Identifying COPD patients at risk for worse symptoms, HRQoL, and self-efficacy: A cluster analysis

Objectives: To identify clusters of chronic obstructive pulmonary disease (COPD) patients with distinct beliefs about their illness in terms of symptoms, health-related quality of life (HRQoL), self-efficacy, and daily life physical activity (DLPA).Methods: This cross-sectional study included 150 COPD outpatients. The patients’ illness perceptions, clinical control, HRQoL, self-efficacy, and DLPA (accelerometry) were evaluated. A cluster analysis was conducted using data from the Illness Perceptions Questionnaire - Revised to establish groups of patients with distinct illness perceptions. Differences between clusters were tested using a T-test or a Mann–Whitney U test.Results: The cluster analysis revealed two groups: distressed (n = 95) and coping (n = 55). Despite the fact that both clusters presented similar pulmonary function, between-cluster differences were observed in their self-efficacy, dyspnea, HRQoL, clinical control (p < 0.001), and educational level (p = 0.002). The levels of DLPA did not differ between the clusters.Discussion:We observed that clinically stable COPD patients who displayed higher emotional representations and less coherence had heightened symptoms, poorer HRQoL, worse self-efficacy, and lower educational levels. These results emphasize the need to routinely evaluate illness perceptions in COPD patients to target and tailor the proper treatment to improve these important health outcomes.