Revised Illness Perception Questionnaire Research Articles

Psychological and Psychosocial Consequences of Zoonotic Cutaneous Leishmaniasis among Women in Tunisia: Preliminary Findings from an Exploratory Study.

BackgroundThe incidence of zoonotic cutaneous leishmaniasis (ZCL) makes it the most widespread parasitic disease in Tunisia and the Arab world. Yet, few studies have addressed its psychological and psychosocial effects. The purpose of this study was to examine the psychosocial impact of ZCL scars among Tunisian women.MethodsWe conducted an exploratory study, we administered Revised Illness Perception Questionnaire (IPQ-R), World Health Organization Quality Of Life-26 (WHOQOL-26) and Psoriasis Life Stress Inventory (PLSI) to a group of girls and women with ZCL scar in the region of Sidi Bouzid. This group was randomly selected from volunteers who came to primary health care facilities to seek for treatment for any pathology.ResultsDescriptive statistics showed that the collected scores from the three scales exhibit heterogeneous distributions: IPQ-R (M = 63.6, SD = 15.6), PSLI (M = 9.5, SD = 6.7), WHOQOL-Physical (M = 63, SD = 12.9), WHOQOL-Psychological (M = 52.6, SD = 11.1), WHOQOL-Social (M = 61.8, SD = 17.5), and WHOQOL-Environmental (M = 47.8, SD = 13.3). The correlation analyses performed on Inter and intra-subscales showed that the emotional representations associated with ZCL were correlated with the loss of self-esteem and feelings of inferiority (r = 0.77, p<0.05). In addition, high education level and the knowledge about ZCL are positively correlated with cognitive and emotional representation in the IPQ-R (r = 0.33, p<0.05). "Rejection experiences" and the "anticipation and avoidance of stress" were respectively negatively correlated with age (r = -0.33, p<0.05 and r = -0.31, p<0.05). Correlations between the scores on IPQ-R domains and PLSI factors were significant. The results showed that anticipation of rejection and avoidance of stress are strongly correlated with a negative perception of ZCL. Quality of life scores were not correlated with either age, education level, time of illness, or the number of facial or body scars. However, the correlations between quality of life scores and the multiple IPQ-R domains were all insignificant. Finally, there was a negative correlation between the scores on the perceived quality of social life and the knowledge about ZCL (r = -0.34, p<0.05).ConclusionsThis makes it vital to strengthen preventive health education. Conducting studies on ways to establish a holistic support system for managing ZCL, a system that covers the psychological challenges and the barriers it causes to women’s social and professional integration, is a vital first step.

Illness perceptions of gout patients and the use of allopurinol in primary care: baseline findings from a prospective cohort study

BackgroundPatients’ perceptions of their illness are dynamic and can directly influence aspects of management. Our aim was to examine the illness perceptions of gout patients in UK primary care and associations with allopurinol use.MethodsA health questionnaire was sent to 1805 people with gout aged ≥18 years identified by a gout diagnosis or prescriptions for allopurinol or colchicine in their primary care medical records in the preceding 2 years. The questionnaire included selected items from the revised illness perception questionnaire (IPQ-R). Associations between illness perceptions and use of allopurinol were calculated using multinomial logistic regression adjusted for age, gender, deprivation status, body mass index, alcohol consumption, comorbidities and gout characteristics.ResultsOne thousand one hundred eighty-four participants responded to the baseline questionnaire (65.6 %). Approximately half of responders perceived that they were able to control (51.2 %) or affect their gout through their own actions (44.8 %). Three quarters perceived treatments to be effective (76.4 %) and agreed that gout is a serious condition (76.4 %). Patients who agreed that they could control their gout (Relative Risk Ratio, 95 % confidence interval 1.66 (1.12 to 2.45)) and that treatments were effective (2.24 (1.32 to 3.81)) were more likely to currently be using allopurinol than not using allopurinol. However, this significance was attenuated after adjustment for self-reported gout characteristics (1.39 (0.89 to 2.17) & 1.78 (0.96 to 3.29) respectively).ConclusionsPatients who perceive that they can control their gout and that treatments are effective are more likely to be using allopurinol, this suggests that better information is needed for the patient from GPs and rheumatologist to reassure and support their use of ULT.

