Illness perceptions in patients receiving rheumatology rehabilitation: association with health and outcomes at 12 months

BMC Musculoskeletal Disorders

Andrew M Garratt³  Elin Fjerstad²  Ida Løchting¹ 

[1] Communication- and Research Unit for Musculoskeletal Disorders (FORMI), Oslo University Hospital, Ullevaal, P.O. Box 4950 Nydalen, Oslo, 0424, Norway;National Resource Centre for Rehabilitation in Rheumatology (NRRK), Department of Rheumatology, Diakonhjemmet Hospital, P.O. Box 23 Vinderen, Oslo, 0319, Norway;Norwegian Knowledge Centre for the Health Services, P.O. Box 7004, St Olavs plass, Oslo, N-0130, Norway

关键词: Illness perceptions;    Rheumatic diseases;    Rehabilitation;   

Others  :  1134162
DOI  :  10.1186/1471-2474-14-28

 received in 2012-09-21, accepted in 2013-01-12,  发布年份 2013

【 摘 要 】

Background

Illness perceptions have been found to change over time and following health care. Hence, addressing illness perceptions alongside existing health care interventions may be important for the sustainment of health gains following rehabilitation. The aim of this study was to measure the illness perceptions of patients receiving inpatient rheumatology rehabilitation and assess the association with aspects of health and outcomes at baseline, discharge and 12 months.

Methods

Patients with a rehabilitation stay of one week or more at three institutions in Norway in 2009 were invited to participate in the study. At baseline, discharge and 12 months, patients completed The Rheumatic Disease Illness Perception Questionnaire (RD-IPQ) which includes aspects of illness perceptions important to patients with rheumatic diseases. Stepwise regression analysis was used to assess associations between RD-IPQ scores and different aspects of health at baseline and follow-up after controlling for other aspects of health and sociodemographic variables.

Results

For the 134 patients included in the study, baseline RD-IPQ scores had a mean of 58.2 (SD 14.9) on a 0–100 scale, where 100 is the worst possible. Scores showed improvement after the rehabilitation stay which were maintained at 12 months. RD-IPQ scores were positively associated with health and outcomes. At baseline RD-IPQ scores were statistically significant in explaining variation in pain, physical function and SF-36 mental health scores. Baseline RD-IPQ scores were significant in explaining fatigue, pain, SF-36 role limitations and social function scores following rehabilitation and at 12 months.

Conclusion

Illness perceptions as measured by the RD-IPQ were associated with health and outcomes as measured by rheumatology-specific and generic instruments. The consideration of illness perceptions as a component of rehabilitation may be important in achieving desired outcomes.

