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Objective. To examine patients' beliefs about systemic sclerosis (SSc) and to investigate the relationship between these beliefs, symptom report, and clinical and demographic variables. Methods. A total of 49 patients (7 male, 42 female) with SSc underwent clinical examination and completed the Revised Illness Perception Questionnaire. This measure assesses beliefs about symptoms, chronicity or recurrence of the condition, consequences, personal and treatment control, illness coherence, perceived causes of the condition, and patients' emotional response to their condition. Results. The symptoms patients most frequently associated with their SSc were stiff joints (79%), pain (75%), and fatigue (75%). The most commonly reported causes of SSc were stress (53%), altered immunity (49%), and chance or bad luck (46%). More than 96% of patients believed that their condition would be chronic and 78% believed that the condition had serious consequences on their lives. Patients with diffuse cutaneous SSc reported more significant consequences of the condition and less personal control of their SSc compared with patients with limited cutaneous disease. There were no significant differences in illness beliefs between patients with nonsevere and severe ischemia. Multiple regression analyses indicated that illness beliefs, in particular perceived consequences associated with the condition, accounted for a significant proportion of the variance in emotional response to the condition. Conclusions. The beliefs held and symptoms experienced by patients with SSc are not ruled by disease subtype, skin score, functional ability, or severity of digital ischemia. This suggests patients' beliefs and emotional response are associated with the meaning they ascribe to their condition rather than its severity.

The psychological impact of chronic, disabling, disfiguring and painful conditions such as systemic sclerosis (SSc) may be considerable. The purpose of the study was to examine the psychological impact of SSc and to investigate the relative importance of disease parameters, functional ability and cognitive variables specifically regarding fear of negative evaluation and negative body related attitudes in relation to psychological adjustment to the condition. Forty-nine consecutive patients with SSc completed a range of standardized psychological assessments measuring anxiety, depression, attitudes towards the body, fear of negative evaluation and specific SSc-related clinical problems experienced. Over one-third of patients sampled were classified as being probable cases for anxiety or depression. Multiple regression analysis indicated that fear of negative evaluation was the most important variable accounting for 56% of the variance in anxiety, whereas overall interference of SSc on activities made the most significant contribution (F 1,38 = 17.3, p 5 0.001) to depression. Holistic assessment of patients with SSc including psychosocial as well as clinical assessments may be pertinent in optimizing patient management.

All participants in the Introduction to Clinical Leadership and Management programme were required to carry out a work-based project (WBP). The following is a list of abstracts from the WBPs which have not already been presented in this special issue. The authors’ e-mail addresses are included so that readers can contact them for a copy of the full WBP if they wish.