Common Sense Model Of Illness Research Articles

The disease recurrence perception scale for patients with inflammatory bowel disease: Instrument development and cross‐sectional validation study

AbstractDisease recurrence perception plays a key role in disease management and subsequent disease recurrence prevention. However, there are no specific tools for assessing disease recurrence perception in patients with inflammatory bowel disease (IBD) characterized by alternating remission and recurrence. To develop and validate an instrument for measuring disease recurrence perception of patients with IBD, the study was conducted in two steps: (1) instrument development and (2) psychometric tests. A total of 623 patients with IBD participated in the study. The common sense model of illness self‐regulation (CSM) was used as a framework for instrument development. The administered version contained 48 items intended to be relevant to at least one of the six dimensions of the model. Based on preliminary analyzes, 12 items were deleted leaving 36 items for more detailed psychometric and factor analyzes. The Cronbach's alpha coefficient of the total 36‐item instrument was 0.915. The content validity indexes at item and scale levels were satisfactory. The test‐retest reliability of the total instrument was 0.870. Exploratory principal components analysis (n = 278) was used to identify six components congruent with intended CSM constructs that accounted for 62.6% of total item variance. Confirmatory factor analysis (n = 345) found acceptable fit for the six factor measurement model (χ2/df = 1.999, GFI = 0.846, NFI = 0.855, IFI = 0.922, TLI = 0.910, CFI = 0.921, RMSEA = 0.054). Overall, the DRPSIBD demonstrated satisfactory reliability and validity to warrant further development as a measure of disease recurrence perception of patients with IBD.

A significant burden: A qualitative exploration of the experience of women living with fibroids in St. Kitts and Nevis

Background: Our study aimed to understand the illness experience of women living in St Kitts and Nevis who have been affected by fibroids by utilising Leventhal’s commonsense model of illness. Methods: Upon receiving ethics approval, females aged between 18 and 55 who were currently a resident in St Kitts and Nevis and who had an experience with fibroids within the last 5 years were recruited to consent and complete 1-hour interviews during which they described the different ways in which fibroids affects them. Results: The interview guide incorporated the common-sense model; all interviews were 1:1 and a thematic analysis was conducted. The final sample consisted of 11 women, 10 from St Kitts and 1 from Nevis. Their ages ranged from 23 to 49, and the average age of participants was 39 years. Participants described their fibroids in generally negative terms and noted several physical, emotional, social and professional consequences as a result of their fibroid symptoms. Conclusions: Our study revealed the need for a clear strategy for managing patients with symptomatic fibroids—a strategy that includes regular monitoring of patients, good communication between doctor and patient and clear guidance on management for patients.

Predicting different dimensions of schizophrenia-related stigma in Israel: Exploring the applicability of the common sense model of illness

The common sense model of illness is a promising conceptual framework that can promote our understanding of the predictors of schizophrenia-related public stigma. Because stigma is a multidimensional phenomenon, studies on schizophrenia-related stigma need to account for the origins of the various aspects of this phenomenon. This study explored which common sense model of illness components (cognitive and emotional) predicted three distinct indicators of stigma (stereotypes and discrimination on the individual and structural levels). A nonprobability sample of 149 students from one of the largest universities in Israel was drawn. Data were collected via a self-reported questionnaire. We found that five of the nine common sense model of illness variables predicted schizophrenia stereotypes, whereas very few predicted discrimination. Additionally, we found that greater belief in the effectiveness of schizophrenia treatment was associated with lower stereotypes and social-level discrimination. The less the perceived consequences of schizophrenia (the extent to which the illness is perceived to affect one's life), the lower the stereotypes and discrimination (individual and social). The perceived cause of schizophrenia and attribution of personal control over the illness did not predict any stigma dimension. The findings suggest that the common sense model of illness is more suitable for predicting stereotypes than discrimination. More research is needed to understand the unique drivers of different dimensions of stigma. The findings also imply the need to design separate programs to address different aspects of schizophrenia-related stigma.

