BackgroundChronic 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.MethodIn 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.ResultsPatients 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.ConclusionConstraining 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.

The aim of this study was to enhance knowledge about patients' beliefs related to different kinds of illnesses and to describe and understand their beliefs as they relate to their outlook on their illnesses. Fifty-two patients with various illness symptoms receiving integrative anthroposophic care answered an item in a questionnaire about their own thinking of the causes of their illness. The method used for analysis was qualitative content analysis. The result showed that from a patient's perspective a complex combination of causes led to illness. The most prominent causes were psychosocial factors, but personal attitudes, biological factors and chance were also mentioned. Beliefs act as either facilitating or constraining. The informants displayed more constraining than facilitating beliefs, which might prevent them from improving their health. Furthermore, the informants might improve their ability to deal with their illness by identifying their own personal internal resources.

BackgroundThis study describes the translation and cultural adaptation procedure and guidelines for the Illness Invalidation Inventory for use in Sweden. Invalidation includes responses to negative social interactions and to the lack of positive social interactions, responses that can negatively affect health and suffering. Although invalidation is a recognized phenomenon, in Sweden no instruments exist that describe and measure invalidation. To this end, this study evaluates the translation and adaptation of the Illness Invalidation Inventory as an instrument for measuring invalidation in a Swedish context.MethodsInternationally recognized ten-step guidelines were used. Both forward and back translations were performed. Patients from a patient organization for chronic pain were recruited and cognitive interviews were performed using concurrent think aloud protocols, probing techniques and observations of behaviour. Analysis of data collected from cognitive interviews was inspired by the generic response model and a centralized review procedure and thorough documentation was emphasized.ResultsAlthough difficulties regarding concepts were found, these issues were solved during the process. The Swedish version contains the same number of items as the original questionnaire. Four of eight items required revision after cognitive interviews.ConclusionsThe study highlights the importance of using guidelines to produce translations and to ensure validity and results. The results indicate that the Illness Invalidation Inventory can be used in Sweden to measure invalidation.

Objective: The concept of “invalidation” refers to the patient’s perception that the social environment does not recognize their medical condition. This study explores and describes invalidation experiences among Swedish patients with chronic widespread pain with regard to sociodemographic and pain characteristics, impact of pain, self-reported health, and symptoms of anxiety and depressive.  Methods: A cross-sectional design using questionnaires, including sociodemographic and pain variables, the Illness Invalidation Inventory (Likert scale items regarding 5 sources), the Hospital Anxiety and Depression Scale, and the Short-Form General Health Survey. Descriptive and univariate analyses were applied.  Results: Of the 152 respondents, 91% were women. Swedish patients with chronic widespread pain experienced invalidation to a large extent from all sources. The highest scores for invalidation were reported from contacts with social services (68%), and the lowest from spouses (30%). Being younger (p < 0.006), having periodic pain (p = 0.011), and having had more frequent visits to a doctor in the previous year (p = 0.007) were characteristics associated with higher invalidation scores. Experiences of invalidation were associated with worse self-reported mental health scores (r = –0.29 to –0.46).  Conclusion: Since patients with chronic widespread pain frequently experience invalidation from the social environment, this further challenge in daily life must be taken into consideration in pain management within multimodal pain rehabilitation.