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Pilevar S, Teymouri S, Bayazi MH, Rajaei AR. The effectiveness of acceptance and commitment therapy (ACT) on illness perception in orthopedic patients. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:342. [PMID: 38144033 PMCID: PMC10743938 DOI: 10.4103/jehp.jehp_918_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/27/2022] [Indexed: 12/26/2023]
Abstract
BACKGROUND Orthopedic pain is diagnosed and treated as a global health problem. Therapeutic interventions can change the behavior of patients and improve their quality of life. This study was aimed to evaluate the effectiveness of acceptance and commitment therapy (ACT) on illness perception among orthopedic patients. MATERIALS AND METHODS This quasi-experimental study was conducted as a two-group design (one experimental group and one control group) with pretest and posttest. Participants were selected from patients referred to the Mooud Physiotherapy Center in Mashhad, Iran. Patients were randomly divided into experimental and control groups (12 in each group). The experimental group received weekly sessions for three months (eight sessions), whereas the control group did not receive any intervention. Data were collected through Weinman's Illness Perception Questionnaire (with Cronbach's alpha coefficient of 0.72). Data were analyzed using multivariate analysis of covariance (MANCOVA). RESULTS The results of the study showed that in terms of time, the outcome, and the meaning of disease, the patients in the ACT group had a lower mean in the posttest. Patients of the ACT group in personal and therapeutic controls showed a higher mean in the posttest than those of the control group. Therefore, ACT had a significant effect on improving the understanding of disease in orthopedic patients (P < 0.05). CONCLUSION Based on the results, ACT has a significant effect on the disease perception of orthopedic patients. Therefore, it is suggested that therapists use this therapy approach to illness perception in orthopedic patients.
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Affiliation(s)
- Sahar Pilevar
- Department of Psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran
| | - Saeed Teymouri
- Department of Psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran
| | | | - Ali Reza Rajaei
- Department of Psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran
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Rometsch C, Teufel M, Skoda EM, Schweda A, Cosci F, Zipfel S, Stengel A, Salewski C. Depression and anxiety mediate the relationship between illness representations and perceived distress in patients with chronic pain. Sci Rep 2023; 13:15527. [PMID: 37726367 PMCID: PMC10509225 DOI: 10.1038/s41598-023-42156-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023] Open
Abstract
Illness representations explain the individual's perception and processing of health-related information. In a chronic condition such as persistent pain, illness representations might influence treatment adherence and outcome. This study aims to exploratively identify illness representations of patients with chronic pain and their association to mental disorders and subjective distress. 95 participants admitted to an inpatient university clinic were included. Validated instruments were used to assess illness representations (IPQ-R), mental health disorders (PHQ-D), and subjective distress (PSQ). Sociodemographic data and scores for the instruments were first inspected descriptively. Correlation, regression, and mediator analyses were conducted. Analyses indicated that the distributions of the IPQ-R range toward higher values. In regard to mental disorders (PHQ-D) and subjective distress (PSQ), we found several significant correlations with subscales of the IPQ-R. A regression analysis showed the IPQ-R subscales personal control, emotional representation and sex (males) to be significant predictors of subjective distress measured with the PSQ (F(11,86) = 11.55, p < .001, adjusted R2 = 0.545). Depression, anxiety, and stress syndromes (PHQ-D) significantly mediated the positive association between emotional representations (IPQ-R, predictor) and subjective distress (PSQ, outcome) with a total effect of c = .005, 95% CI [.005; .129]. Illness representations play a significant role in evaluating patients' subjective distress and mental health. It is advised to incorporate illness representations into standard protocols for psychological interventions to comprehend their influence on targeted therapeutic strategies, particularly those tailored for pain management.
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Affiliation(s)
- Caroline Rometsch
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.
- Department of Psychology, University of Hagen, Hagen, Germany.
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Adam Schweda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Site Tübingen, Tübingen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Site Tübingen, Tübingen, Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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Hill EM, Frost A. Illness perceptions, coping, and health-related quality of life among individuals experiencing chronic Lyme disease. Chronic Illn 2022; 18:426-438. [PMID: 33377395 DOI: 10.1177/1742395320983875] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of the present study was to examine illness perceptions and coping in relation to the health-related quality of life (HRQOL) among individuals experiencing chronic Lyme disease (CLD). METHODS Participants were 82 individuals who had a confirmed diagnosis of Lyme disease and had been experiencing symptoms for 6 months or more. They were recruited through various online mechanisms (e.g., social media, online support groups), and they completed the consent form and questionnaires via Qualtrics. Participants completed questions about their demographics and health status as well as the Illness Perception Questionnaire-Revised (Moss-Morris et al., 2002), the Brief COPE (Carver, 1997), and the 36-item Short Form Health Survey (SF-36; Ware & Sherbourne, 1992). RESULTS Illness perceptions and coping explained a significant amount of variance in HRQOL. Among the illness perceptions, the consequences and identity dimensions were most strongly associated with HRQOL. Behavioral disengagement and substance use were the coping strategies most strongly associated with the emotional health outcomes. DISCUSSION Illness perceptions and coping are related to HRQOL among individuals with CLD. Given the increase in Lyme disease incidence and the chronicity of symptoms in some cases, it is critical to continue to examine the psychosocial factors associated with HRQOL in this population.
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Affiliation(s)
- Erin M Hill
- Department of Psychology, West Chester University, West Chester, PA, USA
| | - Andriana Frost
- Department of Psychology, West Chester University, West Chester, PA, USA
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Kallesøe KH, Rimvall MK, Schröder A, Jensen JS, Wicksell RK, Rask CU. Adolescents with functional somatic syndromes: Symptom profiles, illness perception, illness worry and attachment orientation. J Psychosom Res 2021; 145:110430. [PMID: 33810861 DOI: 10.1016/j.jpsychores.2021.110430] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 03/04/2021] [Accepted: 03/17/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Karen Hansen Kallesøe
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
| | - Martin K Rimvall
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Gentofte, Denmark; Department of Child and Adolescent Psychiatry, Psychiatry Region Zealand, Roskilde, Denmark
| | - Andreas Schröder
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| | - Jens Søndergaard Jensen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Rikard K Wicksell
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Ulrikka Rask
- Department of Clinical Medicine, Aarhus University, Denmark; Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Aarhus, Denmark
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Laranjeira C, Querido AI, Valentim O. Psychometric properties of the revised illness perception questionnaire for people with alcohol use disorder in Portugal. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1916848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Research in Education and Community Intervention (RECI), Viseu, Portugal
- Center for Innovative Care and Health Technology (ciTechcare), Polytechnic Institute of Leiria, Leiria, Portugal
| | - Ana Isabel Querido
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Center for Innovative Care and Health Technology (ciTechcare), Polytechnic Institute of Leiria, Leiria, Portugal
- Center for Research in Health and Information Systems (CINTESIS, NursID, University of Porto, Porto, Portugal
| | - Olga Valentim
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Center for Research in Health and Information Systems (CINTESIS, NursID, University of Porto, Porto, Portugal
- Regional Health Administration of Lisbon and Tagus Valley, Taipas Center Withdrawal Unit, Lisboa, Portugal
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Revista Digital Internacional de Psicología y Ciencia Social | Volumen 6 | Número 2 | Julio-Diciembre 2020 | Desafíos contemporáneos en educación y salud. REVISTA DIGITAL INTERNACIONAL DE PSICOLOGÍA Y CIENCIA SOCIAL 2020. [DOI: 10.22402/j.rdipycs.unam.6.2.2020.327.245-526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
El actual número se titula “Desafíos contemporáneos en educación y salud” y nos permite conocer acerca de los temas de interés para algunos investigadores y la manera en que se han abordado para su estudio. De manera coincidente este número ha sido trabajado en tiempos de pandemia, donde también nos hemos enfrentado a retos ante las nuevas condiciones para adaptarnos a nuevas formas de trabajo, mayoritariamente a distancia y por ahora a lo que parece ser “la nueva normalidad”, y con ello, en algunos meses, estaremos leyendo trabajos que surjan de estos momentos históricos mundiales, sus implicaciones, problemas, alcances y tal vez sus repercusiones.
