Illness perceptions in patients with peripheral arterial disease: A systematic review of qualitative studies

Background: Patients with chronic diseases create their own subjective beliefs about their conditions based on their illness perceptions. In the common-sense model, illness perceptions constitute personal beliefs about illness with regard to five components: identity, timeline, cause, control/cure, and conse-quences. Patients' illness perceptions affect both their management of their disease and their adherence to treatment. Since patients with peripheral arterial disease need life-long treatment for secondary pre-vention, generating knowledge about illness perceptions in patients with peripheral arterial disease is essential. Objectives: To systematically review and synthesise the literature on illness perceptions in patients with peripheral arterial disease. Design: A systematic review Data sources: PubMed, CINAHL, and PsycINFO. Review methods: A systematic search strategy was conducted in December 2017, with an update in July 2019. Two team members independently screened all titles and abstracts. A relevance and quality ap-praisal of the studies was performed. The references from the included studies were evaluated for ad-ditional studies. The data from 14 studies were extracted and synthesised using a best-fit approach to framework analysis. A deductive analysis was conducted using the common-sense model. The data not suitable for the framework were analysed separately using inductive conventional content analysis, yield-ing an additional component representing the retrospective consequences of peripheral arterial disease. Findings: The findings showed diversity in illness perceptions in each of the five components of the frame -work as well as in the additional component. The findings showed participants' lack of understanding of the chronic nature of the disease, i.e., about the timeline, the identity of the symptoms and the cause of the disease. The patients' beliefs about control and cures varied from having high motivation to engage in physical activity to thinking that walking could make their situations worse. There was fear about the fu-ture, as patients perceived disease progression and decreasing control to be consequences of their illness. Living with the disease, the emphasis in the additional component, was a process for regaining control and adapting to their situations. Conclusions: Patients with peripheral arterial disease shape their own understandings of their conditions. These beliefs may influence their management of their disease and adherence to treatment. Therefore, the current study suggests that illness perceptions should be addressed when planning secondary prevention for patients with peripheral arterial disease. (c) 2020 Elsevier Ltd. All rights reserved.

Automated summary

The study found diversity in illness perceptions among patients with peripheral arterial disease in each of the five components of the common-sense model as well as in an additional component representing retrospective consequences. Patients lacked understanding of the chronic nature of the disease and had varied beliefs about control and cures, with some having high motivation for physical activity while others feared worsening situations through walking. There was also a fear of future consequences such as disease progression and decreasing control.