Exploring and Changing Cognitive Representations, Coping and Quality Of Life Outcomes in Chronic Spontaneous Urticaria

Chronic Spontaneous Urticaria (CU) is a pruritic skin disorder that affects 0.8% of the population. As its aetiology is not fully understood the aim is to control symptoms through medicines to improve quality of life (QoL). Demographic and clinical factors have been inconsistent and poorly predict Q...

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Main Author: Bucknor, Delaney Andreka
Format: Thesis
Language:English
Published: 2016
Subjects:
Online Access:https://repository.londonmet.ac.uk/1143/1/BucknorDelaney%20-%20PhD%20Final%20Addmission.pdf
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author Bucknor, Delaney Andreka
author_facet Bucknor, Delaney Andreka
author_sort Bucknor, Delaney Andreka
collection LMU
description Chronic Spontaneous Urticaria (CU) is a pruritic skin disorder that affects 0.8% of the population. As its aetiology is not fully understood the aim is to control symptoms through medicines to improve quality of life (QoL). Demographic and clinical factors have been inconsistent and poorly predict QoL but one modifiable factor that has gained credence is ones illness representations. The Common-Sense Model (Leventhal, Meyer and Nerenz, 1980) postulates that these guide coping procedures that impact outcomes. The aim of the thesis was to examine whether CU representations (mediated by coping) predicted QoL and whether both representations and QoL in CU were amenable to change via intervention. Preliminary studies undertaken validated CSM measures in CU and confirmed key reference values for CU-related QoL and its measurement. CU was seen as uncontrollable, emotionally arousing, chronic, cyclical, caused by stress and immunity with serious consequences and has a moderate impact on QoL (n=78). The necessity to take CU medicines equalled concerns about side effects. Cognitive representations were the strongest predictors of QoL explaining 35.0-60.6% of the variance independent of coping. Qualitative analyses presented CU as unsightly, uncontrollable and difficult to comprehend and self-regulate. Fifteen participants undertook psych-education and action plans to change CU representations. Multivariate analyses found a strong within-group main effect on QoL outcomes (p<.001) and for aspects of outcome over time (all p<.001). Correlation based change analysis further inferred that targeting CU cognitions resulted in changing QoL outcomes over time. In summary the thesis supported that: poor QoL is prevalent in individuals experiencing CU. Not only do CU representations predict QoL outcomes, they are amenable to change via intervention as are QoL outcomes. Such findings have implications for CU-related QoL research and how health psychology-dermatology collaborations maybe instrumental to improving outcome through psycho-education interventions in routine care to facilitate better CU self-management.
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spelling oai:repository.londonmet.ac.uk:11432021-07-19T16:04:14Z http://repository.londonmet.ac.uk/1143/ Exploring and Changing Cognitive Representations, Coping and Quality Of Life Outcomes in Chronic Spontaneous Urticaria Bucknor, Delaney Andreka 610 Medicine & health Chronic Spontaneous Urticaria (CU) is a pruritic skin disorder that affects 0.8% of the population. As its aetiology is not fully understood the aim is to control symptoms through medicines to improve quality of life (QoL). Demographic and clinical factors have been inconsistent and poorly predict QoL but one modifiable factor that has gained credence is ones illness representations. The Common-Sense Model (Leventhal, Meyer and Nerenz, 1980) postulates that these guide coping procedures that impact outcomes. The aim of the thesis was to examine whether CU representations (mediated by coping) predicted QoL and whether both representations and QoL in CU were amenable to change via intervention. Preliminary studies undertaken validated CSM measures in CU and confirmed key reference values for CU-related QoL and its measurement. CU was seen as uncontrollable, emotionally arousing, chronic, cyclical, caused by stress and immunity with serious consequences and has a moderate impact on QoL (n=78). The necessity to take CU medicines equalled concerns about side effects. Cognitive representations were the strongest predictors of QoL explaining 35.0-60.6% of the variance independent of coping. Qualitative analyses presented CU as unsightly, uncontrollable and difficult to comprehend and self-regulate. Fifteen participants undertook psych-education and action plans to change CU representations. Multivariate analyses found a strong within-group main effect on QoL outcomes (p<.001) and for aspects of outcome over time (all p<.001). Correlation based change analysis further inferred that targeting CU cognitions resulted in changing QoL outcomes over time. In summary the thesis supported that: poor QoL is prevalent in individuals experiencing CU. Not only do CU representations predict QoL outcomes, they are amenable to change via intervention as are QoL outcomes. Such findings have implications for CU-related QoL research and how health psychology-dermatology collaborations maybe instrumental to improving outcome through psycho-education interventions in routine care to facilitate better CU self-management. 2016-03 Thesis NonPeerReviewed text en https://repository.londonmet.ac.uk/1143/1/BucknorDelaney%20-%20PhD%20Final%20Addmission.pdf Bucknor, Delaney Andreka (2016) Exploring and Changing Cognitive Representations, Coping and Quality Of Life Outcomes in Chronic Spontaneous Urticaria. Doctoral thesis, London Metropolitan University.
spellingShingle 610 Medicine & health
Bucknor, Delaney Andreka
Exploring and Changing Cognitive Representations, Coping and Quality Of Life Outcomes in Chronic Spontaneous Urticaria
title Exploring and Changing Cognitive Representations, Coping and Quality Of Life Outcomes in Chronic Spontaneous Urticaria
title_full Exploring and Changing Cognitive Representations, Coping and Quality Of Life Outcomes in Chronic Spontaneous Urticaria
title_fullStr Exploring and Changing Cognitive Representations, Coping and Quality Of Life Outcomes in Chronic Spontaneous Urticaria
title_full_unstemmed Exploring and Changing Cognitive Representations, Coping and Quality Of Life Outcomes in Chronic Spontaneous Urticaria
title_short Exploring and Changing Cognitive Representations, Coping and Quality Of Life Outcomes in Chronic Spontaneous Urticaria
title_sort exploring and changing cognitive representations coping and quality of life outcomes in chronic spontaneous urticaria
topic 610 Medicine & health
url https://repository.londonmet.ac.uk/1143/1/BucknorDelaney%20-%20PhD%20Final%20Addmission.pdf
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