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Propiedades psicométricas del Cuestionario Revisado de Percepción de Enfermedad (IPQ-R) en adultos mexicanos con asma. REVISTA DIGITAL INTERNACIONAL DE PSICOLOGÍA Y CIENCIA SOCIAL 2020. [DOI: 10.22402/j.rdipycs.unam.6.2.2020.271.388-413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
El objetivo del presente trabajo fue evaluar las propiedades psicométricas de la versión en español del Illness Perception Questionnaire-Revised (IPQ-R) en pacientes mexicanos con asma. Se obtuvo una muestra por conveniencia de 315 adultos quienes respondieron una batería de evaluación. Los resultados muestran que el IPQ-R cuenta con una escala de identidad con 16 síntomas, escala de causas con 21 opciones y un grupo de subescalas en las que se agrupan cuatro factores y tres indicadores con αlfas que van de 0.591 a 0.874, con un KMO= 0.809 y una varianza total explicada del 51.611%, Se incluyen evidencias de validez convergente y divergente con variables de adherencia, creencias sobre medicamentos y control del asma. Se concluye que el IPQ-R es un instrumento confiable y valido para la evaluación de creencias sobre la enfermedad en adultos mexicanos con asma.
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Psychometric Characteristics of the Revised Illness Perception Questionnaire (IPQ-R) in People Undergoing Weight Loss Surgery. J Clin Psychol Med Settings 2019; 27:79-88. [PMID: 31069587 DOI: 10.1007/s10880-019-09624-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The Illness Perception Questionnaire-Revised (IPQ-R) has been used extensively across many health conditions to measure patient illness and treatment perceptions. The constructs have an association with treatment adaptation and adherence which, in turn, are considered core factors involved in bariatric surgery outcome. This study examines the factorial validity and internal reliability of a modified (IPQ-R) in bariatric surgery candidates. After wording modifications, participants (N = 310) completed the IPQ-R as part of standard pre-surgery assessments. After removal of two items, confirmatory factor analysis (CFA) supported the original 7-factor solution of the Beliefs scale, with good to marginal subscale internal consistency. Exploratory factor analysis (EFA), with two items removed only partially supported the original 5-factor Causal Attributions scale. Internal consistency was unacceptably low for two subscales. Further research is needed to generate new items which better fit the IPQ-R to this population before research can explore the relevance of illness perceptions.
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Kristoffersen ES, Lundqvist C, Russell MB. Illness perception in people with primary and secondary chronic headache in the general population. J Psychosom Res 2019; 116:83-92. [PMID: 30654999 DOI: 10.1016/j.jpsychores.2018.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 12/02/2018] [Accepted: 12/02/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chronic headache (headache ≥15 days/month) is a leading cause of disability. Illness perception, beliefs and cognitive models are likely central for patient understanding of their chronic pain condition and are associated with treatment outcome. However, these factors are insufficiently described in chronic headache. OBJECTIVE To describe illness perception, and to explore the effect of background variables and headache characteristics on illness perceptions in primary and secondary chronic headaches in the general population. METHODS 30,000 persons aged 3044 from the general population were screened for chronic headache by a mailed questionnaire. Those with self-reported chronic headache were interviewed by headache specialists. The questionnaire response rate was 71%, and the interview participation rate was 74%. The International Classification of Headache Disorders III was applied. Illness perception was assessed by the Revised Illness Perception Questionnaire (IPQ-R). The statistical approach was exploratory. RESULTS 405 of the 516 eligible participants (78%) completed the IPQ-R. Confirmatory factor analysis showed good internal validity in chronic headache. People believed their chronic headache to be long-lasting, with negative life consequences including emotional distress. Severe headache-related disability was associated with more perception of chronicity, more perceived consequences, emotional load and illness identity and less illness coherence. People with secondary chronic headache scored significantly higher on chronicity and life consequences, and had less personal control than those with primary chronic headache. CONCLUSION Chronic primary and secondary headache is associated with a high symptom burden and chronicity with large perceived negative consequences for daily living, suggesting multidisciplinary management may be necessary.
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Affiliation(s)
- Espen Saxhaug Kristoffersen
- Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog, Norway; Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Christofer Lundqvist
- Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Nordbyhagen, Norway; HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway; Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Michael Bjørn Russell
- Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Nordbyhagen, Norway
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Sindlinger K, Meng K, Dorn M, Faller H, Schuler M. Illness representations, pain and physical function in patients with rheumatic disorders: between- and within-person associations. Psychol Health 2018; 34:200-215. [PMID: 30358411 DOI: 10.1080/08870446.2018.1523406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Rehabilitation for patients with rheumatic diseases improves both illness representations (IR) and clinical outcomes such as pain and physical functioning (PF). However, it is unclear whether IR may affect and, in turn, are affected by pain and PF. In this study, we examined both between-person associations and within-person associations between IR and pain/PF over time on three measurement occasions. Furthermore, cross-lagged relationships were examined. DESIGN AND MAIN OUTCOME MEASURES This secondary analysis is based on data from N = 186 patients with rheumatic diseases. Data on pain, PF and IR were assessed using self-report questionnaires at the beginning, the end and three months after a 3-week inpatient rehabilitation. METHODS To separate between- and within-person level, data were analysed using random-intercept cross-lagged panel models. RESULTS On both the between-person level (r = |0.21| - |0.44|) and the within-person level (r = |0.15| - |0.46|), pain and PF were related to cognitive and emotional IR. In addition, we found within-person bidirectional cross-lagged effects between emotional IR and PF. CONCLUSION IR show complex relationships with pain and PF. Improving PF might improve subsequent illness-related emotional distress and vice versa.
