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Lindgren LH, de Thurah A, Thomsen T, Hetland ML, Aadahl M, Vestergaard SB, Kristensen SD, Esbensen BA. Sociodemographic and clinical variables associated with negative illness perception in patients newly diagnosed with rheumatoid arthritis, axial spondyloarthritis, or psoriatic arthritis-a survey based cross-sectional study. Rheumatol Int 2024; 44:1119-1131. [PMID: 38563971 PMCID: PMC11108915 DOI: 10.1007/s00296-024-05553-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 01/31/2024] [Indexed: 04/04/2024]
Abstract
When newly diagnosed with inflammatory arthritis (IA), acquiring self-management skills is beneficial, to enhance quality of life. The personal beliefs and mental representations patients hold about their illness, known as illness perception, significantly influence the development of these skills. Recognizing characteristics that affect illness perception is key to identifying patients requiring additional support for the development of self-management skills. This study aimed at identifying the sociodemographic and clinical characteristics associated with a negative illness perception. This cross-sectional study was based on survey data from patients diagnosed for ≤ 2 years. The Brief Illness Perception Questionnaire (B-IPQ) was used to measure illness perception. After psychometric testing, we divided the B-IPQ into two domains: (1) a control domain and (2) a consequence domain. We performed logistic regression analyses with multiple imputations. A total of 1,360 patients (61% females) were included. Among them, 64%, 20%, and 16% were diagnosed with rheumatoid arthritis, psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), respectively. Younger patients with lower socioeconomic status, a diagnosis of PsA or axSpA, high disease activity (OR 3.026, CI 2.208;4.147), severe physical disability (OR 4.147. CI 2.883;6.007), severe pain (OR 3.034, CI 1.991;4.622), and severe fatigue (OR 2.612, CI 1.942;3.513) were significantly more likely to report having a negative illness perception. Younger patients with a higher symptom burden, increased disease activity, lower socioeconomic status, and a diagnosis of PsA or axSpA may require additional attention and support in rheumatology clinical practice to aid in the development of their self-management skills.
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Affiliation(s)
- Luise Holberg Lindgren
- Copenhagen Center for Arthritis Research (COPECARE)Center for Rheumatology and Spine DiseasesCentre for Head and Orthopedics Rigshospitalet, Glostrup, Denmark.
| | - Annette de Thurah
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Tanja Thomsen
- Copenhagen Center for Arthritis Research (COPECARE)Center for Rheumatology and Spine DiseasesCentre for Head and Orthopedics Rigshospitalet, Glostrup, Denmark
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Merete Lund Hetland
- Copenhagen Center for Arthritis Research (COPECARE)Center for Rheumatology and Spine DiseasesCentre for Head and Orthopedics Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mette Aadahl
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Sara Danshøj Kristensen
- Copenhagen Center for Arthritis Research (COPECARE)Center for Rheumatology and Spine DiseasesCentre for Head and Orthopedics Rigshospitalet, Glostrup, Denmark
| | - Bente Appel Esbensen
- Copenhagen Center for Arthritis Research (COPECARE)Center for Rheumatology and Spine DiseasesCentre for Head and Orthopedics Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Tanemoto Y, Yamada U, Nakayama M, Takeuchi T, Tanemoto F, Ito Y, Kobayashi D, Ohta D, Hashizume M. Association of illness perception and alexithymia with fatigue in hemodialysis recipients: a single-center, cross-sectional study. Sci Rep 2023; 13:16592. [PMID: 37789052 PMCID: PMC10547682 DOI: 10.1038/s41598-023-43935-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/30/2023] [Indexed: 10/05/2023] Open
Abstract
