Illness beliefs predict disability in rheumatoid arthritis

Abstract

Objective This study examined the relationships between patients' beliefs about rheumatoid arthritis (using Leventhal's Common Sense Model) and their levels of disability, health-related quality of life, and disease activity. A proposed illness beliefs construct of “seriousness” was also investigated, combining beliefs about illness identity (symptoms), consequences, and timeline. Method A cross-sectional study evaluated 125 patients with rheumatoid arthritis from two South East London hospitals. Questionnaires assessed their illness beliefs, disability, and quality of life. An objective measure of disease activity was also obtained. Results Higher disability scores were associated with beliefs about identity ( r=.31, P<.01) and consequences ( r=.28, P<.01). Stronger control beliefs were associated with lower disability ( r=−.40, P<.01) and better physical ( r=.20, P<.05) quality of life. Disease activity scores, although positively related to disability scores ( r=.39, P<.01), showed no associations with illness beliefs. Multivariate analysis resulted in models accounting for 45.5%, 27.3%, and 19.3% variance in disability, “physical quality of life” scores, and “mental quality of life” scores, respectively. The hypothesis for a proposed “seriousness” construct was not supported. Conclusion Patients' beliefs about their rheumatoid arthritis are associated with disability and quality of life and cannot be explained by disease status. Longitudinal research is needed to assess the stability of beliefs.