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Affiliation(s)
- K Sindlinger
- a Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences , University of Würzburg , Würzburg , Germany
| | - K Meng
- a Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences , University of Würzburg , Würzburg , Germany
| | - M Dorn
- b Rehabilitation Center Bad Eilsen , Bad Eilsen , Germany
| | - H Faller
- a Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences , University of Würzburg , Würzburg , Germany
| | - M Schuler
- a Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences , University of Würzburg , Würzburg , Germany
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Özkan Tuncay F, Fertelli T, Mollaoğlu M. Effects of loneliness on illness perception in persons with a chronic disease. J Clin Nurs 2018; 27:e1494-e1500. [DOI: 10.1111/jocn.14273] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Fatma Özkan Tuncay
- Department of Medical Nursing; Health Sciences Faculty; Cumhuriyet University; Sivas Turkey
| | - Tülay Fertelli
- Department of Medical Nursing; Health Sciences Faculty; Cumhuriyet University; Sivas Turkey
| | - Mukadder Mollaoğlu
- Department of Medical Nursing; Health Sciences Faculty; Cumhuriyet University; Sivas Turkey
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12
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Homma M, Ishikawa H, Kiuchi T. Illness perceptions and negative responses from medical professionals in patients with fibromyalgia: Association with patient satisfaction and number of hospital visits. PATIENT EDUCATION AND COUNSELING 2018; 101:532-540. [PMID: 28893471 DOI: 10.1016/j.pec.2017.08.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 08/24/2017] [Accepted: 08/26/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To examine whether illness perceptions among patients with fibromyalgia and negative responses from medical professionals correlate with their satisfaction with their physicians or with their number of hospital visits. METHODS Questionnaires were sent by post to members of the Japan Fibromyalgia Support Association. Measures collected included, as independent variables, the Brief Illness Perception Questionnaire and the Illness Invalidation Inventory; and as outcomes, the Patient Satisfaction Consultation Questionnaire and the number of hospital visits. RESULTS We analyzed data from 304 patients. Multiple logistic regressions showed that perception of poor treatment control and the experience of being discounted and misunderstood by medical professionals were strongly correlated with dissatisfaction with attending physicians. Patients who perceived poor treatment control visited the hospital fewer times, while patients who reported being discounted by medical professionals visited more times. Patients' negative emotions correlated neither with patient satisfaction nor with the number of hospital visits. CONCLUSION Treatment effectiveness and the respect accorded to patients were the key factors significantly correlated both with patient satisfaction and the number of hospital visits. PRACTICE IMPLICATIONS Physicians should not emphasize only patients' negative psychological status but also should convey a respectful attitude and help patients understand their current treatment is useful.
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Affiliation(s)
- Mieko Homma
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Hirono Ishikawa
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan.
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Wu X, Lau JTF, Mak WWS, Gu J, Mo PKH, Wang X. How newly diagnosed HIV-positive men who have sex with men look at HIV/AIDS - validation of the Chinese version of the revised illness perception questionnaire. BMC Infect Dis 2018; 18:2. [PMID: 29291733 PMCID: PMC5748952 DOI: 10.1186/s12879-017-2902-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 12/10/2017] [Indexed: 02/07/2023] Open
Abstract
Background Newly diagnosed HIV-positive men who have sex with men (MSM) are an important subgroup in HIV intervention. How newly diagnosed HIV-positive MSM look at HIV/AIDS is consequential and is potentially associated with their risk behaviors and mental health problems. Illness representation has been used to define patients’ beliefs and expectations on an illness, and the revised Illness Perception Questionnaire (IPQ-R) has been developed to measure illness representations. This study aims to examine the psychometric properties of the IPQ-R among newly diagnosed HIV-positive MSM and to investigate their views towards HIV/AIDS. Method A total of 225 newly diagnosed HIV-positive MSM completed the Chinese version of IPQ-R. Both confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were applied to examine the factor structure of IPQ-R. Results CFA showed a poor goodness of fit to the original factor structure of IPQ-R. EFA of the IPQ-R revealed 7 factors, including Emotional Response, Treatment Control, Timeline-acute/chronic, Illness Coherence, Consequence, Personal Control and Helplessness. Cronbach’s alpha showed acceptable internal consistency for the derived factors, except the Personal Control (0.61) and Helplessness (0.55). Person correlation coefficients demonstrated that the derived factors of IPQ-R had significant associations with the outcome variables (depression and posttraumatic growth). The scores of the Emotional Response, Consequence, Treatment Control, Personal Control, Timeline-acute/chronic and Illness Coherence were above the midpoint, and the score of the Helplessness was below the midpoint. Conclusion Both similarities and differences were found when the IPQ-R is applied to newly diagnosed HIV-positive MSM. The IPQ-R can be used with some refinements in future studies. Newly diagnosed HIV-positive MSM have a relatively high level of negative perceptions towards HIV/AIDS in both cognitive and emotional aspects.
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Affiliation(s)
- Xiaobing Wu
- Department of STD control, Shenzhen Center for Chronic Disease Control, No.2021, Buxin Road, Luohu District, Shenzhen City, Guangdong Province, People's Republic of China.,Centre for Health Behaviors Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, 5/F, School of Public Health, Prince of Wales Hospital, Shatin, NT, Hong Kong, Special Administrative Region of China
| | - Joseph T F Lau
- Centre for Health Behaviors Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, 5/F, School of Public Health, Prince of Wales Hospital, Shatin, NT, Hong Kong, Special Administrative Region of China.
| | - Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, Special Administrative Region of China
| | - Jing Gu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou City, Guangdong province, People's Republic of China
| | - Phoenix K H Mo
- Centre for Health Behaviors Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, 5/F, School of Public Health, Prince of Wales Hospital, Shatin, NT, Hong Kong, Special Administrative Region of China
| | - Xiaodong Wang
- Chengdu Tongle Health Counselling Service Center, Chengdu City, Sichuan Province, People's Republic of China
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Järemo P, Arman M, Gerdle B, Larsson B, Gottberg K. Illness beliefs among patients with chronic widespread pain - associations with self-reported health status, anxiety and depressive symptoms and impact of pain. BMC Psychol 2017; 5:24. [PMID: 28679446 PMCID: PMC5499007 DOI: 10.1186/s40359-017-0192-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/20/2017] [Indexed: 12/31/2022] Open
Abstract
Background Chronic widespread pain (CWP) is a disabling condition associated with a decrease in health. Illness beliefs are individual and are acquired during life. Constraining beliefs may prevent patients from regaining health. Understanding these patients’ illness beliefs may be a way to improve the health care they are offered. The aim of this study was to describe illness beliefs among patients with CWP and associations with self-reported health, anxiety and depressive symptoms, and impact of pain. Method In this cross-sectional study, questionnaires were sent by mail to 330 patients including socio-demographic information, the Illness Perception Questionnaire (IPQ-R), the Short-Form General Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Data were analysed using descriptive statistics, non-parametric tests and linear regression analyses. Results Patients experienced and related a high number of symptoms to CWP (mean (SD) 9 (3)). The patients believed their illness to be long lasting, to affect their emotional well being, and to have negative consequences for their lives. Some 72% reported having severe or very severe pain, and impact of pain according to SF-36 was negatively correlated to several illness beliefs dimensions, anxiety- and depressive symptoms. In regression analyses, the Identity, Consequences and Personal control dimensions of IPQ-R and Anxiety- and Depressive symptoms explained 32.6–56.1% of the variance in the two component scores of SF-36. Conclusion Constraining illness beliefs in patients with CWP are related to worse health status, especially in cases of high number of physical or mental symptoms, beliefs of negative consequences or the illness affecting them emotionally. Identification and understanding of these beliefs may reduce patients’ suffering if they are taken into consideration in rehabilitation programs and in development of new evidence-based interventions aimed at increasing health in patients with CWP.