P620 Differences in illness perceptions of Inflammatory Bowel Disease (IBD) between Healthcare Practitioners (HCPs) and patients in a UK tertiary IBD centre

Abstract Background The common sense model of illness (Leventhal et al 1997) suggests that illness perceptions influence coping strategies and outcomes. Negative perceptions of IBD are associated with poorer psychological and physical health, quality of life (Polak et al, 2019) and adherence (van der Have et al, 2016). There are differences among healthcare professionals in how they view IBD (Dickman et al, 2011) however, it is unknown how perceptions of illness vary between patients and HCPs Methods All patients with IBD who were referred to IBD psychology clinic were asked to complete Brief Illness Perception Questionnaire (BIPQ, Broadbent et al, 2006) as part of their assessment. HCPs as part of the same team were asked to complete 5 items adapted from the BIPQ (How long do you think your patients will have IBD, how much control do think is possible with IBD, how much do you think treatment can help, how much do you feel that you understand IBD and how much do you feel IBD affects patients emotionally) and asked for 3 causes of IBD. Descriptive statistics and Mann-Whitney tests were performed as well as a thematic analysis (Braun & Clarke, 2006) of the causes. Results Data was available for 148 patients and 24 HCPs (11 doctors and 13 other HCPs). There were no significant differences between HCPs and patients in their views of illness duration or their understanding of IBD. However, patients felt that disease control was less likely and treatment effectiveness was less helpful than HCPs. HCPs felt that patients were more emotionally impacted by IBD than patients themselves. There was a difference in how each group ranked the themes. All HCPs identified genetics, whereas many fewer patients did. Patients were more likely to identify psychological, environmental and lifestyle as being important, were more likely to say that the cause was unknown or to not respond to the question. Conclusion Our findings suggest a disconnect between the views held by patients and HCPs as to the underlying cause of their IBD as well as our ability to achieve disease control with effective medical therapy. This highlights the importance of open communication with and education of patients from their first encounter with HCPs and throughout their disease course. It is worth noting that all patients included had been referred to the IBD psychology service and are more likely to have had a difficult disease course or persistent symptoms which may explain the difference in views on treatment and remission.

Preliminary examination of the relations between disease stage, illness perceptions, coping strategies, and psychological morbidity in chronic hepatitis B and C guided by the Common-Sense Model of Illness.

Chronic viral hepatitis (CVH) has a spectrum from asymptomatic disease to cirrhosis and hepatocellular carcinoma. In our study, we aimed to establish the relations between disease stage, illness perception, coping strategies and psychological morbidity in CVH. A total of 182 patients with chronic hepatitis B (CHB) (n = 136) and chronic hepatitis C (CHC) (n = 46) were enrolled. Illness perceptions were measured with the Brief Illness Perceptions Questionnaire. Coping strategies were measured with the Carver Brief Coping Questionnaire. Anxiety and depression were measured with the Hospital Anxiety and Depression Scale. Relations were evaluated by structural equation modeling (SEM). In CHB, combining the questionnaire data using SEM resulted in a final model with an excellent fit [χ2 (2) = 0.00, P = 1.000, χ2/N = 0.00, root mean square error of approximation (RMSEA) < 0.001, comparative fit index (CFI) = 1.000, goodness-of-fit index (GFI) = 1.000]. Disease stage had a significant direct influence on illness perceptions (β = 0.23, P = 0.006). Illness perceptions had a significant direct influence on emotional coping strategy, depression and anxiety (β = 0.20, P = 0.019; β = 0.33, P < 0.001; β = 0.59, P < 0.001, respectively). While the use of emotional coping strategies was associated significantly (P = 0.01) with the presence of anxiety, problem-focused coping strategy was associated with depression (P = 0.004). In CHC, SEM resulted in a final model with an excellent fit [χ2 (2) = 0.078, P = 0.962, χ2/N = 0.039, RMSEA<0.001, CFI = 1.000, GFI = 0.999]. Disease stage did not have a significant direct influence on illness perceptions (P > 0.05). Illness perceptions had a significant direct influence on depression and anxiety (β = 0.27, P = 0.023; β = 0.44, P < 0.001, respectively). The psychological consequences of the disease vary depending on the person's perception of illness and coping strategies.

