title: District-level primary care supply buffers the negative impact of functional limitations on illness perceptions in older adults with multiple illnesses.
abstract: BACKGROUND
  Illness perceptions predict important outcomes, e.g. coping, adherence and well-being. Less is known about the sources of illness perceptions, in particular the role of environmental factors such as primary care supply.
  
  
  OBJECTIVE
  This study examines whether and how primary care supply (on district level) affects individual illness perceptions.
  
  
  METHODS
  We conducted a longitudinal study in 271 adults 65 years and older with multiple illnesses. Functional limitations (SF-36 physical functioning subscale) at time 1 were tested as predictors of illness perceptions 6 months later. Primary care supply on district level was matched to individual data.
  
  
  RESULTS
  In multilevel models, functional limitations predicted illness perceptions. Primary care supply on district level moderated the impact of functional limitations on individual identity and emotional response perceptions, with better supply buffering detrimental effects of functional limitations.
  
  
  CONCLUSIONS
  Illness perceptions do not only depend on individual factors, but socio-structural factors also substantially contribute to individual illness perceptions.
authors.affiliation: School of Psychology, University of Tasmania, Private Bag 30, Hobart, TAS 7001, Australia, Benjamin.Schuez@utas.edu.au.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Schüz
authors.forename: Clemens
authors.initials: C
authors.lastname: Tesch-Römer
authors.forename: Susanne
authors.initials: S
authors.lastname: Wurm
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D015897:Comorbidity; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008137:Longitudinal Studies; D008297:Male