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Affiliation(s)
- P Järemo
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 83, Huddinge, Sweden.
| | - M Arman
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 83, Huddinge, Sweden
| | - B Gerdle
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - B Larsson
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - K Gottberg
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 83, Huddinge, Sweden
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de Heer EW, Vriezekolk JE, van der Feltz-Cornelis CM. Poor Illness Perceptions Are a Risk Factor for Depressive and Anxious Symptomatology in Fibromyalgia Syndrome: A Longitudinal Cohort Study. Front Psychiatry 2017; 8:217. [PMID: 29163236 PMCID: PMC5671978 DOI: 10.3389/fpsyt.2017.00217] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 10/17/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Patients with widespread pain, such as in fibromyalgia, are vulnerable for depression and anxiety, which composes a relevant public health problem. Identifying risk factors for the onset of depression and anxiety is therefore warranted. Objective of this study was to determine whether severe pain, maladaptive coping, and poor illness perceptions are associated with depressive and anxious symptomatology in fibromyalgia. METHOD Consecutive patients referred to an outpatient clinic completed sets of physical and psychological questionnaires at baseline and at 18-month follow-up. A total of 452 patients with fibromyalgia syndrome (FMS) were eligible for inclusion, and subsequently, 280 patients returned the baseline questionnaire. Depressive and anxious symptomatology was measured with the Hospital Anxiety and Depression Scale. To measure pain severity, coping style, and illness perceptions, the Fibromyalgia Impact Questionnaire, Pain Coping Inventory, and the Illness Perception Questionnaire-Revised (IPQ-R) were used, respectively. Multivariable logistic regression analyses, bootstrapping and calibration, were performed to examine the association of pain severity, pain coping, and illness perception with depressive and anxiety symptoms at follow-up, adjusted for sociodemographic variables. Initial level of depressive and anxiety symptoms was selected as covariates. RESULTS Mean age was 42.6 years and 95.4% were female. At 18-month follow-up, 68 (of the 195) patients were depressed and 80 (of the 197) were anxious. Only the IPQ-R subscale "emotional representations" showed a significant positive association with depressive symptoms at follow-up (OR = 1.10), next to the initial level of depressive symptoms (OR = 1.30). In case of anxiety, only the IPQ-R subscale "treatment control" showed a significant negative association with anxiety symptoms at follow-up (OR = 0.87), next to the initial level of anxiety symptoms (OR = 1.45). CONCLUSION Our data suggest that not pain severity or maladaptive coping, but poor illness perceptions are important in elevated depressive and anxious symptomatology. Patients with fibromyalgia who think their illness negatively affects their mental well-being are at increased risk for more depressive symptoms, and those who think treatment of their illness will not be effective are at increased risk for more anxiety symptoms. Strengthening illness beliefs and reducing catastrophic thinking, therefore, seem crucial factors in the treatment of patients with FMS.
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Affiliation(s)
- Eric W de Heer
- Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, Netherlands.,Tranzo Department, Tilburg School of Behavioural and Social Sciences, Tilburg University, Tilburg, Netherlands
| | | | - Christina M van der Feltz-Cornelis
- Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, Netherlands.,Tranzo Department, Tilburg School of Behavioural and Social Sciences, Tilburg University, Tilburg, Netherlands
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Najafimanesh Z, Karambakhsh AR, Salesi M, Mohammadi J. Prediction of Quality of Life by Type D Personality and Illness Perception Factors in Patients With Coronary Artery Disease: A Structural Equation Model. HEALTH SCOPE 2016. [DOI: 10.17795/jhealthscope-27673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Roussel NA, Neels H, Kuppens K, Leysen M, Kerckhofs E, Nijs J, Beetsma AJ, Van Wilgen CP. History taking by physiotherapists with low back pain patients: are illness perceptions addressed properly? Disabil Rehabil 2015; 38:1268-79. [DOI: 10.3109/09638288.2015.1077530] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ruiz-Montero PJ, Van Wilgen CP, Segura-Jiménez V, Carbonell-Baeza A, Delgado-Fernández M. Illness perception and fibromyalgia impact on female patients from Spain and the Netherlands: do cultural differences exist? Rheumatol Int 2015; 35:1985-93. [PMID: 25969339 DOI: 10.1007/s00296-015-3281-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 05/04/2015] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to examine the differences in illness perception and overall impact on fibromyalgia females from Spain and the Netherlands. A total of 325 fibromyalgia females from Spain (54.3 ± 7.1 years) and the Netherlands (51.8 ± 7.2 years) participated in the study. Illness perception and impact of fibromyalgia were assessed by the Revised Illness Perception Questionnaire and the Fibromyalgia Impact Questionnaire, respectively. Spanish fibromyalgia females perceived more symptoms related to their fibromyalgia (identity) such as nausea, breathlessness, wheezing or fatigue (P < 0.001) and had greater emotional representation (P < 0.01). Dutch fibromyalgia females experienced less timeline (acute/chronic) and consequences (all, P < 0.05), had a better cyclical timeline, personal control, treatment control and illness coherence (all, P < 0.001). Spanish fibromyalgia females reported higher impact of fibromyalgia than Dutch females (61.2 + 14.8 vs. 54.9 + 16.4, respectively; P < 0.001), but the effect size was small (Cohen's d = 0.41) . Impact of fibromyalgia and negative views of fibromyalgia were higher in Spanish fibromyalgia females, whereas Dutch fibromyalgia females presented higher score of positive beliefs about the controllability of the illness. Psychological interventions which help patients to cope with their illness perception might lead to an improvement of the impact of the disease on fibromyalgia females.
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Affiliation(s)
- Pedro J Ruiz-Montero
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n, CP 18071, Granada, Spain.
| | - C Paul Van Wilgen
- Pain in Motion Research Group, Transcare, Transdisciplinary Pain Management Centre, Groningen, The Netherlands.,Department of Physiotherapy and Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Victor Segura-Jiménez
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n, CP 18071, Granada, Spain
| | - Ana Carbonell-Baeza
- Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cádiz, Spain
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n, CP 18071, Granada, Spain
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Christensen SS, Frostholm L, Ørnbøl E, Schröder A. Changes in illness perceptions mediated the effect of cognitive behavioural therapy in severe functional somatic syndromes. J Psychosom Res 2015; 78:363-70. [PMID: 25541119 DOI: 10.1016/j.jpsychores.2014.12.005] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 11/18/2014] [Accepted: 12/07/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Although there is substantial evidence that cognitive behavioural therapy alleviates symptoms in functional somatic syndromes, the mechanisms of change are less investigated. This study examined whether changes in illness perceptions mediated the effect of cognitive behavioural therapy. METHODS We analysed additional data from a randomised controlled trial comparing completers of cognitive behavioural group therapy (46 patients) to an enhanced usual care group (66 patients). Proposed mediators (illness perceptions) and primary (physical health) and secondary (somatic symptoms and illness worry) outcomes were assessed by means of questionnaires at referral, baseline, end of treatment, and 10 and 16 months after randomisation. Multiple mediation analysis determined whether (1) changes in specific illness perceptions during treatment mediated the effect of cognitive behavioural therapy (primary analysis), and (2) whether changes in illness perceptions during the whole trial period were associated with improved outcome (secondary analysis). RESULTS Improvements in illness perceptions during treatment partially mediated the effect of cognitive behavioural therapy on physical health one year after treatment (sum of indirect effects 1.556, BCa 95% CI (0.006; 3.620)). Improving perceived control was particularly important. Changes in illness perceptions from baseline to 16 months after randomisation were associated with clinically meaningful improvements in physical health, somatic symptoms and illness worry during the same period. CONCLUSION Our results suggest that changing patients' illness perceptions is an important process in cognitive behavioural therapy for functional somatic syndromes. Challenging patients' own understanding of their illness may hence be a key element of successful treatment.
