Illness beliefs predict disability in rheumatoid arthritis

Graves, Helen; Scott, David; Lempp, Heidi; Weinman, John

doi:10.1016/j.jpsychores.2009.01.006

Cited by 49 publications

(42 citation statements)

References 42 publications

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“…In the literature, there are a few studies investigating the relationship between illness perceptions and disease activity in RA and the results are contradictory. [6][7][8] Cordingley et al 6 and Fraenkel and Cunningham 7 found a correlation between disease activity and patients' illness beliefs. In concordance with our study, Graves et al 8 reported that disease activity scores showed no associations with illness beliefs and they concluded that patients' beliefs about their RA cannot be explained by disease status.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] Cordingley et al 6 and Fraenkel and Cunningham 7 found a correlation between disease activity and patients' illness beliefs. In concordance with our study, Graves et al 8 reported that disease activity scores showed no associations with illness beliefs and they concluded that patients' beliefs about their RA cannot be explained by disease status. Patients with higher disease activity would be expected to have more negative illness representations because their illness was more active and severe.…”

Section: Discussionmentioning

confidence: 99%

“…36 With respect to RA, different domains of illness perceptions have been shown to be related to depression. 5,6,8,[32][33][34][35] The association between the illness perceptions, and depression and life satisfaction scores in Turkish RA patients may be mutual. Patients may view their illness more negatively because of the poor well-being, or negative beliefs of the patients about their RA may cause them to become depressive and less satisfied with life.…”

Section: Discussionmentioning

confidence: 99%

“…There have been reports on the illness perceptions in several diseases such as RA, [5][6][7][8] ankylosing spondylitis, 4 fibromyalgia, 9 sport injuries, 10 low back pain, 11 osteoarthritis, 12 and chronic fatigue syndrome. 13 In RA patients, illness perceptions have shown association with disease activity, pain, disability, quality of life, depression, and anxiety.…”

mentioning

confidence: 99%

“…13 In RA patients, illness perceptions have shown association with disease activity, pain, disability, quality of life, depression, and anxiety. [5][6][7][8] The results of the studies reveal that how the patients perceive their RA has an impact on disease outcome, and RA is more serious in patients with negative beliefs about their illness. 5,6 The Revised Illness Perception Questionnaire (IPQ-R) has been used extensively for the assessment of illness perception.…”

mentioning

confidence: 99%

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Are Illness Perceptions Associated With Disease Activity or Psychological Well-Being in Rheumatoid Arthritis? A Study With the Evidence of Confirmatory Factor Analysis

et al. 2017

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Objectives: This study aims to assess the factor structure of the Turkish Revised Illness Perception Questionnaire (IPQ-R) in patients with rheumatoid arthritis (RA) and the relationship of illness perceptions with disease activity and psychological well-being. Materials and methods: One hundred and fifty RA patients (8 males, 142 females; mean age 51.1±12.7 years; range 21 to 81 years) were included in the study. Confirmatory factor analysis was used to test the factor structure of the IPQ-R. Pain was assessed by visual analog scale, disease activity by Disease Activity Score 28, depression by Beck Depression Inventory, global life satisfaction by the Satisfaction with Life Scale, and illness perception by the IPQ-R. Results: Three items (items 12, 18, 19) were deleted because of poor factor loadings. The modified 35-item model showed good reliability and discriminant validity. Beck Depression Inventory scores were correlated with identity, consequences, and emotional representations subscales positively (p<0.001); and with illness coherence subscale negatively (p<0.05). There were positive correlations between Satisfaction with Life Scale scores, and treatment control and illness coherence subscales (p<0.05). Satisfaction with Life Scale scores were negatively correlated with identity, emotional representation, and timeline acute/chronic subscales (p<0.05), and consequences subscale (p<0.001). Disease Activity Score 28 was not correlated with IPQ-R domains (p>0.05). Conclusion:The Turkish IPQ-R appears to be a useful clinical assessment tool to evaluate RA-related illness perceptions. RA healthcare should include psychological intervention to strengthen patients' beliefs about their RA regardless of disease activity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Are Illness Perceptions Associated With Disease Activity or Psychological Well-Being in Rheumatoid Arthritis? A Study With the Evidence of Confirmatory Factor Analysis

et al. 2017

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High Disease Activity May Not Be Sufficient to Escalate Care

