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Confirmatory factor analysis of illness behavior in the Swedish Adoption/Twin Study of Aging (SATSA)
Univ Calif Riverside, San Diego, USA.
Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).ORCID iD: 0000-0002-6305-8993
Karolinska Inst, Stockholm, Sweden.
Univ Calif Riverside, Riverside, USA.
2017 (English)In: Annals of Behavioral Medicine, ISSN 0883-6612, E-ISSN 1532-4796, Vol. 51, no Suppl. 1, S2654-S2655 p.Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Illness behaviors—or affective, cognitive, and behavioral responses to symptoms of illness—predict patient outcomes, including symptom exacerbation and functional recovery, and they account for a large proportion of U.S. healthcare costs. Although priorcross-sectional work has examined illness behaviors like symptom reporting in isolation, the measurement of illness behavior using a longitudinal, multi-indicator approach has yet to be explored.

Aim: We evaluated illness behavior as a latent, developmental construct in the Swedish Adoption/Twin Study of Aging (SATSA).

Method: Participants were up to 1,886 individuals (from 1,223 twin pairs) ages 29 to 102 years (Mage baseline = 62.32 years; SD =13.69; 59% Female). Illness behavior indicators included somatic complaints, non-prescription medication use, pain-related disability and perceived illness complications. The psychomotor retardation subscale of the CES-D was used to index somatic complaints, and medication use was a simple composite of 9 dichotomous items on participants’ use of non-prescription medications, such as over-the-counter analgesics, in the previous month. Pain-related disability included a simple composite of three dichotomous items on the presence of neck,back, or shoulder pain that prevented participants from performing daily tasks or activities. Perceived illness disability was a composite of difference scores, calculated from subtracting a physician panel’s objective ratings of disability for each of 35 medical conditions (on a 3-pointscale; 1= Little or no disability; 3= Severe disability) from participants’ self-ratings of how much each of the same endorsed medical conditions interfered with their daily lives (on the same 3-point scale; 1= Not at all; 3= A lot). Positive composite scores reflected higher perceived disability relative to what was expected from the objective ratings, whereas a composite score of zero reflected “accuracy” or agreement in perceived illness complications. Confirmatory Factor Analysis (CFA) was used to evaluate invariance in the loadings of these four indicatorson a latent illness behavior factor across four questionnaire waves (1987-2004).

Findings: Confirmatory factor analyses revealed moderate factor loadings of the four indicators (standardized loadings ranged from .49 to .52, all ps < .0001). Also, practical fit indices from the nested model comparisons suggested strong factorial invariance in the loadings across time (CFI = .96; TLI = .95, RMSEA= .03, 90% CI: [.026, .035]).

Conclusion: Illness behavior as a latent, multi-indicator construct represents a promising focus for longitudinal work on behavior change and maintenance.

Place, publisher, year, edition, pages
Springer, 2017. Vol. 51, no Suppl. 1, S2654-S2655 p.
National Category
Other Medical Sciences
Identifiers
URN: urn:nbn:se:hj:diva-35562ISI: 000398947203352Local ID: HHJÅldrandeISOAI: oai:DiVA.org:hj-35562DiVA: diva2:1096710
Conference
38th Annual Meeting & Scientific Sessions of the Society of Behavioral Medicine (SBM), San Diego, California, March 29 to April 1, 2017
Available from: 2017-05-18 Created: 2017-05-18 Last updated: 2017-05-31Bibliographically approved

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