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Affiliation(s)
- Sara Sletten Christensen
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Nørrebrogade 44, Aarhus C, Denmark
| | - Lisbeth Frostholm
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Nørrebrogade 44, Aarhus C, Denmark
| | - Eva Ørnbøl
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Nørrebrogade 44, Aarhus C, Denmark
| | - Andreas Schröder
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Nørrebrogade 44, Aarhus C, Denmark.
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Leysen M, Nijs J, Meeus M, Paul van Wilgen C, Struyf F, Vermandel A, Kuppens K, Roussel NA. Clinimetric properties of illness perception questionnaire revised (IPQ-R) and brief illness perception questionnaire (Brief IPQ) in patients with musculoskeletal disorders: A systematic review. ACTA ACUST UNITED AC 2015; 20:10-7. [DOI: 10.1016/j.math.2014.05.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 04/04/2014] [Accepted: 05/06/2014] [Indexed: 12/26/2022]
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Amutio A, Franco C, Pérez-Fuentes MDC, Gázquez JJ, Mercader I. Mindfulness training for reducing anger, anxiety, and depression in fibromyalgia patients. Front Psychol 2015; 5:1572. [PMID: 25628591 PMCID: PMC4290530 DOI: 10.3389/fpsyg.2014.01572] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 12/19/2014] [Indexed: 12/22/2022] Open
Abstract
Fibromyalgia is a disabling syndrome. Results obtained with different therapies are very limited to date. The goal of this study was to verify whether the application of a mindfulness-based training program was effective in modifying anger, anxiety, and depression levels in a group of women diagnosed with fibromyalgia. This study is an experimental trial that employed a waiting list control group. Measures were taken at three different times: pretest, posttest, and follow-up. The statistical analyses revealed a significant reduction of anger (trait) levels, internal expression of anger, state anxiety, and depression in the experimental group as compared to the control group, as well as a significant increase in internal control of anger. It can be concluded that the mindfulness-based treatment was effective after 7 weeks. These results were maintained 3 months after the end of the intervention.
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Affiliation(s)
- Alberto Amutio
- Department of Social Psychology and Methodology of the Behavioral Sciences, Faculty of Psychology, University of the Basque Country San Sebastián, Spain
| | - Clemente Franco
- Department of Psychology, Faculty of Educational Sciences and Health, University of Almería Almeríaw, Spain
| | | | - José J Gázquez
- Department of Psychology, Faculty of Educational Sciences and Health, University of Almería Almeríaw, Spain
| | - Isabel Mercader
- Department of Psychology, Faculty of Educational Sciences and Health, University of Almería Almeríaw, Spain
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Snell DL, Surgenor LJ, Hay-Smith EJC, Williman J, Siegert RJ. The contribution of psychological factors to recovery after mild traumatic brain injury: Is cluster analysis a useful approach? Brain Inj 2014; 29:291-9. [DOI: 10.3109/02699052.2014.976594] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Association of physicians' illness perception of fibromyalgia with frustration and resistance to accepting patients: a cross-sectional study. Clin Rheumatol 2014; 35:1019-27. [PMID: 25085273 DOI: 10.1007/s10067-014-2752-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 06/27/2014] [Accepted: 07/17/2014] [Indexed: 12/25/2022]
Abstract
The aim of this study was to elucidate whether physicians' illness perceptions correlate with their frustration or resistance to accepting patients with fibromyalgia (FM). In this cross-sectional postal survey, questionnaires were sent to member physicians of the Japan College of Rheumatology and Japan Rheumatism Foundation. Measures collected included the Brief Illness Perception Questionnaire with Causal Attribution, the Illness Invalidation Inventory, and the Difficult Doctor-Patient Relationship Questionnaire (DDPRQ-10). Multiple logistic regression was performed to examine associations between the DDPRQ-10 and resistance to accepting patients with FM for treatment. We analyzed data from 233 physicians who had experience in consulting with patients with FM. Only 44.2 % answered that they wanted to accept additional patients with FM. Physicians' frustration was associated with difficulty controlling symptoms, patients' emotional responses, and causal attribution of FM to patient internal factors. Conversely, lower levels of frustration were associated with causal attributions to biological factors and uncontrollable external factors. However, the "difficult patient" perception did not correlate with resistance to accepting patients with FM. Difficulty controlling symptoms with treatment was the one factor common to both physicians' frustration and resistance to accepting patients with FM. Physicians may hesitate to accept patients with FM not because of the stigmatic image of the "difficult patient," but instead because of the difficulty in controlling the symptoms of FM. Thus, to improve the quality of consultation, physicians must continuously receive new information about the treatments and causes of FM.
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Durif-Bruckert C, Roux P, Rousset H. Medication and the patient-doctor relationship: a qualitative study with patients suffering from fibromyalgia. Health Expect 2014; 18:2584-94. [PMID: 24995371 DOI: 10.1111/hex.12230] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Fibromyalgia is characterized by a diffuse and predominantly axial and chronic pain, for which there is no explicit rationale for treatment options. OBJECTIVE This qualitative study aims to understand the medication experience of patients with fibromyalgia and their relationship with the doctors derived from treatment negotiation. DESIGN A qualitative approach was used, based on interviews with patients. SETTING AND PARTICIPANTS Semi-structured interviews were held in a public hospital, with 35 patients diagnosed with fibromyalgia. Qualitative content analysis was performed. RESULTS The first axis is centred on the unsuccessful quest for an effective treatment for pain and the feeling of dismissal of patients, who are in search of validation and recognition. The second part of the accounts explains the medication adjustments and the search for collaboration. Developing a model of partnership with the doctor enables the patients to shape their own illness, through the medication. DISCUSSION It is by mediating their relationship with medication that patients gain access to this state of co-expertise and that they put sense into the collaboration they develop with their doctors. Through this collaboration, useful drugs are identified and adjusted to treat the pain.