Experience of a tertiary-level urology center in the clinical urological events of rare and very rare incidence. III. Psychourological events: 2. Phobia of renal failure due to loin pain

BackgroundEnd-stage renal disease and loin pain are prevalent nephrourological topics with unfavorable reputations among populations. We aimed to present our center’s experience with the cases of phobia of renal failure in relation to loin pain.MethodsIt is a retrospective study of phobia of renal failure among the patients who presented with loin pain to our center between July 1991 and June 2017. Description of perception of renal failure risk was guided by the modified Common Sense Model of Illness Representation.ResultsOf more than 64, 000 patients who presented with loin pain, only 78 patients (0.12%) had phobia of renal failure. Mean age ± SD (Range) was 41.12 ± 9.58 (23–60) years. Sixty-four patients (82.1%) expressed directly fear of renal failure. Physical examination and investigations revealed no risks of renal failure in all patients. High percentages of phobia of renal failure were associated with the female gender (73.1%), the presence of a relative patient with renal failure (83.3%), and low socioeconomic levels: education (89.7%), residential (75.6%), and economic status (88.5%) levels. The modified Common Sense Model of Illness Representation revealed predominant emotional representations and unreal cognitive domains with altered perception of renal failure risk.ConclusionsPhobia of renal failure is very rare. It is a consequence of the altered perception of risk of renal failure due to unconscious attribution of loin pain to renal failure. Female gender, the presence of a relative with renal failure, and low socioeconomic levels could be suggested as risk factors for phobia of renal failure.

Understanding and managing pelvic girdle pain from a person-centred biopsychosocial perspective

IntroductionClinicians need support to effectively implement a biopsychosocial approach to people with pelvic girdle pain disorders. PurposeA practical clinical framework aligned with a contemporary biopsychosocial approach is provided to help guide clinician's management of pelvic girdle pain. This approach is consistent with current pain science which helps to explain potential mechanistic links with co/multi-morbid conditions related to pelvic girdle pain. Further, this approach also aligns with the Common-Sense Model of Illness and provides insight into how an individual's illness perceptions can influence their emotional and behavioural response to their pain disorder. Communication is critical to supporting recovery and facilitating behaviour change within the biopsychosocial context and in this context, the patient interview is central to exploring the multidimensional nature of a persons' presentation. Focusing the biopsychosocial framework on targeted cognitive-functional therapy as a key component of care can help an individual with pelvic girdle pain make sense of their pain, build confidence and self-efficacy and facilitate positive behaviour and lifestyle change. There is growing evidence of the efficacy for this broader integrative approach, although large scale effectiveness trials are still needed. An in-depth case study provides guidance for clinicians, showing ‘how to’ implement these concepts into their own practice within a coherent practical framework. ImplicationsThis framework can give clinicians more confidence in understanding and managing pelvic girdle pain. The framework provides practical strategies to assist clinicians with implementation; assisting the transition from knowing to doing in an evidence-informed manner that resonates with real world practice.

Utilizing the common sense model to explore African Americans' perception of type 2 diabetes: A qualitative study.

Illness perceptions, which are likely influenced by patients’ cultural contexts, are associated with disease self-management and adherence. African American patients perceptions of type 2 diabetes is not well understood and no known studies has used a comprehensive evidence-based theoretical framework to explore what AAs with type 2 diabetes know, believe, and think about type 2 diabetes. Understanding perceptions of an illness shared by a group of people will be useful in developing culturally-appropriate interventions targeted to the needs of the community. The purpose of this study is to explore African Americans’ perceptions of type 2 diabetes based on the common sense model of illness and self-regulation. Using a phenomenology qualitative approach and purposive sampling, 40 African American men and women, age 45–60 years old with diagnosed type 2 diabetes at least one year prior, and who took at least one prescription diabetes medication, participated in six semi-structured 90-minute focus groups conducted in a private space. Qualitative content analysis was conducted to explore African Americans beliefs about type 2 diabetes. Participants expressed that historical issues, e.g., slavery, healthcare providers, the government, and God influenced how they developed diabetes. Participants reported a loss of autonomy, a change of their identity as an employee, a social individual and sexual person, as well as anger and frustration due to having diabetes. Diabetes made the African American family bonding experience of eating difficult, and the disease diminished their cultural experiences. Concerns about diabetes ranged from fear of death and amputations to the inability to prevent the disease among their children/grandchildren. Participants perceived that medications, faith in God, and positive thinking about survival helped control diabetes. Conclusions: Improved diabetes self-management and medication adherence may depend on the meaning African Americans attach to diabetes, available psychosocial support for managing diabetes, and African Americans experience with diabetes.

