Causal Attributions about Disease Onset and Relapse in Patients with Systemic Vasculitis

Abstract

Objectives Patients vary in their beliefs related to the cause of serious illness. The impact of these beliefs among patients with systemic vasculitis is not known. This study aimed to describe causal attributions about disease-onset and relapse in systemic vasculitis and to examine whether causal beliefs a) differ by type of vasculitis; and b) are associated with negative health outcomes. Methods Patients with vasculitis were recruited to complete an online questionnaire. Categories of causal beliefs were assessed with the Revised Illness Perception Questionnaire (IPQ-R). Differences in beliefs about disease-onset versus relapse were compared across different forms of vasculitis. Causal beliefs were assessed in association with several health outcomes including fatigue, functional impairments, and personal understanding of the condition. Results 692 patients representing 9 forms of vasculitis completed the questionnaire. The majority (90%) of patients had beliefs about the cause of their illness. Causal attributions were highly variable, but altered immunity and stress were the most commonly agreed upon causal beliefs. Frequencies of causal beliefs were strikingly similar across different forms of vasculitis, with few notable exceptions primarily in Behçet’s disease. Beliefs differed about causes of disease-onset versus relapse. Specific beliefs about disease-onset and relapse were weakly associated with fatigue, functional impairments, and understanding of the condition. Conclusion Patient beliefs related to the cause of systemic vasculitis are highly variable. Patterns of causal beliefs are associated with important negative health outcomes. Clinicians who care for patients with vasculitis should be mindful of these associations and consider asking about patients’ causal beliefs.

Status epilepticus of inflammatory etiology

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An attribution theory perspective on emotional labour in nurse–patient encounters: a nested cross‐sectional study in paediatric settings

“…The process is usually activated in certain situations of serving or helping another person (Weiner 1980a), hence it is introduced in this study as a relevant lens to nurses emotional labour. The attribution process has been shown to affect interactions in various serviceproviding scenarios including health care (Morrow et al 2011, Grayson et al 2014, Weiss et al 2014. Its connection to nurses' emotional labour, however, has only been recently implied (Crego et al 2013) and yet to be fully clear.…”

“…The same nurse might engage deep acting in certain encounters and surface acting in others. The attribution process has been shown to affect interactions in various serviceproviding scenarios including health care (Morrow et al 2011, Grayson et al 2014, Weiss et al 2014. Attribution theory (Weiner 1982) suggests that individuals act as naive psychologists in their desire to understand causes of events.…”

Cancer Survivors’ Beliefs About the Causes of Their Insomnia: Associations of Causal Attributions With Survivor Characteristics

“…Confusion is understandable given the multidimensional and complex etiology of insomnia, but may suggest that these survivors might particularly benefit from treatment modalities that include a strong psychoeducational component. Among chronically ill individuals, those who spoke with their doctors about their illness beliefs were less likely to ascribe their illness to "chance," (Grayson et al, 2014) and educational interventions are capable of shifting individuals' causal attributions of illness (Abood, Black, & Feral, 2003;Boling, Laufman, Lynch, & Weinberg, 2005). Future research is warranted to understand whether these "unsure" individuals demonstrated better treatment response to CBT-I, which heavily emphasizes education, or acupuncture, which does not rely on individuals' understanding of their insomnia.…”