Online assessment of patients’ work disability representations to promote evidence based practice in rehabilitation setting

The Revised Illness Perception Questionnaire adapted for Work Disability (IPQR-WD) is an adaptation of Illness Perception Questionnaire-Revised: the most used and most comprehensive tool for measuring illness perceptions. Evaluating representations is crucial, since it is a main determinant of return to work in cases of persistent pain due to musculoskeletal disorders. This study aim at facilitating systematic assessment of work disability representations by assessing the usability of the Web platform and the usefulness of automatic interpretation of the results. An exploratory and descriptive study was conducted. Web designers and researchers followed the principles of web surveys of Dillman and colleagues (2000). A convenience sample of individuals absent from work due to musculoskeletal pain ( n = 16) and their rehabilitation professional ( n = 8) were recruited. The socio-demographic profile of the participants, the friendliness of the platform and the usefulness of the interpretation of IPQR-WD (professionals only) were documented by pretested Web-based questionnaires. A total of 16 patients (5 men, 11 women; age ranges 22–62 years, variety of levels of education and familiarity with computers) were interviewed. Descriptive analyzes show that over 75% of patients ( n = 12) perceive the site attractive, airy, pleasant to navigate, organized, easy to complete and having an appropriate download speed. For professionals, all ( n = 8) indicated that the site is very user friendly. One professional said the site is moderately attractive. Seven professional indicated that the interpretation provided automatically is relevant, useful, related to their needs, easy to use and understand and they intend to use in their practice. The web used of the IPQR-WD is considered friendly and relevant by clients and rehabilitation professionals. The free automatic interpretation of results appears important to promote the use of the questionnaire in clinical setting, acting on the main barrier to the use of this new knowledge: lack of time.

Effect of Illness Representations and Catastrophizing on Quality of Life in Adults With Irritable Bowel Syndrome.

There is limited understanding of the influence of psychosocial factors on irritable bowel syndrome (IBS), which contributes to management difficulties and ineffective long-term treatment. The goal of the current study was to assess the effect illness representations and coping had on health-related quality of life (HRQOL) in adults with IBS. Self-report data were collected from 101 adults with IBS. Illness representations were measured with the Revised Illness Perception Questionnaire; catastrophizing was measured with the catastrophizing subscale of the Coping Strategies Questionnaire; and HRQOL was measured using the IBS-Quality of Life Measure. Participants perceived their IBS to be a chronic, cyclical condition with negative consequences, moderate symptomatology, and strong negative emotional impact. Their quality of life was poor and catastrophic thinking was noted to be used. Therefore, integrating illness beliefs and coping style into the management of IBS may improve well-being and minimize suffering. [Journal of Psychosocial Nursing and Mental Health Services, 54(9), 44-53.].

Relationships of anxiety and depressive symptoms with pain perception in post-mastectomy women. An intragroup analysis

Background Breast cancer confronts women with a threat to life and is classified among the most traumatic life experiences. The disease is often accompanied by strong negative emotions, often in the form of anxiety and depressive symptoms. Studies also point to the presence of chronic pain breast-cancer survivors. Objective To determine the relationships of: (1) anxiety and depressive symptoms with the experienced severity and interference of pain in post-mastectomy women; (2) anxiety and depressive symptoms with beliefs about pain. Method The studied group consisted of 53 women after radical mastectomy, experiencing chronic pain, despite positive results of cancer treatment. IPQ-R (Illness Perception Questionnaire – Revised) and HADS (The Hospital Anxiety and Depression Scale) were applied. Results Correlation and regression analyses confirmed relationships of anxiety and depressive symptoms with pain in the group of post-mastectomy women. Cluster analysis separated three groups of patients, differing in the severity of depressive symptoms and anxiety. For each group, a different pattern of beliefs about pain was characteristic. Discussion The study has shown that psychological determinants play a significant role in the perception of pain severity and interference, which are related to anxiety, depressive symptoms and a system of beliefs about pain duration.