Fatigue in hemodialysis recipients interferes with daily activities and renal rehabilitation, and its underlying causes and treatment remain unclear. Psychological factors, like illness perceptions and alexithymia, cause fatigue in other diseases; however, their contribution to hemodialysis-related fatigue is unknown. This cross-sectional study included 53 hemodialysis recipients. To assess participants' fatigue, we used a self-administered patient-reported outcome questionnaire whose items have shown correlation with those of established scales, such as the Profile of Mood States and Visual Analogue Scales. The associations among the scores of the revised Illness Perceptions Questionnaire (IPQ-R), Toronto Alexithymia Scale (TAS-20), and Hospital Anxiety and Depression Scale and fatigue were analyzed using bivariable and multivariable analyses. Patients with fatigue had significantly higher median scores for the IPQ-R subscales "Identity" and "Negative emotional representation about illness" than those without fatigue, suggesting the association of specific illness perception with fatigue. Median scores for the TAS-20 subscale "Difficulty identifying feelings" were also significantly higher among fatigued patients, suggesting the association of alexithymia with fatigue. Depression was not associated with fatigue. Multivariable logistic regression revealed the association of a high "Identity" score with the risk of fatigue (adjusted odds ratio, 1.32; 95% confidence interval, 1.00-1.73; P = 0.04), while there were no significant association between a high "Difficulty identifying feelings" score and the risk of fatigue (adjusted odds ratio, 1.09; 95% confidence interval, 0.95-1.24). Specific illness perception and alexithymia were slightly associated with hemodialysis-related fatigue. Cognitive-behavioral therapy for these conditions could reduce fatigue and promote renal rehabilitation.
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Affiliation(s)
- Yoko Tanemoto
- Department of Psychosomatic Medicine, Toho University Graduate School of Medicine, Omori Nishi 5-21-16, Ota-Ku, Tokyo, 143-0015, Japan.
- Department of Psychosomatic Medicine, St. Luke's International Hospital, Akashicho 9-1, Chuo-Ku, Tokyo, 104-0044, Japan.
| | - Ui Yamada
- Department of Psychosomatic Medicine, St. Luke's International Hospital, Akashicho 9-1, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Masaaki Nakayama
- Department of Nephrology, St. Luke's International Hospital, Akashicho 9-1, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Takeaki Takeuchi
- Department of Psychosomatic Medicine, Toho University School of Medicine, Omori Nishi 5-21-16, Ota-Ku, Tokyo, 143-0015, Japan
| | - Fumiaki Tanemoto
- Department of Nephrology, St. Luke's International Hospital, Akashicho 9-1, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Yugo Ito
- Department of Nephrology, St. Luke's International Hospital, Akashicho 9-1, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Daiki Kobayashi
- Division of General Internal Medicine, Department of Internal Medicine, Tokyo Medical University Ibaraki Medical Center, Amicho Chuo 3-20-1, Inashiki-Gun, Ibaraki, 300-0332, Japan
| | - Daisuke Ohta
- Department of Psychosomatic Medicine, St. Luke's International Hospital, Akashicho 9-1, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Masahiro Hashizume
- Department of Psychosomatic Medicine, Toho University Graduate School of Medicine, Omori Nishi 5-21-16, Ota-Ku, Tokyo, 143-0015, Japan
- Department of Psychosomatic Medicine, Toho University School of Medicine, Omori Nishi 5-21-16, Ota-Ku, Tokyo, 143-0015, Japan
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Kallesøe KH, Schröder A, Jensen JS, Wicksell RK, Rask CU. Group‐based Acceptance and Commitment Therapy (AHEAD) for adolescents with multiple functional somatic syndromes: A randomised trial. JCPP ADVANCES 2021. [DOI: 10.1002/jcv2.12047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Karen Hansen Kallesøe
- The Research Clinic for Functional Disorders and Psychosomatics Aarhus University Hospital Aarhus C Denmark
- Department of Clinical Medicine Aarhus University Aarhus N Denmark
| | - Andreas Schröder
- The Research Clinic for Functional Disorders and Psychosomatics Aarhus University Hospital Aarhus C Denmark
- Department of Clinical Medicine Aarhus University Aarhus N Denmark
| | - Jens Søndergaard Jensen
- The Research Clinic for Functional Disorders and Psychosomatics Aarhus University Hospital Aarhus C Denmark
| | - Rikard K. Wicksell
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
| | - Charlotte Ulrikka Rask
- Department of Clinical Medicine Aarhus University Aarhus N Denmark
- Department of Child and Adolescent Psychiatry Aarhus University Hospital Aarhus N Denmark