【 授权许可】

   
2013 Loechting et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]The World Health Report 1997: Conquering suffering. Enriching humanity. Geneva: WHO; 1997:1-168. Ref Type: Report
• [2]The Norwegian Labour and Welfare Administration- NAV: Arbeid og Velferd. NAV. Rapport nr. 1 2009, 1-80. Ref Type: Report
• [3]Deighton C, O’Mahony R, Tosh J, Turner C, Rudolf M: Management of rheumatoid arthritis: summary of NICE guidance. BMJ 2009, 338:b702.
• [4]Cieza A, Stucki G: Understanding functioning, disability, and health in rheumatoid arthritis: the basis for rehabilitation care. Curr Opin Rheumatol 2005, 17:183-189.
• [5]Covic T, Adamson B, Spencer D, Howe G: A biopsychosocial model of pain and depression in rheumatoid arthritis: a 12-month longitudinal study. Rheumatology (Oxford) 2003, 42:1287-1294.
• [6]Hagger MS, Orbell S: A Meta-Analytic review of the common- sense model of illness representations. Psychol Heal 2003, 18:141-184.
• [7]Hill S, Dziedzic K, Thomas E, Baker SR, Croft P: The illness perceptions associated with health and behavioural outcomes in people with musculoskeletal hand problems: findings from the North Staffordshire Osteoarthritis Project (NorStOP). Rheumatology (Oxford) 2007, 46:944-951.
• [8]Maas M, Taal E, van der LS, Boonen A: A review of instruments to assess illness representations in patients with rheumatic diseases. Ann Rheum Dis 2009, 68:305-309.
• [9]Leventhal H, Benyamini Y, Brownlee S, et al.: Illness representations: theoretical foundations. In Perceptions of health and illness. Edited by Petrie KJ, Weinman J. Amsterdam: Harwood; 1997:1-18.
• [10]Frostholm L, Fink P, Christensen KS, Toft T, Oernboel E, Olesen F, et al.: The patients’ illness perceptions and the use of primary health care. Psychosom Med 2005, 67:997-1005.
• [11]Foster NE, Bishop A, Thomas E, Main C, Horne R, Weinman J, et al.: Illness perceptions of low back pain patients in primary care: what are they, do they change and are they associated with outcome? Pain 2008, 136:177-187.
• [12]Boot CR, Heijmans M, van der Gulden JW, Rijken M: The role of illness perceptions in labor participation of the chronically ill. Int Arch Occup Environ Health 2008, 82:13-20.
• [13]Petrie KJ, Cameron LD, Ellis CJ, Buick D, Weinman J: Changing illness perceptions after myocardial infarction: an early intervention randomized controlled trial. Psychosom Med 2002, 64:580-586.
• [14]Llewellyn CD, McGurk M, Weinman J: Illness and treatment beliefs in head and neck cancer: is Leventhal’s common sense model a useful framework for determining changes in outcomes over time? J Psychosom Res 2007, 63:17-26.
• [15]Petrie KJ, Weinman J: Why illness perceptions matter. Clin Med 2006, 6:536-539.
• [16]Loechting I, Garratt AM, Klokkerud M, Fjerstad E: Development of the Rheumatic Disease Illness Perception Questionnaire (RD-IPQ). Reliability, validity and responsiveness. Clin Exp Rheumatol 2012, 3:308.
• [17]Uhlig T, Haavardsholm EA, Kvien TK: Comparison of the Health Assessment Questionnaire (HAQ) and the modified HAQ (MHAQ) in patients with rheumatoid arthritis. Rheumatology (Oxford) 2006, 45:454-458.
• [18]Pincus T, Summey JA, Soraci SA Jr, Wallston KA, Hummon NP: Assessment of patient satisfaction in activities of daily living using a modified Stanford Health Assessment Questionnaire. Arthritis Rheum 1983, 26:1346-1353.
• [19]Ware JE, Sherbourne CD: The MOS 36-item Short- Form Health Survey (SF-36). Med Care 1992, 30:473-483.
• [20]Loge JH, Kaasa S: Short form 36 (SF-36) health survey: normativedata from the general Norwegian population. Scand J Soc Med 1998, 26:250-258.
• [21]Williamson A, Hoggart B: Pain: a review of three commonly used pain rating scales. J Clin Nurs 2005, 14:798-804.
• [22]Minnock P, Kirwan J, Bresnihan B: Fatigue is a reliable, sensitive and unique outcome measure in rheumatoid arthritis. Rheumatology (Oxford) 2009, 48:1533-1536.
• [23]Armitage P, Berry G, Matthews JNS: Statistical Methods in Medical Research. 4th edition. Oxford: Blackwell Science; 2002.
• [24]Cohen J, Cohen P, West SG, Aiken LS: Applied multiple regression/correlation analysis for the behavioral sciences. Mahwah, NJ: Lawrence Erlbaum Associates; 2003.
• [25]Menard S: Applied Logistic Regression Analysis. Thousand Oaks, CA: Sage; 1995.
• [26]Glattacker M, Opitz U, Jackel WH: Illness representations in women with fibromyalgia. Br J Health Psychol 2010, 15:367-387.
• [27]Klokkerud M, Hagen K, Lochting I, Uhlig T, Kjeken I, Grotle M: Does the content really matter? A study comparing structure, process. Scand J Rheumatol 2012, 41:20-28.
• [28]Lambert CM, Hurst NP, Forbes JF, Lochhead A, Macleod M, Nuki G: Is day care equivalent to inpatient care for active rheumatoid arthritis? Randomised controlled clinical and economic evaluation. BMJ 1998, 316:965-969.
• [29]Bijsterbosch J, Scharloo M, Visser AW, Watt I, Meulenbelt I, Huizinga TW, et al.: Illness perceptions in patients with osteoarthritis: Change over time and association with disability. Arthritis Rheum 2009, 61:1054-1061.
• [30]Kaptein AA, Bijsterbosch J, Scharloo M, Hampson SE, Kroon HM, Kloppenburg M: Using the common sense model of illness perceptions to examine Osteoarthritis Change: A 6 year Longitudinal Study. Health Psychol 2010, 29:56-64.
• [31]van Wilgen CP, van Ittersum MW, Kaptein AA, van WM: Illness perceptions in patients with fibromyalgia and their relationship to quality of life and catastrophizing. Arthritis Rheum 2008, 58:3618-3626.