Depression and anxiety in patients receiving interferon-alpha: The role of illness perceptions.

Development of psychiatric symptoms during interferon-alpha therapy may be influenced by psychological factors. We examined illness perceptions using the Revised Illness Perceptions Questionnaire in 55 patients with chronic hepatitis C virus infection, due to receive interferon-alpha. The Hospital Anxiety and Depression Scale was used to assess the development of symptoms. Negative identity, consequences and emotional representation beliefs were significantly associated with both higher depression and anxiety scores. Negative illness perceptions play a predictive role in the development of interferon-alpha-induced psychiatric symptoms.

Illness Beliefs in End Stage Renal Disease and Associations with Self-Care Modality Choice

BackgroundInterest in self-care haemodialysis (HD) has increased because it improves patients’clinical and quality-of-life outcomes. Patients who undertake self-management for haemodialysis may hold illness beliefs differently to those choosing institutional care at the time of making the modality choice or moulded by their illness and dialysis treatment experience. Illness perceptions amongst predialysis patients and in those undertaking fully-assisted and self-care haemodialysis are being investigated in a combined cross-sectional and longitudinal study.Study DesignThe study data are derived from the BASIC-HHD study, a multicentre observational study on factors influencing home haemodialysis uptake. 535 patients were enrolled into three groups: Predialysis CKD-5 group, prevalent ‘in-centre’ HD and self-care HD groups (93% at home). We explore illness perceptions in the cross-sectional analyses of the three study groups, using the revised Illness Perception Questionnaire (IPQ-R). Predialysis patients’ illness beliefs were reassessed prospectively, typically between 4 and 12 months after dialysis commencement.ResultsIllness belief subscales are significantly different between in-centre and self-care HD groups. In a step-wise hierarchical regression analysis, after adjustment for age, education, marital status, diabetes, dialysis vintage, depression, anxiety scores, and IPQ-R subscales, personal control (p = 0.01) and illness coherence (p = 0.04) are significantly higher in the self-care HD group. In the predialysis group, no significant associations were found between illness representations and modality choices. In prospectively observed predialysis group, scores for personal control, treatment control, timeline cyclical and emotional representations reduced significantly after commencing dialysis and increased significantly for illness coherence.ConclusionsIllness beliefs differ between hospital and self-care haemodialysis patients. Patient’s affect and neurocognitive ability may have an important role in determining illness beliefs. The impact of modality upon illness representations may also be significant and remains to be explored.

Role and Determinants of Adherence to Off-loading in Diabetic Foot Ulcer Healing: A Prospective Investigation.

Studies indicate that off-loading adherence is low in patients with diabetic foot ulcers (DFUs), which may subsequently delay healing. However, there is little empirical evidence for this relationship or the factors that influence adherence. This prospective, multicenter, international study of 79 (46 from the U.K. and 33 the U.S.) persons with type 2 diabetes and plantar DFUs assessed the association between off-loading adherence and DFU healing over a 6-week period. Additionally, potential demographic, disease, and psychological determinants of adherence were examined. DFUs were off-loaded with a removable device (77% a removable cast walker). Off-loading adherence was assessed objectively by activity monitors. Patient-reported measures included Hospital Anxiety and Depression Scale (HADS), Neuropathy and Foot Ulcer Quality of Life (NeuroQoL) instrument, and Revised Illness Perception Questionnaire (IPQ-R). Off-loading adherence was monitored for 35 ± 10 days, and devices were used during 59 ± 22% of subjects' activity. In multivariate analyses, smaller baseline DFU size, U.K. study site, and better off-loading adherence predicted smaller DFU size at 6 weeks (P < 0.05). Better off-loading adherence was, in turn, predicted by larger and more severe baseline DFUs, more severe neuropathy, and NeuroQoL foot pain (P < 0.05). In contrast, greater NeuroQoL postural instability predicted worse off-loading adherence (P < 0.001). HADS and IPQ-R measures were not significantly associated with off-loading adherence. Off-loading adherence is associated with the amount of DFU healing that occurs, while postural instability is a powerful predictor of nonadherence. Clinicians should take this neuropathic symptom into consideration when selecting an off-loading device, as off-loading-induced postural instability may further contribute to nonadherence.