Fraenkel¹,

Cunningham

2014

Arthritis Care & Research

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Background Rheumatoid arthritis (RA) treatment regimens are not adjusted in response to active disease as frequently as indicated. The objective of this study was to examine how disease activity and patients’ illness beliefs combine to predict future treatment changes in patients who are currently under the care of a rheumatologist. Methods We interviewed RA patients at baseline, 2, 4 and 6 months. We examined the association of disease activity (RAPID-4) and five specific illness beliefs (consequences, treatment control, symptom burden, concern, emotional impact) with future escalation of treatment using logistic regression. Analyses were adjusted for age, current biologic use, and disease duration. Disease activity and illness beliefs were dichotomized at the median to create four dummy variables (e.g. Low disease activity + High illness belief) in order to examine the combined impact of disease activity and illness beliefs on escalation. Results Twenty-nine percent of the participants (N=142) had an escalation of treatment during the follow-up period. When examined separately, disease activity and four of the illness beliefs (consequences, symptom burden, concern, and emotional impact) were associated with future escalation. High disease activity was predictive of future escalation only when combined with high levels of consequences, concern, and emotional impact. The combinations of high disease activity and high consequences, concern, and emotional impact were much stronger predictors or future escalation than either factor in isolation. Conclusions The findings suggest that patients’ illness beliefs are an important determinant of treatment decisions which are not fully captured by disease activity measures alone.

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Impact of Psychological Factors on Subjective Disease Activity Assessments in Patients With Severe Rheumatoid Arthritis

Cordingley

Prajapati

Plant

et al. 2014

Arthritis Care & Research

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ObjectiveThe Disease Activity Score in 28 joints (DAS28), used to assess disease activity in rheumatoid arthritis (RA), is a composite score comprising clinical, biochemical, and patient self-report measures. We hypothesized that psychological factors (cognitions and mood) would be more strongly associated with patient-reported components of the DAS28 than clinical or biochemical components.MethodsA cross-sectional, observational study of 322 RA patients with active disease (mean DAS28 6.0) awaiting therapy with a biologic agent was undertaken. Patients' illness beliefs, treatment beliefs, and mood were measured using the Brief Illness Perception Questionnaire (IPQ), the Beliefs about Medicines Questionnaire (BMQ), and the Hospital Anxiety and Depression Scale (HADS), respectively. Relationships between psychological factors and 1) total DAS28 and 2) individual components of the DAS28 were analyzed using linear regression.ResultsTotal DAS28 produced significant but weak associations with 2 of the Brief IPQ items, but no associations with BMQ or HADS scores. There were larger significant associations between the patient-reported visual analog scale (VAS) with 5 items of the Brief IPQ and with HADS depression. Low illness coherence was associated with higher tender joint count. Three Brief IPQ items and HADS anxiety scores were significantly associated with C-reactive protein level or erythrocyte sedimentation rate. No psychological factors were associated with the swollen joint count.ConclusionOne of the subjective components of the DAS28, patient VAS, was highly correlated with cognitive factors and depression in those with severe RA. By reporting individual DAS28 components, clinicians may be better able to assess the impact of therapies on each component, adjusting approaches according to patients' needs.

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Illness beliefs predict disability in rheumatoid arthritis

Cited by 49 publications

References 42 publications

Are Illness Perceptions Associated With Disease Activity or Psychological Well-Being in Rheumatoid Arthritis? A Study With the Evidence of Confirmatory Factor Analysis

Are Illness Perceptions Associated With Disease Activity or Psychological Well-Being in Rheumatoid Arthritis? A Study With the Evidence of Confirmatory Factor Analysis

High Disease Activity May Not Be Sufficient to Escalate Care

Impact of Psychological Factors on Subjective Disease Activity Assessments in Patients With Severe Rheumatoid Arthritis

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