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Affiliation(s)
- Christine Durif-Bruckert
- Social Psychology Research Group, EA 4163, Psychology Department, University of Lyon (Lyon 2), Bron, France
| | - Pauline Roux
- Social Psychology Research Group, EA 4163, Psychology Department, University of Lyon (Lyon 2), Bron, France
| | - Hugues Rousset
- Lyon - Internal Medicine, Claude Bernard University, University Hospital of Lyon South, Lyon, France
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de Rooij A, van der Leeden M, de Boer MR, Steultjens MPM, Dekker J, Roorda LD. Fatigue in patients with chronic widespread pain participating in multidisciplinary rehabilitation treatment: a prospective cohort study. Disabil Rehabil 2014; 37:490-8. [DOI: 10.3109/09638288.2014.923530] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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26
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van Wilgen P, Beetsma A, Neels H, Roussel N, Nijs J. Physical therapists should integrate illness perceptions in their assessment in patients with chronic musculoskeletal pain; a qualitative analysis. ACTA ACUST UNITED AC 2014; 19:229-34. [DOI: 10.1016/j.math.2013.11.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 11/08/2013] [Accepted: 11/16/2013] [Indexed: 12/26/2022]
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27
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Dolphens M, Nijs J, Cagnie B, Meeus M, Roussel N, Kregel J, Malfliet A, Vanderstraeten G, Danneels L. Efficacy of a modern neuroscience approach versus usual care evidence-based physiotherapy on pain, disability and brain characteristics in chronic spinal pain patients: protocol of a randomized clinical trial. BMC Musculoskelet Disord 2014; 15:149. [PMID: 24885889 PMCID: PMC4028010 DOI: 10.1186/1471-2474-15-149] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 04/29/2014] [Indexed: 12/19/2022] Open
Abstract
Background Among the multiple conservative modalities, physiotherapy is a commonly utilized treatment modality in managing chronic non-specific spinal pain. Despite the scientific progresses with regard to pain and motor control neuroscience, treatment of chronic spinal pain (CSP) often tends to stick to a peripheral biomechanical model, without targeting brain mechanisms. With a view to enhance clinical efficacy of existing physiotherapeutic treatments for CSP, the development of clinical strategies targeted at ‘training the brain’ is to be pursued. Promising proof-of-principle results have been reported for the effectiveness of a modern neuroscience approach to CSP when compared to usual care, but confirmation is required in a larger, multi-center trial with appropriate evidence-based control intervention and long-term follow-up. The aim of this study is to assess the effectiveness of a modern neuroscience approach, compared to usual care evidence-based physiotherapy, for reducing pain and improving functioning in patients with CSP. A secondary objective entails examining the effectiveness of the modern neuroscience approach versus usual care physiotherapy for normalizing brain gray matter in patients with CSP. Methods/Design The study is a multi-center, triple-blind, two-arm (1:1) randomized clinical trial with 1-year follow-up. 120 CSP patients will be randomly allocated to either the experimental (receiving pain neuroscience education followed by cognition-targeted motor control training) or the control group (receiving usual care physiotherapy), each comprising of 3 months treatment. The main outcome measures are pain (including symptoms and indices of central sensitization) and self-reported disability. Secondary outcome measures include brain gray matter structure, motor control, muscle properties, and psychosocial correlates. Clinical assessment and brain imaging will be performed at baseline, post-treatment and at 1-year follow-up. Web-based questionnaires will be completed at baseline, after the first 3 treatment sessions, post-treatment, and at 6 and 12-months follow-up. Discussion Findings may provide empirical evidence on: (1) the effectiveness of a modern neuroscience approach to CSP for reducing pain and improving functioning, (2) the effectiveness of a modern neuroscience approach for normalizing brain gray matter in CSP patients, and (3) factors associated with therapy success. Hence, this trial might contribute towards refining guidelines for good clinical practice and might be used as a basis for health authorities’ recommendations. Trial registration ClinicalTrials.gov Identifier: NCT02098005.
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Affiliation(s)
- Mieke Dolphens
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Campus Heymans (UZ, 3B3), De Pintelaan 185, 9000 Ghent, Belgium.
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28
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Chen AT. Information use and illness representations: Understanding their connection in illness coping. J Assoc Inf Sci Technol 2014. [DOI: 10.1002/asi.23173] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Annie T. Chen
- University of North Carolina at Chapel Hill; School of Information and Library Science; 216 Lenoir Drive CB #3360 100 Manning Hall Chapel Hill NC 27599-3360
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van Ittersum MW, van Wilgen CP, van der Schans CP, Lambrecht L, Groothoff JW, Nijs J. Written Pain Neuroscience Education in Fibromyalgia: A Multicenter Randomized Controlled Trial. Pain Pract 2013; 14:689-700. [DOI: 10.1111/papr.12137] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 09/15/2013] [Indexed: 01/13/2023]
Affiliation(s)
- Miriam W. van Ittersum
- Research and Innovation Group in Health Care and in Nursing; Hanze University of Applied Sciences Groningen; Groningen The Netherlands
- Department of Health Sciences, Community and Occupational Medicine; University Medical Centre Groningen; University of Groningen; Groningen The Netherlands
| | - C. Paul van Wilgen
- Pain in Motion Research Group; Brussels Belgium
- Transcare; Transdisciplinary Pain Management Center; Groningen The Netherlands
| | - Cees P. van der Schans
- Research and Innovation Group in Health Care and in Nursing; Hanze University of Applied Sciences Groningen; Groningen The Netherlands
- Department of Rehabilitation Medicine; Center for Rehabilitation; University Medical Centre Groningen; Groningen The Netherlands
| | | | - Johan W. Groothoff
- Department of Health Sciences, Community and Occupational Medicine; University Medical Centre Groningen; University of Groningen; Groningen The Netherlands
| | - Jo Nijs
- Pain in Motion Research Group; Brussels Belgium
- Departments of Human Physiology and Rehabilitation Sciences; Faculty of Physical Education & Physiotherapy; Vrije Universiteit Brussel; Brussels Belgium
- Department of Rehabilitation and Physiotherapy; University Hospital Brussels; Brussels Belgium
- Interfaculty Department of Education and Teaching; Vrije Universiteit Brussel; Brussels Belgium
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30
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Snell DL, Hay-Smith EJC, Surgenor LJ, Siegert RJ. Examination of outcome after mild traumatic brain injury: The contribution of injury beliefs and Leventhal's Common Sense Model. Neuropsychol Rehabil 2013; 23:333-62. [DOI: 10.1080/09658211.2012.758419] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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de Rooij A, van der Leeden M, Roorda LD, Steultjens MP, Dekker J. Predictors of outcome of multidisciplinary treatment in chronic widespread pain: an observational study. BMC Musculoskelet Disord 2013; 14:133. [PMID: 23577981 PMCID: PMC3637493 DOI: 10.1186/1471-2474-14-133] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 04/08/2013] [Indexed: 12/21/2022] Open
Abstract
Background The effectiveness of multidisciplinary treatment in chronic widespread pain (CWP) is limited. The considerable heterogeneity among patients is a likely explanation. Knowledge on predictors of the outcome of multidisciplinary treatment can help to optimize treatment effectiveness. The purpose of this study was to identify predictors of multidisciplinary treatment outcome in patients with CWP. Methods Data were used from baseline and 6 months follow-up measurements of a prospective cohort study of 120 CWP. Regression models were used to assess whether baseline variables predicted treatment outcome. Outcome domains included: pain, pain interference, depression, and global perceived effect (GPE). Potential predictors included: psychological distress, illness and self-efficacy beliefs, fear-avoidance beliefs and behaviour, symptoms, disability, and socio-demographic factors. Results Greater improvement in pain was predicted by more pain at baseline and male gender. Greater improvement in interference of pain in daily life was predicted by more interference of pain in daily life at baseline, lower levels of anxiety, a stronger belief in personal control, less belief in consequences, male gender, and a higher level of education. Greater improvement in depression was predicted by higher baseline values of depression, stronger beliefs in personal control, and a higher level of education. Better outcome on GPE was predicted by less pain, less fatigue, and a higher level of education. Conclusion Less anxiety, stronger beliefs in personal control, less belief in consequences, less pain, less fatigue, higher level of education, and male gender are predictors of better outcome of multidisciplinary treatment in CWP. Tailoring treatment to these specific patient characteristics or selecting eligible patients for multidisciplinary treatment may further improve treatment outcome.