Visual Cancer Communication on Social Media: An Examination of Content and Effects of #Melanomasucks.

BackgroundInstagram is increasingly becoming a platform on which visual communication of cancer takes place, but few studies have investigated the content and effects. In particular, a paucity of research has evaluated the effects of visual communication of cancer on participative engagement outcomes.ObjectiveThe objective of our study was to investigate cancer-related beliefs and emotions shared on Instagram and to examine their effects on participative engagement outcomes including likes, comments, and social support.MethodsThis study analyzed the content of 441 posts of #melanomasucks on Instagram and assessed the effects of the content characteristics on outcomes, including the number of likes and comments and types of social support using group least absolute shrinkage and selection operator logistic regression.ResultsPosts about controlling melanoma were most frequent (271/441, 61.5%), followed by 240 (54.4%) posts about outcomes of having melanoma. Ninety posts (20.4%) were about the causes of melanoma. A greater number of posts expressed positive (159/441, 36.1%) than negative emotions (100/441, 22.7%). Eighty posts (18.1%) expressed hope, making it the most frequently expressed emotion; 49 posts expressed fear (11.1%), 46 were humorous (10.4%), and 46 showed sadness (10.4%). Posts about self behavior as a cause of melanoma decreased likes (P<.001) and social support comments (P=.048). Posts about physical consequences of melanoma decreased likes (P=.02) but increased comments (P<.001) and emotional social support (P<.001); posts about melanoma treatment experience increased comments (P=.03) and emotional social support (P<.001). None of the expressions of positive emotions increased likes, comments, or social support. Expression of anger increased the number of likes (P<.001) but those about fear (P<.001) and joy (P=.006) decreased the number of likes. Posts about fear (P=.003) and sadness (P=.003) increased emotional social support. Posts showing images of melanoma or its treatment on the face or body parts made up 21.8% (96/441) of total posts. Inclusion of images increased the number of comments (P=.001).ConclusionsTo our knowledge, this is the first investigation of the content and effects of user-generated visual cancer communication on social media. The findings show where the self-expressive and social engagement functions of #melanomasucks converge and diverge, providing implications for extending research on the commonsense model of illness and for developing conceptual frameworks explaining participative engagement on social media.

Relations between symptom severity, illness perceptions, visceral sensitivity, coping strategies and well-being in irritable bowel syndrome guided by the common sense model of illness

Irritable Bowel Syndrome (IBS) is a common condition affecting around 10–20% of the population and associated with poorer psychological well-being and quality of life. The aim of the current study was to explore the efficacy of the Common Sense Model (CSM) using Structural Equation Modelling (SEM) in an IBS cohort. One hundred and thirty-one IBS patients (29 males, 102 females, mean age 38 years) participating in the IBSclinic.org.au pre-intervention assessment were included. Measures included IBS severity (Irritable Bowel Syndrome Severity Scoring System), coping patterns (Carver Brief COPE), visceral sensitivity (Visceral Sensitivity Index), illness perceptions (Brief Illness Perceptions Questionnaire), psychological distress (Depression, Anxiety and Stress Scale), and quality of life (IBS Quality of Life scale; IBS-QoL). Using SEM, a final model with an excellent fit was identified (χ2 (8) = 11.91, p = .16, χ2/N = 1.49, CFI > .98, TLI > .96, SRMR < .05). Consistent with the CSM, Illness perceptions were significantly and directly influenced by IBS severity (β = .90, p < .001). Illness perceptions in turn directly influenced maladaptive coping (β = .40, p < .001) and visceral sensitivity (β = .70, p < .001). Maladaptive coping and visceral sensitivity were significantly associated with psychological distress (β = .55, p < .001; β = .22, p < .01) and IBS-QoL (β = –.28, p < .001; β = –.62, p < .001). Based on these findings, we argue that to augment the adverse impact of IBS severity on IBS-QoL and psychological distress, psychological interventions will be best to target the mediating psychological processes including illness beliefs, visceral sensitivity and maladaptive coping.

Using the common sense model of illness to examine interrelationships between symptom severity and health outcomes in end-stage osteoarthritis patients.