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Kretchy IA, Boadu JA, Kretchy JP, Agyabeng K, Passah AA, Koduah A, Opuni KFM. Utilization of complementary and alternative medicine for the prevention of COVID-19 infection in Ghana: A national cross-sectional online survey. Prev Med Rep 2021; 24:101633. [PMID: 34777985 PMCID: PMC8575551 DOI: 10.1016/j.pmedr.2021.101633] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/28/2021] [Accepted: 11/07/2021] [Indexed: 12/24/2022] Open
Abstract
82.5% of all participants reported CAM use during the COVID-19 pandemic period. 69.1% of CAM users intended it for COVID-19 infection prevention. Commonly used CAM include vitamins, spiritual healing/prayer, minerals and herbals. Age, sex and COVID-19 illness perception significantly predicted CAM use.
Complementary and alternative medicine (CAM) use is widespread and has played critical roles in preventing infections, including previous coronaviruses. This study sought to document current practices in the use of CAM for the prevention of COVID-19 disease in Ghana. An anonymous electronic survey was conducted from February 1, 2021 to April 30, 2021. Data on demographic characteristics, basic clinical information, illness perceptions about COVID-19, and CAM use during the pandemic period were generated. While about 82.5% (986/1195) of the participants used CAM during the COVID-19 period, 69.1% (681/986) of CAM users intented it for COVID-19 infection prevention. Vitamin supplements (88.1%, 869/986), spiritual healing/prayer (23.3%, 230/986), mineral supplements (22.3%, 220/986), botanical/herbal medicines (22.2%, 219/986), and diet therapy (19.4%, 191/986) were the main types of CAM used. From the adjusted binary logistic regression model, current age (aOR: 1.03, 95%CI: 1.01–1.05), sex (aOR: 1.41, 95%CI: 1.02–1.95), participants’ perceptions of consequences (aOR: 1.10, 95%CI: 1.04–1.17), identity (aOR: 1.15, 95%CI: 1.06–1.25) and concerns about COVID-19 (aOR: 0.91, 95%CI: 0.85–0.97) were statistically significant predictors of CAM use. These results suggest the need for appropriate public health policy on COVID-19 and CAM use in addition to directing further research initiatives toward an optimized COVID-19 prevention scheme using clinically validated CAM treatments. Research to validate the clinical efficacy of these products, especially the herbs, for COVID-19 prevention while isolating lead compounds that could be optimized and used for the treatment and prevention of COVID-19 is also recommended.
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Affiliation(s)
- Irene A Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
| | - Joseph A Boadu
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
| | - James-Paul Kretchy
- Department of Physician Assistantship Studies, School of Medicine and Health Sciences, Central University, Miotso, Accra, Ghana
| | - Kofi Agyabeng
- Department of Mathematics, KU Leuven, Leuven, Belgium
| | - Alfred A Passah
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
| | - Augustina Koduah
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
| | - Kwabena F M Opuni
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
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Anakwa NO, Teye‐Kwadjo E, Kretchy IA. Illness perceptions, social support and antiretroviral medication adherence in people living with HIV in the greater Accra region, Ghana. Nurs Open 2021; 8:2595-2604. [PMID: 33626226 PMCID: PMC8363381 DOI: 10.1002/nop2.797] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 11/14/2020] [Accepted: 01/29/2021] [Indexed: 11/08/2022] Open
Abstract
AIM To assess how illness perceptions and social support influence antiretroviral medication adherence in a HIV patient population in Ghana. DESIGN This study used a correlational research design with cross-sectional data. METHOD A total of 235 people living with HIV at two general hospitals in the Greater Accra Region of Ghana provided data on illness perceptions, social support and medication adherence. Hierarchical multiple regression test was used to analyse the data. RESULTS Illness perceptions' facets of timeline, personal control and treatment control were negatively associated with medication adherence, whereas emotional response was positively associated with adherence. Further, significant other support was negatively associated with adherence. Family and friend support were not associated with adherence. The findings offer preliminary evidence that illness perceptions may have utility for medication adherence in a HIV patient population in Ghana.