Study of Relationship Between Illness Perception and Delay in Seeking Help for Breast Cancer Patients Based on Leventhal's Self-Regulation Model.

One of the major causes of morbidity and mortality in breast cancer patients is delay in seeking help. Leventhal's self-regulation model provides an appropriate framework to assess delay in seeking help. The aim of this study was to investigate the relationship between "illness perception" and "help seeking delay" in breast cancer patients based on Leventhal's self-regulation model. In this correlational descriptive study with convenience sampling conducted in 2013, participants were 120 women with breast cancer who were diagnosed in the last year and referred to chemotherapy and radiotherapy centers in Rasht, Iran. Data collection scales included demographic data, Revised Illness Perception Questionnaire (IPQ-R)and a researcher made questionnaire to measure the delay in seeking help. Pre-hospital delay (help seeking delay) was evaluated in 3 phases (assessment, disease, behavior). The data were analyzed using SPSS-19. The mean (SD) age calculated for the patients was 47.3±10.2. Some 43% of the patients had a high school or higher education level and 82% were married. The "pre-hospital delay" was reported ≥3 months. Logistic regression analysis showed that none of the illness perception components were correlated with appraisal and behavioral delay phases. In the illness delay phase, "time line" (p-value =0.04) and "risk factors"(p-value=0.03) had significant effects on reducing and "psychological attributions" had significant effects on increasing the delay (p-value =0.01). "Illness coherence" was correlated with decreased pre-hospital patient delay (p-value<0.01). Women's perceptions of breast cancer influences delay in seeking help. In addition to verifying the validity of Leventhal's self-regulation model in explaining delay in seeking help, the results signify the importance of the "illness delay phase" (decision to seek help) and educational interventions-counseling for women in the community.

Development and preliminary evaluation of the validity and reliability of a revised illness perception questionnaire for healthcare professionals.

BackgroundDiverging perceptions between individual patients with somatic diseases and their healthcare professionals might cause problems in communication and decision-making. To date, no measurement tool is available to compare the illness perceptions between these two groups. The Revised Illness Perception Questionnaire (IPQ-R) is a validated, widely used instrument in many patient populations with somatic conditions. The aim of this study was to adapt the IPQ-R to a healthcare professional’s version (IPQ-R HP) and to perform a preliminary evaluation of its validity and reliability.MethodsAfter adaptation of the IPQ-R HP, 17 doctors from 3 general hospitals and 9 head nurses from a university hospital evaluated the face and content validity of the IPQ-R HP. The results were quantified using the content validity index (CVI) and a modified kappa index (k*). For the reliability measurements a group of nurses from 4 nursing wards participated at 2 time points with an interval of 4 weeks. Internal consistency and test-retest reliability were calculated.ResultsTwenty-eight of the 38 items demonstrated excellent content validity and four items showed good content validity. Four items had a sufficient k* and two items had a low CVI. The average CVI of the 7 dimensions ranged from 0.66 to 0.89. The Cronbach’s alpha scores for the seven dimensions, intraclass coefficients and effect size estimates were acceptable.ConclusionsThis preliminary evaluation of the IPQ-R HP shows an acceptable to good validity and reliability. Further exploration of the psychometric properties of this questionnaire in a large cohort of healthcare professionals is warranted.Electronic supplementary materialThe online version of this article (doi:10.1186/s12912-016-0156-4) contains supplementary material, which is available to authorized users.