The aim was to evaluate the utility of the common sense model (CSM) in characterizing contributors to psychological well-being and quality of life (QoL) in patients with end-stage OA. One hundred and twenty patients [34 males, 86 females; mean (s.d.) age 65.52 (9.14) years] with end-stage OA (57.5% hip, 42.5% knee) were recruited. OA symptom severity was evaluated according to the WOMAC; coping styles were assessed with the Carver Brief COPE scale; illness perceptions were explored with the Brief Illness Perceptions Questionnaire; self-efficacy was assessed with the Arthritis Self-efficacy scale; anxiety, depression and overall distress were measured using the Hospital Anxiety and Depression Scale; and QoL was assessed using the WHO Quality of Life-short version. The CSM was used to explore the interrelationships between OA symptom severity, illness perceptions and coping strategies in patients. Two structural equation models were developed, with both found to have good fit. Consistent with the CSM, the standard model indicated that self-reported OA symptom severity directly influenced illness perceptions, which in turn had direct impacts upon maladaptive coping, distress and QoL. The addition of self-efficacy to the CSM resulted in a complex interaction, with OA severity directly influencing self-efficacy and self-efficacy influencing maladaptive coping, distress and QoL. We found interrelationships amongst OA activity, illness perceptions, coping strategies, self-efficacy, psychological distress and QoL broadly consistent with the CSM. The CSM may help inform the approach to the psychological support that patients with end-stage OA often require.

Automatic effects of illness schema activation on behavioral manifestations of illness.

Relatively little research has directly evaluated the schematic nature of illness representations proposed by the common sense model of illness. Four studies tested the hypothesis that illness schema activation leads directly and automatically to behavioral manifestations of illness. Study 1 was a survey (N = 970) that evaluated the proposition that the mental representation of common cold symptom experience includes functional deviation from the usual prototypical self. Studies 2 and 3 were experiments that tested effects of cold schema activation using a subliminal priming paradigm on walking speed (Study 2, N = 53) and free recall in a memory task (Study 3, N = 30). Study 4 (N = 65) used a 2 (cold prime vs. control) × 2 (alternate self vs. control) experimental design to investigate attenuation of the effect of the cold prime on free recall. Study 1 confirmed the multifactorial nature of functional self-deviations representing the common cold symptomology. Studies 2 and 3 showed that participants primed with the common cold schema walked more slowly and performed worse on a memory recall task relative to controls in whom the schema was not activated. These effects were automatic in the sense that participants were not aware of the prime or of this influence. In Study 4, priming an alternative self-identity overcame the deleterious effect of automatic common cold schema activation on free recall in a memory task. Subliminal activation of a schematic representation of illness automatically activates behavioral manifestations of illness. (PsycINFO Database Record

The role of illness perceptions in predicting outcome after acute whiplash trauma: a multicenter 12-month follow-up study.

To examine (1) whether the patients' perceptions of their symptoms immediately after the accident and at 3-month follow-up predict working ability and neck pain at 12-month follow-up and (2) the possible changes in patients' illness perceptions during the follow-up period. A total of 740 consecutive patients exposed to acute whiplash trauma consulting emergency units and general practitioners in 4 Danish counties from 2001 to 2003. The patients completed questionnaires at baseline, 3-, and 12-month follow-up. Illness perceptions were measured using a condensed version of the Illness Perception Questionnaire and a 1-item question concerning return to work expectation. Neck pain was measured using an 11-point box scale, and working ability was measured by self-report at 12-month follow-up. Multiple logistic regression analyses were applied controlling for possible confounders. Patients with pessimistic illness perceptions at baseline and 3-month follow-up were more likely to experience neck pain and affected working ability at 12 months compared with patients with optimistic illness perceptions. Negative return-to-work expectation predicted affected working ability at 12 months. Furthermore, patients with high neck pain intensity or affected working ability report more changes in their illness perceptions during follow-up than patients with low neck pain intensity or unaffected working ability. The findings are in line with the common-sense model of illness and previous research demonstrating that patient's expectations for recovery and illness perceptions might influence the course after whiplash injury. Illness perceptions and expectations may provide a useful starting point for future interventions and be targeted in the prevention of chronicity.

Analysis of Multiple Partially Ordered Responses to Belief Items with Don't Know Option.

