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District-Level Primary Care Supply Buffers the Negative Impact of Functional Limitations on Illness Perceptions in Older Adults with Multiple Illnesses

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Illness perceptions predict important outcomes, e.g. coping, adherence and well-being. Less is known about the sources of illness perceptions, in particular the role of environmental factors such as primary care supply.

Purpose

This study examines whether and how primary care supply (on district level) affects individual illness perceptions.

Methods

We conducted a longitudinal study in 271 adults 65 years and older with multiple illnesses. Functional limitations (SF-36 physical functioning subscale) at time 1 were tested as predictors of illness perceptions 6 months later. Primary care supply on district level was matched to individual data.

Results

In multilevel models, functional limitations predicted illness perceptions. Primary care supply on district level moderated the impact of functional limitations on individual identity and emotional response perceptions, with better supply buffering detrimental effects of functional limitations.

Conclusions

Illness perceptions do not only depend on individual factors, but socio-structural factors also substantially contribute to individual illness perceptions.

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Notes

  1. We re-ran all analyses examining cross-level interactions with gross domestic product (GDP) on district level to test whether the primary care supply effects were due to socioeconomic differences between the districts. None of the GDP cross-level interactions emerged as significant.

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Acknowledgments

This study (PREFER) was funded by the German Federal Ministry of Education and Research (Grant No. 01ET0702). The content is the sole responsibility of the authors.

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Authors Schüz, Tesch-Römer, and Wurm declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Authors and Affiliations

  1. School of Psychology, University of Tasmania, Private Bag 30, Hobart, TAS 7001, Australia

    Benjamin Schüz Ph.D.

  2. German Centre of Gerontology, Berlin, Germany

    Clemens Tesch-Römer Ph.D. & Susanne Wurm Ph.D.

  3. Institute of Psychogerontology, University of Erlangen-Nuremberg, Nuremberg, Germany

    Susanne Wurm Ph.D.

Authors
  1. Benjamin Schüz Ph.D.
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  2. Clemens Tesch-Römer Ph.D.
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Schüz, B., Tesch-Römer, C. & Wurm, S. District-Level Primary Care Supply Buffers the Negative Impact of Functional Limitations on Illness Perceptions in Older Adults with Multiple Illnesses. ann. behav. med. 49, 463–472 (2015). https://doi.org/10.1007/s12160-014-9671-2

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  • DOI: https://doi.org/10.1007/s12160-014-9671-2

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