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Affiliation(s)
- Nella O. Anakwa
- Department of PsychologySchool of Social SciencesUniversity of GhanaLegonGhana
| | - Enoch Teye‐Kwadjo
- Department of PsychologySchool of Social SciencesUniversity of GhanaLegonGhana
| | - Irene A. Kretchy
- Department of Pharmacy Practice and Clinical PharmacySchool of PharmacyUniversity of GhanaLegonGhana
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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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Loades ME, Crawley E, Chalder T, Flannery H. Paediatric chronic fatigue syndrome: 25 year perspective. Clin Child Psychol Psychiatry 2021; 26:8-17. [PMID: 33300388 DOI: 10.1177/1359104520978461] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Maria E Loades
- Department of Psychology, University of Bath, Bath, UK.,Centre for Child and Adolescent Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Esther Crawley
- Centre for Child and Adolescent Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London & Maudsley NHS Foundation Trust, UK
| | - Halina Flannery
- Child and Adolescent Psychology Team, Paediatric and Adolescent Division, University College London Hospitals NHS Foundation Trust, London, UK
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Feasibility of group-based acceptance and commitment therapy for adolescents (AHEAD) with multiple functional somatic syndromes: a pilot study. BMC Psychiatry 2020; 20:457. [PMID: 32957944 PMCID: PMC7507241 DOI: 10.1186/s12888-020-02862-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 09/10/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Recurrent and impairing functional somatic syndromes (FSS) are common in adolescents. Despite a high need for care, empirically supported treatments are lacking for youth. The aim of this uncontrolled pilot study was to assess feasibility and treatment potential of a new intervention with group-based Acceptance and Commitment Therapy (ACT) in a generic treatment approach for adolescents with multiple FSS. METHODS Twenty-one patients received 'ACT for Health in Adolescents' (AHEAD) (30 h), specifically developed for adolescents (aged 15-19 years) with moderate to severe FSS. Close relatives attended an information meeting to facilitate support of the patients throughout treatment. Treatment satisfaction was evaluated by means of self-report and relatives' impressions. Self-reported physical health at 3 months follow-up (FU) after end of treatment was the primary outcome whereas secondary outcomes included symptom burden, limitation due to symptoms, illness worry, emotional distress and physical and emotional symptoms. Treatment targets were assessed by measures on illness behaviour, illness perception and psychological inflexibility. RESULTS Nineteen patients (90.5%) completed the treatment with a high overall attendance rate of 93%. All would recommend the treatment to a friend with similar problems. Close relatives rated it valuable to participate in an information meeting. Patients' physical health improved significantly from assessment to FU with a clinically relevant mean change of 8.9 points (95% CI [5.4; 12.4]; SRM 0.91 [0.26;1.57]). Improvement was also seen on all secondary outcome measures, from assessment to FU. Maladaptive illness behaviours and perceptions as well as psychological inflexibility showed a significant decline from assessment to FU. CONCLUSION AHEAD was feasible and potentially efficacious and warrants testing in a larger clinical trial. TRIAL REGISTRATION Clinical Trials gov NCT04464447 , registration date July 9th, 2020. Retrospectively registered.