Understanding beliefs, values, and preferences of patients is a tenet of contemporary health sciences. This application was motivated by the analysis of multiple partially ordered set (poset) responses from an inventory on layman beliefs about diabetes. The partially ordered set arises because of two features in the data-first, the response options contain a Don't Know (DK) option, and second, there were two consecutive occasions of measurement. As predicted by the common sense model of illness, beliefs about diabetes were not necessarily stable across the two measurement occasions. Instead of analyzing the two occasions separately, we studied the joint responses across the occasions as a poset response. Few analytic methods exist for data structures other than ordered or nominal categories. Poset responses are routinely collapsed and then analyzed as either rank ordered or nominal data, leading to the loss of nuanced information that might be present within poset categories. In this paper we developed a general class of item response models for analyzing the poset data collected from the Common Sense Model of Diabetes Inventory. The inferential object of interest is the latent trait that indicates congruence of belief with the biomedical model. To apply an item response model to the poset diabetes inventory, we proved that a simple coding algorithm circumvents the requirement of writing new codes such that standard IRT software could be directly used for the purpose of item estimation and individual scoring. Simulation experiments were used to examine parameter recovery for the proposed poset model.

De la definición semántica a los ítems a través de las tablas de especificaciones: elaboración de la escala sobre representación de la enfermedad, e.r.c.e.

The aim of this work is to stress the relevance of all the previous steps before items construction (semantic definition, test and items specifications, experts judges, etc.). There are few works in attitude tests construction where all the steps before items where showed, despite its importance is remarked by standards (AERA, APA, NCME, 1999). The process of ERCE Scale construction is showed as an example in that way. ERCE (De los Santos-Roig, 2009) was developed to assess illness representations which is a construct inserted in Common Sense Model of Illness (Leventhal et al, 1997). In the second part of this work qualitative items analysis of scale is showed and discussed.

Common Sense Model of Illness in Youth With Type 1 Diabetes or Sickle Cell Disease

To qualitatively explore differences in Leventhal's common sense model (CSM) constructs between youth with type 1 diabetes (T1D) and sickle cell disease (SCD) and between different age groups and level of disease control. Two structured individual interviews were conducted in 24 youth with T1D (n=12) or SCD (n=12). Patients were between 8 and 21 years of age, had either good or poor disease control, and were seen at an outpatient children's hospital medical clinic. YOUTH CONCEPTUALIZE THEIR CHRONIC DISEASE IN TERMS OF IDENTITY, CAUSE, TIMELINE, CONTROL, AND CONSEQUENCES: both cognitive and emotional dimensions are apparent. There was considerable contrast between discussions of youth with well- and poorly controlled T1D but little contrast between youth with well- and poorly controlled SCD. Surprisingly, youth with well-controlled T1D mentioned emotions most frequently. No youth with poorly controlled T1D described disease acceptance, but the majority of youth with well-controlled T1D did. Adolescents and young adults with good T1D control appear to understand disease cause, have better illness coherence, and habitually link discussion of symptoms and negative emotions with solutions. Youth with poorly controlled T1D appeared more likely to connect symptoms with negative consequences. Consequences included 1) disease symptoms, 2) the need to perform self-care activities, 3) physical outcomes, 4) health-system activities, 5) emotions, and 6) life impact. Interestingly, sickling crisis was mentioned more frequently by youth with good SCD control than by those with poor SCD control. Youth with SCD are distressed by others' judgmental perceptions and by feeling different from others. In contrast to previous CSM work, youth with well-controlled T1D in this study discussed emotions more frequently than did those with poor control. Disease perceptions were similar between youth with well- and poorly controlled SCD. Results indicate there are noteworthy cognitive and emotional differences between youth with different types of disease and levels of disease control.

Preliminary examination of the relations between disease activity, illness perceptions, coping strategies, and psychological morbidity in Crohnʼs disease guided by the common sense model of illness