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van Wilgen CP, van Ittersum MW, Kaptein AA. Do illness perceptions of people with chronic low back pain differ from people without chronic low back pain? Physiotherapy 2013; 99:27-32. [DOI: 10.1016/j.physio.2011.09.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Accepted: 09/08/2011] [Indexed: 11/26/2022]
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Nicholls EE, Hill S, Foster NE. Musculoskeletal pain illness perceptions: factor structure of the Illness Perceptions Questionnaire-Revised. Psychol Health 2012; 28:84-102. [PMID: 22891727 PMCID: PMC3516816 DOI: 10.1080/08870446.2012.714782] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The Revised Illness Perceptions Questionnaire (IPQ-R) is commonly used to measure illness perceptions. We tested whether the structure of the IPQ-R was appropriate for use with primary care musculoskeletal pain patients. METHODS Confirmatory (C) and exploratory (E) factor analyses (FA) were used to test whether the structure of the IPQ-R was supported for patients with knee pain (n = 393), hand pain (n = 2113) and back pain (n = 1591). CFA was used to test whether the timeline acute/chronic, timeline cyclical, consequences, personal control, treatment control, illness coherence and emotional representation dimensions of the IPQ-R were distinct; EFA was used to explore potential structure for patients' views on the cause of their condition. RESULTS Goodness-of-fit indices for the CFA were below our criteria for good model fit. Removal of six items from the model improved model fit, but our criteria for good model fit was still not achieved. An interpretable factor solution could not be determined for the causal items on the questionnaire. CONCLUSIONS Our data show limited evidence that the seven dimensions of the IPQ-R are distinct. A clear structure for the causal items was not determined. Further work is needed to develop the IPQ-R for use with primary care musculoskeletal pain patients.
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Affiliation(s)
- Elaine E Nicholls
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, UK.
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34
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Ferrari R. Quantitative assessment of the “inexplicability” of fibromyalgia patients: a pilot study of the fibromyalgia narrative of “medically unexplained” pain. Clin Rheumatol 2012; 31:1455-61. [DOI: 10.1007/s10067-012-2029-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 06/24/2012] [Accepted: 07/02/2012] [Indexed: 11/30/2022]
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Sallinen M, Kukkurainen ML, Peltokallio L, Mikkelsson M, Anderberg UM. Fatigue, Worry, and Fear—Life Events in the Narratives of Women With Fibromyalgia. Health Care Women Int 2012; 33:473-94. [DOI: 10.1080/07399332.2011.645967] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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The Relationship Between Illness Perception and Quality of life in Iranian Patients with Coronary Artery Bypass Graft. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.sbspro.2012.06.061] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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37
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Bazzazian S, Besharat MA. An explanatory model of adjustment to type I diabetes based on attachment, coping, and self-regulation theories. PSYCHOL HEALTH MED 2012; 17:47-58. [DOI: 10.1080/13548506.2011.575168] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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van Ittersum MW, van Wilgen CP, Groothoff JW, van der Schans CP. Is appreciation of written education about pain neurophysiology related to changes in illness perceptions and health status in patients with fibromyalgia? PATIENT EDUCATION AND COUNSELING 2011; 85:269-274. [PMID: 20880654 DOI: 10.1016/j.pec.2010.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2010] [Revised: 08/29/2010] [Accepted: 09/01/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To investigate the appreciation of written education about pain neurophysiology in patients with fibromyalgia (FM) and its effects on illness perceptions and perceived health status. METHODS A booklet explaining pain neurophysiology was sent to participants with FM. Appreciation was assessed with 10 questions addressing relevance (0-30) and reassurance (0-30). Illness perceptions, catastrophizing and health status were measured with the Revised Illness Perception Questionnaire (IPQ-R), the Pain Catastrophizing Scale (PCS) and the Fibromyalgia Impact Questionnaire (FIQ) at baseline (T0), after a 2-week control period (T1) and 6 weeks after the intervention (T2). RESULTS Forty-one patients participated. Mean (SD) scores for relevance and reassurance were 21.6 (5.6) and 18.7 (5.7), respectively. Only illness coherence, emotional representations, pain and fatigue changed significantly between T0 and T2. Correlations between appreciation and changes in outcomes ranged between r=0.00 and r=0.34. CONCLUSIONS Although a majority of subjects appreciated the written information, it did not have clinically relevant effects on illness perceptions, catastrophizing or impact of FM on daily life. PRACTICE IMPLICATIONS Written education about pain neurophysiology is inadequate toward changing illness perceptions, catastrophizing or perceived health status of participants with FM; education should be incorporated into a broader multidisciplinary self-management program.
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Affiliation(s)
- M W van Ittersum
- Research and Innovation Group in Health Care and Nursing, Hanze University Groningen, Groningen, The Netherlands.
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de Rooij A, Steultjens MPM, Siemonsma PC, Vollebregt JA, Roorda LD, Beuving W, Dekker J. Overlap of cognitive concepts in chronic widespread pain: an exploratory study. BMC Musculoskelet Disord 2011; 12:218. [PMID: 21974867 PMCID: PMC3209471 DOI: 10.1186/1471-2474-12-218] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Accepted: 10/05/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A wide variety of cognitive concepts have been shown to play an important role in chronic widespread pain (CWP). Although these concepts are generally considered to be distinct entities, some might in fact be highly overlapping. The objectives of this study were to (i) to establish inter-relationships between self-efficacy, cognitive coping styles, fear-avoidance cognitions and illness beliefs in patients with CWP and (ii) to explore the possibility of a reduction of these cognitions into a more limited number of domains. METHODS Baseline measurement data of a prospective cohort study of 138 patients with CWP were used. Factor analysis was used to study the associations between 16 different cognitive concepts. RESULTS Factor analysis resulted in three factors: 1) negative emotional cognitions, 2) active cognitive coping, and 3) control beliefs and expectations of chronicity. CONCLUSION Negative emotional cognitions, active cognitive coping, control beliefs and expectations of chronicity seem to constitute principal domains of cognitive processes in CWP. These findings contribute to the understanding of overlap and uniqueness of cognitive concepts in chronic widespread pain.
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Affiliation(s)
- Aleid de Rooij
- Department of Rehabilitation Research, Reade, Centre for Rehabilitation and Rheumatology (formerly Jan van Breemen Institute), Amsterdam, Netherlands.
