Patients’ illness perceptions and coping as predictors of functional status in psoriasis: a 1-year follow-up

Abstract

In a longitudinal study (two measurements with a 1-year interval), 69 patients with psoriasis completed the Illness Perception Questionnaire, the Medical Outcomes Study SF-20 Health Survey, and the Hospital Anxiety and Depression Scale. Data on coping (Utrecht Coping List) and severity of illness (body surface scores) were also collected. The results of regression analyses indicated that a strong illness identity was associated with more visits to the outpatient clinic, and worse outcome on physical health, social functioning, mental health, health perceptions and depression. Strong beliefs that the disease is controllable/curable and that the disease has disabling consequences were also related to more clinic visits and more negative perceived health, respectively. Patients who initially engaged in coping characterized by more expression of emotions, seeking more social support, seeking more distraction, and less passive coping were prescribed a lower number of different therapies, were less anxious, less depressed, and had a better physical health 1 year later. These results have implications for the management of patients with psoriasis, which reinforces current views on integrating psychosocial aspects into clinical care.

Why illness perceptions matter

“…11 A number of studies have shown that when patients hold generally negative illness perceptions about their illness (eg a large number of symptoms associated with the condition, more severe consequences, longer timeline beliefs) these perceptions are associated with increased future disability and a slower recovery, independent of the initial medical severity of the condition. [12][13][14] For example, in a study of over 1,000 general practice patients presenting with a new health problem, a strong illness identity, long timeline and perceived severe consequences from the condition were associated with future healthcare use, independent of previous healthcare use and the doctors' rating of the severity of their health problem. 15 Such studies pose the question whether patients' recovery can be improved if their illness perceptions can be modified early in their recovery process.…”

Beliefs about illness and quality of life among men with erectile dysfunction

“…23 In the previous study, the quality of life measure used differed to the one used in the current study: however, these measures are highly correlated and are considered alternative measures of the effect of ED on quality of life. 14 The results suggest that, within clinic, it is important to examine not only sexual function but also the impact that ED has on the individual's quality of life.…”

“…The illness perceptions scale was adapted from the revised Illness Perception Questionnaire (IPQ-R). 12 The IPQ 11 has been utilised in studies examining patients' adaptation to various conditions, such as heart disease, 13 rheumatoid arthritis, 14 chronic fatigue syndrome 15 and diabetes. 16 The IPQ subscales demonstrated good internal and test-retest reliability and good discriminant, construct and predictive validity.…”

Views on respiratory tract symptoms and antibiotics of Dutch general practitioners, practice staff and patients

“…Patients' views on seriousness, time-line, curability, and controllability have been shown to play a role in patients' coping behaviour relating to their illness, and therefore, in the doctor-patient relationship in patients with chronic diseases [27][28][29][30]. Probably, this is also the case in selflimiting illnesses; mutual misunderstanding and ignorance or disagreement about views on health and illness may negatively influence patient-doctor relationship, patient compliance regarding advice and treatment, and patient satisfaction [21,31,32].…”