An individual's psychological adjustment to illness is influenced by disease severity, illness perceptions, and coping strategies. A more precise understanding of the contribution of each of these factors to a patient's well-being may influence the kind of psychological support required by patients. This study therefore aimed to characterize the contributors to psychological well-being in patients with Crohn's disease (CD). The design was a cross-sectional questionnaire-based study. Ninety-six CD patients (34 males, 62 females, mean age 38 years) attending a tertiary hospital inflammatory bowel disease outpatient clinic were studied. Disease severity was evaluated according to the Crohn's Disease Activity Index (CDAI), coping styles assessed with the Carver Brief COPE scale, illness perceptions explored with the Brief Illness Perceptions Questionnaire (BIPQ), and anxiety and depression measured using the Hospital Anxiety and Depression Scale (HADS). Combining the questionnaire data using structural equation modeling resulted in a final model with an excellent fit (χ(2) (7) = 10.42, P = 0.17, χ(2) /N = 1.49, root mean square error of approximation (RMSEA) < 0.07, comparative fit index (CFI) > 0.97, Goodness-of-fit index (GFI) > 0.97). Disease activity had a significant direct influence on illness perceptions (β = 51, P < 0.001). In turn, illness perceptions had a significant direct influence on depression and anxiety (β = 41, P < 0.001, β = 0.40, P < 0.001, respectively). Use of emotional coping strategies was associated significantly (P < 0.001) with the presence of anxiety and depression. There is an interrelationship between disease activity, illness perceptions, coping strategies, and depression and anxiety. These aspects of psychological processing provide a framework and direction for the psychological support that patients with CD require.

Improving Uptake of Cardiac Rehabilitation: Using Theoretical Modelling to Design an Intervention

Attendance rates at cardiac rehabilitation remain low with typically fewer than 35% of eligible patients attending. Much of the poor attendance stems from invited patients failing to attend. To design a theoretically based intervention to improve attendance at cardiac rehabilitation. Our methods followed recommendations that have been developed from the Medical Research Council (MRC) framework for the design of complex interventions. We conducted three processes that progressed simultaneously: 1) literature review for evidence on epidemiology, behavioural theory, and efficacy of interventions; 2) expert meetings on behavioural theory and to select target points for intervention; and 3) development and theoretical modelling of the intervention. Our final interventions were a theoretically worded invitation letter and leaflet based on the Theory of Planned Behaviour and the Common Sense Model of Illness, designed to: a) motivate patients through professional recommendation; b) provide simple information on the contents of cardiac rehabilitation emphasising ease for participants; c) reassure participants that the programme is tailored to their personal needs in a safe supervised environment; and d) reinforce the benefits of attending cardiac rehabilitation. A theoretically worded letter and leaflet could be an inexpensive intervention to improve attendance at cardiac rehabilitation. The letters and leaflets will now be evaluated in a randomised trial.

Illness schema activation and attentional bias to coping procedures.

Relatively little research to date has directly addressed the schematic nature of illness representations proposed by H. Leventhal, J. Weinman, and L. A. Phillips' (1980) common sense model of illness. The present experiments tested the hypothesis that coping information is schematically encoded within the representations of a specific illness. A 2 (primed vs. control) x 2 (past user of coping strategy vs. nonuser of coping strategy) design was used in 2 experiments with independent samples. A subliminal prime was used to activate a common cold schema outside of conscious awareness. Response latencies in milliseconds for correct responses to a target common cold remedy word on a grammatical decision task served as the dependent measure in each experiment. Target words were Lemsip in Experiment 1 and lozenge in Experiment 2. In each experiment, a significant interaction of Prime x Past Strategy Use was obtained. Participants in whom the "common cold" schema was activated and who also reported high past strategy use demonstrated attentional bias to the name of a popular common cold remedy. Activation of a schematic representation of illness may automatically activate information related to coping procedures encoded in memory with the illness.

Evaluation of second curettage in reduction of persistent mole

The aim of this study was to explore the effect of kidney transplantation (KT) on psychological distress and quality of life (QoL) in patients with end-stage kidney disease using the Common Sense Model of illness adjustment.A total of 52 individuals (35 men and 17 women) with an average age of 53.54 years from a large metropolitan nephrology outpatient clinic participated.Poorer health status, illness perceptions and increased engagement in maladaptive coping were associated with psychological distress (specifically anxiety and depression) and poorer QoL. Hierarchical regression, after correcting for KT characteristics (years since most recent KT, number of transplants) indicated that poorer illness status and illness perception predicted QoL. After controlling for KT characteristics, poorer illness status and greater engagement in maladaptive coping predicted depression. In contrast, poorer illness perceptions and greater engagement in maladaptive coping predicted anxiety. Adaptive problem-focused and emotion-focused coping styles were not found to predict anxiety, depression or QoL.The finding of the present study emphasize on the importance of exploring and understanding the effect of illness status, illness perceptions and coping patterns in patients who have underwent KT.