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Snell DL, Siegert RJ, Hay-Smith EJC, Surgenor LJ. Associations between illness perceptions, coping styles and outcome after mild traumatic brain injury: Preliminary results from a cohort study. Brain Inj 2011; 25:1126-38. [DOI: 10.3109/02699052.2011.607786] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Glattacker M, Opitz U, Jäckel WH. Illness representations in women with fibromyalgia. Br J Health Psychol 2010; 15:367-87. [DOI: 10.1348/135910709x466315] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Keib CN, Reynolds NR, Ahijevych KL. Poor use of cardiac rehabilitation among older adults: a self-regulatory model for tailored interventions. Heart Lung 2010; 39:504-11. [PMID: 20561883 PMCID: PMC2972354 DOI: 10.1016/j.hrtlng.2009.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Revised: 11/11/2009] [Accepted: 11/19/2009] [Indexed: 12/31/2022]
Abstract
BACKGROUND A greater number of older adults now live with coronary heart disease (CHD). This poses a significant public health problem, because older adults are at high risk for CHD-related mortality and morbidity. Overwhelming data support the benefits of cardiac rehabilitation for secondary prevention, yet only a small portion of eligible older adults receive it. METHODS AND RESULTS Whereas many studies examined factors that affect the use of cardiac rehabilitation among older adults, few interventions aimed to improve their cardiac rehabilitation participation rates. A substantial body of evidence indicates that an individual's illness perceptions play a pivotal role in health behavior, and may be a promising target for intervention. Drawing from the theoretic and empiric findings of others, a self-regulatory model is proposed that explicates how CHD perceptions of older adults may influence participation in cardiac rehabilitation. CONCLUSION The model may provide a useful guide for the development of effective interventions tailored to older adults.
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Affiliation(s)
- Carrie N Keib
- Department of Nursing, Cedarville University, Cedarville, Ohio 45314, USA.
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Snell DL, Siegert RJ, Hay-Smith EJC, Surgenor LJ. An examination of the factor structure of the Revised Illness Perception Questionnaire modified for adults with mild traumatic brain injury. Brain Inj 2010; 24:1595-605. [PMID: 20973627 DOI: 10.3109/02699052.2010.523048] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Factors influencing outcome after mild traumatic brain injury (MTBI) remain poorly understood. In other health conditions patient illness perceptions have been associated with outcome and have provided targets for effective interventions. These have not been systematically explored in MTBI and identifying reliable and valid measures of illness perceptions in MTBI is a first step before such concepts can be explored in clinical and research settings. METHOD This study investigated the factor structure and internal consistency reliability of the Illness Perceptions Questionnaire-Revised (IPQ-R) modified for MTBI in a sample of 147 adults recruited within 3 months of injury. RESULTS The results demonstrated a close replication of the original factor structure although there were notable exceptions likely to be specific to MTBI and potentially other acutely injured populations. Final scales showed good internal consistency although factors relating to causal attribution were less so. CONCLUSION The IPQ-R (MTBI) provides an acceptable measure of key components of injury perceptions after MTBI. Minor refinements appear required if this measure is to make a contribution to research and clinical practice in injury-based populations such as MTBI.
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Affiliation(s)
- Deborah L Snell
- Rehabilitation Teaching and Research Unit, University of Otago at Wellington, Wellington South, New Zealand.
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Van Abbema R, Van Wilgen CP, Van Der Schans CP, Van Ittersum MW. Patients with more severe symptoms benefit the most from an intensive multimodal programme in patients with fibromyalgia. Disabil Rehabil 2010; 33:743-50. [DOI: 10.3109/09638288.2010.510177] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hoving JL, van der Meer M, Volkova AY, Frings-Dresen MHW. Illness perceptions and work participation: a systematic review. Int Arch Occup Environ Health 2010; 83:595-605. [PMID: 20130906 PMCID: PMC2902734 DOI: 10.1007/s00420-010-0506-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Accepted: 01/14/2010] [Indexed: 11/17/2022]
Abstract
Purpose Self-regulatory processes play an important role in mediating between the disease and the health outcomes, and potentially also work outcomes. This systematic review aims to explore the relationship between illness perceptions and work participation in patients with somatic diseases and complaints. Methods The bibliographic databases Medline, PsycINFO and Embase were searched from inception to March 2008. Included were cross-sectional or longitudinal studies, patients with somatic diseases or complaints, illness perceptions based on at least four dimensions of the common sense model of self-regulation, and work participation. Results Two longitudinal and two cross-sectional studies selected for this review report statistically significant findings for one or more illness perception dimensions in patients with various complaints and illnesses, although some dimensions are significant in one study but not in another. Overall, non-working patients perceived more serious consequences, expected their illness to last a longer time, and reported more symptoms and more emotional responses as a result of their illness. Alternatively, working patients had a stronger belief in the controllability of their condition and a better understanding of their disease. Conclusions The limited number of studies in this review suggests that illness perceptions play a role in the work participation of patients with somatic diseases or complaints, although it is not clear how strong this relationship is and which illness perception dimensions are most useful. Identifying individuals with maladaptive illness perceptions and targeting interventions toward changing these perceptions are promising developments in improving work participation.
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Affiliation(s)
- J L Hoving
- Coronel Institute of Occupational Health, Research Center for Insurance Medicine, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 Amsterdam, The Netherlands.
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Bazzazian S, Besharat MA. Reliability and validity of a Farsi version of the brief illness perception questionnaire. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/j.sbspro.2010.07.217] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Casale R, Sarzi-Puttini P, Atzeni F, Gazzoni M, Buskila D, Rainoldi A. Central motor control failure in fibromyalgia: a surface electromyography study. BMC Musculoskelet Disord 2009; 10:78. [PMID: 19570214 PMCID: PMC2714295 DOI: 10.1186/1471-2474-10-78] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2008] [Accepted: 07/01/2009] [Indexed: 12/03/2022] Open
Abstract
Background Fibromyalgia (FM) is characterised by diffuse musculoskeletal pain and stiffness at multiple sites, tender points in characteristic locations, and the frequent presence of symptoms such as fatigue. The aim of this study was to assess whether the myoelectrical manifestations of fatigue in patients affected by FM are central or peripheral in origin. Methods Eight female patients aged 55.6 ± 13.6 years (FM group) and eight healthy female volunteers aged 50.3 ± 9.3 years (MCG) were studied by means of non-invasive surface electromyography (s-EMG) involving a linear array of 16 electrodes placed on the skin overlying the biceps brachii muscle, with muscle fatigue being evoked by means of voluntary and involuntary (electrically elicited) contractions. Maximal voluntary contractions (MVCs), motor unit action potential conduction velocity distributions (mean ± SD and skewness), and the mean power frequency of the spectrum (MNF) were estimated in order to assess whether there were any significant differences between the two groups and contraction types. Results The motor pattern of recruitment during voluntary contractions was altered in the FM patients, who also showed fewer myoelectrical manifestations of fatigue (normalised conduction velocity rate of changes: -0.074 ± 0.052%/s in FM vs -0.196 ± 0.133%/s in MCG; normalised MNF rate of changes: -0.29 ± 0.16%/s in FM vs -0.66 ± 0.34%/s in MCG). Mean conduction velocity distribution and skewnesses values were higher (p < 0.01) in the FM group. There were no between-group differences in the results obtained from the electrically elicited contractions. Conclusion The apparent paradox of fewer myoelectrical manifestations of fatigue in FM is the electrophysiological expression of muscle remodelling in terms of the prevalence of slow conducting fatigue-resistant type I fibres. As the only between-group differences concerned voluntary contractions, they are probably more related to central motor control failure than muscle membrane alterations, which suggests pathological muscle fibre remodelling related to altered suprasegmental control.
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Affiliation(s)
- Roberto Casale
- Department of Clinical Neurophysiology and Pain Rehabilitation Unit, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Montescano, Montescano (PV), Italy.
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