Using Mixed Methods to Examine the Role of Veterans’ Illness Perceptions on Depression Treatment Utilization and HEDIS Concordance

Although depression screening occurs annually in the Department of Veterans Affairs (VA) primary care, many veterans may not be receiving guideline-concordant depression treatment. To determine whether veterans' illness perceptions of depression may be serving as barriers to guideline-concordant treatment. We used a prospective, observational design involving a mailed questionnaire and chart review data collection to assess depression treatment utilization and concordance with Healthcare Effectiveness Data and Information Set guidelines adopted by the VA. The Self-Regulation Model of Illness Behavior guided the study. Veterans who screened positive for a new episode of depression at 3 VA primary care clinics in the US northeast. The Illness Perceptions Questionnaire-Revised, measuring patients' perceptions of their symptoms, cause, timeline, consequences, cure or controllability, and coherence of depression and its symptoms, was our primary measure to calculate veterans' illness perceptions. Treatment utilization was assessed 3 months after the positive depression screen through chart review. Healthcare Effectiveness Data and Information Set (HEDIS) guideline-concordant treatment was determined according to a checklist created for the study. A total of 839 veterans screened positive for a new episode of depression from May 2009-June 2011; 275 (32.8%) completed the survey. Ninety-two (33.9%) received HEDIS guideline-concordant depression treatment. Veterans' illness perceptions of their symptoms, cause, timeline, and controllability of depression predicted receiving guideline-concordant treatment. Many veterans are not receiving guideline-concordant treatment for depression. HEDIS guideline measures may not be assessing all aspects of quality depression care. Conversations about veterans' illness perceptions and their specific needs are encouraged to ensure that appropriate treatment is achieved.

Causal attribution among women with breast cancer

Causal attribution among women with breast cancer was studied. The study included 157 women outpatients with breast cancer. A form for sociodemographic and clinical data and the Revised Illness Perception Questionnaire (IPQ-R) were used. The results showed that women attributed breast cancer primarily to psychological causes, which does not correspond to known multifactorial causes validated by the scientific community. Providing high quality, patient-centered care requires sensitivity to breast cancer women’s beliefs about the causes of their cancer and awareness of how it can influence patient’s health behaviors after diagnosis. If women with breast cancer attribute the illness to modifiable factors then they can keep a healthy lifestyle, improving their recovery and decrease the probability of cancer recurrence after diagnosis.

The measurement of psychological constructs in people with osteoarthritis of the knee: a psychometric evaluation

Purpose To examine the measurement properties of measures of psychological constructs in people with knee osteoarthritis. Method Participants with osteoarthritis of the knee completed the beck depression inventory (BDI-II), state-trait anxiety inventory (STAI), arthritis helplessness index (AHI), fatigue severity scale (FSS), coping strategies questionnaire (CSQ), beliefs about pain control questionnaire (BPCQ), illness perceptions questionnaire-revised (IPQ-R), pain self-efficacy questionnaire (PSEQ) at home as part of a set of measures covering different aspects of osteoarthritis pain. The questionnaires were returned by pre-paid envelope. Rasch analysis was used to check the psychometric properties of the scales in people with osteoarthritis. Results The STAI-SF was an acceptable measure of anxiety and the revised FSS an acceptable measure of fatigue, with removal of items 1 and 2. The BDI subscales were acceptable for measuring negative thoughts and behaviours related to depressive symptomatology with some modifications to the scale. The helplessness scale of the AHI was acceptable as a measure of helplessness. The PSEQ was an acceptable measure of self-efficacy and the CSQ as a measure of cognitive coping strategies. The BPCQ and IPQ-R did not fit the Rasch model. Conclusions These findings indicate that questionnaires need to be checked for their ability to measure psychological constructs in the clinical groups to which they will be applied.Implications for RehabilitationFor people with osteoarthritis, the STAI-SF is an acceptable measure of anxiety and the revised FSS an acceptable measure of fatigue with removal of items 1 and 2.The BDI subscales, but not the total score, are acceptable for measuring depressive symptomatology with some modifications to the scoring of the scale. And helplessness can be measured using the Helplessness subscale of the AHI.The PSEQ was an acceptable measure of self-efficacy and cognitive coping strategies can be measured with the CSQ.Rasch analysis highlighted lack of unidimensionality, disordered response thresholds and poor targeting in some measures commonly used for people with osteoarthritis

