TY - JOUR
T1 - Identifying subgroups based on self-management skills in primary care patients with moderate medically unexplained physical symptoms
AU - Beems, M. E.C.
AU - Toonders, S. A.J.
AU - van Westrienen, P. E.
AU - Veenhof, C.
AU - Pisters, M. F.
N1 - Funding Information:
The PARASOL study is funded by SIA-RAAK-public (PARASOL 2016-2019), the Netherlands.
Funding Information:
The PARASOL study is funded by SIA-RAAK-public (PARASOL 2016-2019), the Netherlands. The Dutch HeiQ was translated by H. van Os-Medendorp & J.W. Ammerlaan (UMC Utrecht), J.P. Sont (LUMC) and L.D. Roorda (Jan van Breemen instituut/Reade, Amsterdam).
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - OBJECTIVE: Medically Unexplained Physical Symptoms (MUPS) are a major burden on both patients and society and frequently develop into chronic MUPS. Self-management interventions may prevent moderate MUPS from becoming chronic. Tailoring interventions to the patient population is strongly recommended. This can be facilitated by identifying subgroups based on self-management skills. This study aimed to identify these subgroups and their clinical profiles in primary care patients with moderate MUPS.METHODS: A cross-sectional study was performed on baseline measurements from a randomized clinical trial (PARASOL-study). To identify subgroups based on self-management skills, a hierarchical cluster analysis was conducted for adults with moderate MUPS from primary health care centers. Self-management skills were measured with the Health education impact Questionnaire. Cluster variables were seven constructs of this questionnaire. Additionally, specific patient profiles were determined by comparing the identified clusters on the clinical variables pain, fatigue and physical functioning.RESULTS: Four subgroups were identified: High-Self-Management Skills (SMS) (n = 29), Medium-SMS (n = 55), Low-SMS (n = 49) and Active & Low Distress-SMS (n = 20). The latter showed a distinctly different pattern on cluster variables, while the other subgroups differed significantly on means of the cluster variables (p < .001). On clinical variables, significant differences between subgroups were mainly found on fatigue and physical functioning.CONCLUSION: This study found four specific subgroups based on self-management skills in moderate MUPS-patients. One subgroup demonstrated a distinctly different pattern on self-management skills. In other subgroups, more similar patterns on self-management skills were found that negatively correlated with pain and fatigue and positively correlated with physical functioning.
AB - OBJECTIVE: Medically Unexplained Physical Symptoms (MUPS) are a major burden on both patients and society and frequently develop into chronic MUPS. Self-management interventions may prevent moderate MUPS from becoming chronic. Tailoring interventions to the patient population is strongly recommended. This can be facilitated by identifying subgroups based on self-management skills. This study aimed to identify these subgroups and their clinical profiles in primary care patients with moderate MUPS.METHODS: A cross-sectional study was performed on baseline measurements from a randomized clinical trial (PARASOL-study). To identify subgroups based on self-management skills, a hierarchical cluster analysis was conducted for adults with moderate MUPS from primary health care centers. Self-management skills were measured with the Health education impact Questionnaire. Cluster variables were seven constructs of this questionnaire. Additionally, specific patient profiles were determined by comparing the identified clusters on the clinical variables pain, fatigue and physical functioning.RESULTS: Four subgroups were identified: High-Self-Management Skills (SMS) (n = 29), Medium-SMS (n = 55), Low-SMS (n = 49) and Active & Low Distress-SMS (n = 20). The latter showed a distinctly different pattern on cluster variables, while the other subgroups differed significantly on means of the cluster variables (p < .001). On clinical variables, significant differences between subgroups were mainly found on fatigue and physical functioning.CONCLUSION: This study found four specific subgroups based on self-management skills in moderate MUPS-patients. One subgroup demonstrated a distinctly different pattern on self-management skills. In other subgroups, more similar patterns on self-management skills were found that negatively correlated with pain and fatigue and positively correlated with physical functioning.
KW - Cluster analysis
KW - Medically unexplained physical symptoms
KW - MUPS
KW - Primary care
KW - Self-management
KW - Subgroups
UR - http://www.scopus.com/inward/record.url?scp=85069898042&partnerID=8YFLogxK
U2 - 10.1016/j.jpsychores.2019.109785
DO - 10.1016/j.jpsychores.2019.109785
M3 - Article
C2 - 31421323
AN - SCOPUS:85069898042
SN - 0022-3999
VL - 125
JO - Journal of Psychosomatic Research
JF - Journal of Psychosomatic Research
M1 - 109785
ER -