title: The association between illness representation profiles and use of unscheduled urgent and emergency health care services.
abstract: OBJECTIVE
  Provision of unscheduled health care (e.g., emergency department, family doctor consultations, pharmacist) is aided by matching patients with the 'right service, first time'. However, service choice is usually made by patients and carers rather than service providers. The self-regulation model (SRM) posits that people cope in ways consistent with their illness understanding. The SRM was used to examine differences in people's use of primary, secondary, and community health care services according to their illness representation, whilst also examining associations with chronic illness. Research historically treats illness representations at the level of independent components; this research focused on components as sets (profiles).
  
  
  METHODS
  A general population postal survey obtained usable data from 588 respondents on service usage and illness representation.
  
  
  RESULTS
  Cluster analysis detected three illness representation profiles (participant groups) comprising people who regarded their illness as serious, unambiguous, distressing, and difficult to manage (group 1); chronic and concerning, but believing they understood and could manage it (group 2); short-term, of limited impact or concern but ambiguous in nature (group 3). Overall, group 1 used secondary care more than the other groups. When considering illness chronicity, group 1 showed more use of primary care with non-chronic conditions and secondary care with chronic conditions.
  
  
  CONCLUSIONS
  Findings highlighted differences in use of unscheduled services that were related to illness representation profiles. Interventions for moderating service use such as patient information campaigns may need to be tuned towards specific groups of service users to optimize impact.
authors: Psychology Department, Swansea University, Singleton Park, Swansea, SA2 8PP, UK. r.p.lowe@swansea.ac.uk
authors: Rob
authors: R
authors: Lowe
authors: Alison
authors: A
authors: Porter
authors: Helen
authors: H
authors: Snooks
authors: Lori
authors: L
authors: Button
authors: Bridie Angela
authors: BA
authors: Evans
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002755:Choice Behavior; D002908:Chronic Disease / Q000523:psychology*; D016000:Cluster Analysis; D003153:Community Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003625:Data Collection; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D014852:Wales; D055815:Young Adult