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Chen S, Zheng S, Wang X, Zhang X, Fa T, Fu L, Zang X, Zhao Y. Linguistic and Psychometric Validation of the Chinese Version of the Control Attitudes Scale-Revised in Patients With Chronic Heart Failure. J Cardiovasc Nurs 2020; 36:349-356. [PMID: 32472800 DOI: 10.1097/jcn.0000000000000705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The concept of perceived control reflects the belief that one has resources needed to cope with negative events and the ability to positively influence consequences of those negative events. In patients with heart failure, perceived control is associated with a variety of health outcomes. Perceived control is commonly measured using the Control Attitudes Scale-Revised (CASR). There is no Chinese version of the CAS-R (CCAS-R). OBJECTIVE The purpose of this article was to perform linguistic validation and psychometric evaluation of the CCAS-R. METHODS The CAS-R was translated into Chinese according to Brislin's model. Then, a multicenter observational study was performed. Floor and ceiling effects, internal consistency, structural validity, and hypothesis testing were all assessed for psychometric validation of the CCAS-R. RESULTS A total of 227 patients with chronic heart failure were included. There were no ceiling or floor effects detected. Cronbach α was 0.94, indicating a high reliability. The results of the confirmatory factor analysis showed that the 1-factor structure as proposed by the original CAS-R fits the data well. The results of the principal component analysis suggested that the 1-factor structure was optimal as well, accounting for 71.6% of the total variance. The a priori hypothesis was supported by a statistically significant correlation between the CCAS-R and 3 theoretically related variables. CONCLUSION We developed a semantically equivalent version of the CAS-R in Chinese. The evaluation of the instruments' psychometric properties demonstrated that the CCAS-R has good reliability and validity for use in Chinese patients with chronic heart failure.
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Affiliation(s)
- Shixiang Chen
- Shixiang Chen, MD Doctoral Student, School of Nursing, Tianjin Medical University, China. Shinan Zheng, MD Nurse-in-charge, Stomatological Hospital of Tianjin Medical University. Xiaobing Wang, MD Master Student, School of Nursing, Tianjin Medical University, China. Xiaonan Zhang, MD Doctoral Student, School of Nursing, Tianjin Medical University, China. Tiane Fa, BD Director of Nursing, Nursing Department, Tianjin Chest Hospital, China. Li Fu, BD Director of Nursing, Nursing Department, The Second Hospital of Tianjin Medical University, China. Xiaoying Zang, PhD Associate Professor, School of Nursing, Tianjin Medical University, China. Yue Zhao, PhD Professor, School of Nursing, Tianjin Medical University, China
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Tack M. The illness perceptions of CFS patients are evidence based. Clin Child Psychol Psychiatry 2019; 24:934-935. [PMID: 31044601 DOI: 10.1177/1359104519846606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Psychometric properties of the Cognitive and Behavioural Responses Questionnaire (CBRQ) in adolescents with chronic fatigue syndrome. Behav Cogn Psychother 2019; 48:160-171. [PMID: 31113527 DOI: 10.1017/s1352465819000390] [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: 11/06/2022]
Abstract
BACKGROUND To better understand the maintenance of chronic fatigue syndrome (CFS), a valid and reliable measure of cognitive and behavioural responses to symptoms is required. Such a measure could also assess beliefs and coping behaviours in the context of fatigue in other somatic conditions. AIMS We aimed to establish the psychometric properties of both the Cognitive and Behavioural Responses Questionnaire (CBRQ) and its shortened version (CBRQ-S) in adolescents with CFS. METHOD The full questionnaire was completed by a clinical cohort of adolescents (n = 121) presenting to specialist CFS units in the UK. RESULTS Both the CBRQ and CBRQ-S had good internal consistency. The CBRQ scores were strongly associated with depression, anxiety, school and social functioning, but weakly associated with fatigue and physical functioning, providing evidence of validity. CONCLUSION Both the 40-item and the 18-item versions of the CBRQ were found to be reliable and valid in adolescents with CFS. To minimize unnecessary burden, the 18-item version is favoured. Using this assessment tool in future studies, including intervention studies, may help to better target interventions during clinical practice and improve outcomes.
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