. Examining the average corrected correlation coefficients across the studies revealed that perceptions of a strong illness identity were significantly and positively related to the use of coping strategies of avoidance and emotion expression. In addition, perceived controllability of the illness was significantly associated with cognitive reappraisal, expressing emotions and problem-focused coping strategies. Perceptions of the illness as highly symptomatic, having a chronic timeline and serious consequences was significantly correlated with avoidance and expressing emotions coping strategies. Further, perceptions that the illness was curable/controllable was significantly and positively related to the adaptive outcomes of psychological well-being, social functioning and vitality and negatively related to psychological distress and disease state. Conversely, illness consequences, timeline and identity exhibited significant, negative relationships with psychological well being, role and social functioning and vitality. The analyses provide evidence for theoretically predictable relations between illness cognitions, coping and outcomes across studies. Keywords: Illness cognitions; Self-regulation model; Research synthesis; Classification of coping An important task for psychological research in health is to understand the factors that influence an individual’s adherence to a medical regime or health behaviour for the man- agement of illness and to identify appropriate targets for intervention (Leventhal et al ., 1984; Petrie et al ., 1996). Much research on adherence has focused on the perceptual and cognitive factors that underlie people’s motivation or intention to attend health care appointments or adopt behaviours that are proposed to improve health (Croyle and Barger, 1993; Leventhal et al ., 1998). Social cognitive models provide a theoretical framework for the study of illness behaviour and adherence to self-management techniques. One theoretical model that has addressed how cognitive factors influence illness coping behaviours and outcomes is the ‘Common Sense’ Model (CSM) of illness *Corresponding author. Tel.: 01206 874898. 07946 419526 (mobile). Fax: 01206 873590.
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