What are the combined effects of negative emotions and illness cognitions on self-care in people with type 2 diabetes? A longitudinal structural equation model

Objective: To explore whether negative emotions mediate the effect of diabetes cognitions on diabetes self-care and conversely whether diabetes cognitions mediate the effect of negative emotions on diabetes self-care.Design: Longitudinal observational study in adults with type 2 diabetes.Main outcome measures: Self-reported depression and anxiety (Diabetes Wellbeing Questionnaire), cognitions (Illness Perceptions Questionnaire-Revised; Beliefs about Medicines Questionnaire), and diabetes self-care (Summary of Diabetes Self-Care Activities Scale) were completed at baseline and six months. Analyses used structural equation modelling.Results: Baseline medication concerns were associated with elevated symptoms of depression and anxiety at follow-up, but emotions did not mediate medication concern’s effect on diabetes self-care. Baseline depression and anxiety symptoms were associated with specific diabetes cognitions over time, but these cognition domains did not mediate emotion’s effect on diabetes self-care. Personal control remained independent of emotions and was associated with diabetes self-care over time.Conclusions: Negative emotions did not act directly or alongside cognitions to influence diabetes self-care. The reciprocal relationship between diabetes cognitions and emotions suggests cognitive restructuring, in addition to other mood management intervention techniques would likely improve the emotional wellbeing of adults with type 2 diabetes. Likewise, personal control beliefs are likely important intervention targets for improving self-care.

Impaired quality of life in systemic sclerosis and patient perception of the disease: A large international survey.

The purpose of this study was to assess health-related quality of life (HRQoL) and disease perception in a large, international group of patients with systemic sclerosis (SSc). We placed a standardized questionnaire on a website for patient access. Socio-demographic information, disease characteristics, and self-assessment questionnaires-the Short Form 36 (SF-36) and the Revised Illness Perception Questionnaire (IPQ-R)-were collected. A total of 1902 patients from 60 countries were included. HRQoL appeared to be impaired in SSc, particularly for physical health (PCS, mean ± SD = 43.4 ± 23.4). SSc patients also had strong perceptions about the chronic nature and negative consequence of the disease, and experienced negative emotions due to SSc. Patients with diffuse cutaneous SSc had a poorer HRQoL than those with limited cutaneous SSc, for both physical (PCS, mean ± SD = 46.6 ± 23.7 vs. 39.8 ± 22.3; p < 0.0001) and mental components (MCS, mean ± SD = 53.8 ± 23.0 vs. 50.3 ± 23.2; p = 0.003). Late-stage SSc patients were more likely to perceive their disease chronic (p < 0.0001), less controllable (p = 0.03) and with more consequences (p = 0.008), but they had a better understanding of their disease and experienced fewer negative emotions. Raynaud's phenomenon and gastrointestinal complications were the organ involvements with the greatest impact on QoL, they were the two variables associated with the most negative perception of illness severity. This study, performed on the largest group ever set up for this purpose, confirms the major impact on QoL and the negative perceptions of their disease expressed by SSc patients. However, the perception of this illness tended to improve with disease duration, suggesting that patients find effective coping strategies.

Psychometric properties of a caregiver illness perception measure for caries in children under 6 years old

ObjectiveBased on the Common-Sense Model of Self-Regulation (CSM), the Revised Illness Perception Questionnaire (IPQ-R) was developed to measure patients' perceptions of their chronic medical illness. Such a measure does not exist for dental conditions. This study describes psychometric properties of the IPQ-R for Dental (IPQ-RD) for parent/caregivers of children under 6years of age. MethodsParent/caregivers (n=160) of children aged <6years attending a pediatric dental clinic completed the IPQ-RD and a questionnaire assessing their socio-demographics, dental anxiety, oral health self-efficacy, and child's preventive dental visits. Dental charts were abstracted for child's decayed, missing, filled teeth (dmft) information. The 33-item IPQ-RD was tested for internal (construct, discriminant) and external validity (concurrent, convergent, discriminant) and reliability (internal consistency). ResultsConfirmatory factor analysis demonstrated that the eight-factor model in accordance with the CSM framework (identity, consequences–child, consequences–caregiver, control–child, control–caregiver, timeline, illness coherence, emotional representations) had good construct validity based on significant factor loadings and acceptable to excellent model fit (RMSEA=0.078, CFI=0.951). Concurrent validity was demonstrated by significant negative correlations and higher mean factor scores for five constructs for children without dental visits indicating inaccurate caregiver perception of cavities. Discriminant validity was suggested by non-relationship with external measures (dental anxiety, self-efficacy). Internal consistency of six IPQ-RD constructs was excellent (Cronbach's alpha >0.74). ConclusionThe IPQ-RD is a valid and reliable measure to assess parent/caregivers' representation of young children's cavities with potential to be a valuable risk assessment tool for oral health behavioral research.

Being a peer mentor for a person recovering from an acute myocardial infarction

Challenge after an acute myocardial infarction (AMI) is to manage the disease and to prevent a second AMI. Other people with the same illness have a unique understanding of the situation; therefore, they can provide valuable support. Being a peer mentor and contributing one’s own experiences of the same illness can even lead to increased self-confidence. The aim was to describe personal perceptions of being a peer mentor for a person recovering from an AMI. Patients in three sparsely populated counties, who had experienced their first AMI the previous year, were offered contact with peer mentors. The peer mentors had experienced an AMI between one and ten years ago. Sixteen of them were interviewed after one year as mentor. The interview texts were analysed using qualitative content analysis. Two themes summarized the interview results, “being in charge” and “being comfortable”, which incorporated six subthemes. The peer mentors also answered a questionnaire, and according to the purpose of the study, certain parts of the questionnaires were analysed using a paired-sample t -test. The dimensions measured in the Revised Illness Perception Questionnaire (IPQ-R) showed significant increased mean values, including Illness Coherence ( p ≤ .001) and Emotional representation ( p ≤ .05). Highlights of the results included that being a peer mentor led to feelings of pride and that peer mentors should be preceded by a careful matching between patients and mentors.

Influence of Illness Representations on Self-Management Behaviors in Korean Hypertensive Patients

Purpose: The purposes of this study were to investigate the factors related to illness representations and their influence on self-management behaviors in hypertensive patients, based on Leventhal’s common-sense model. Method: A cross-sectional study was conducted with a convenience sample of 149 patients with hypertension. Illness representations were assessed with the Illness Perception Questionnaire-Revised (IPQ-R) and data were analyzed using t-test, ANOVA, Pearson’s correlations, and hierarchical regression analysis. Results: There were differences in patients’ illness representations depending on their demographic and healthrelated characteristics including medication adherence and the amount of time since hypertension diagnosis. Two dimensions of illness representations, in terms of predictability (β=-0.226, p=0.036) and coherence (β=0.246, p=0.029), were significant factors predicting self-management behaviors, indicating that patients who believed hypertension was more predictable and who were more confident of their awareness about hypertension engaged more actively in selfmanagement behaviors. Conclusion: This study demonstrates the critical role of illness representations, leading to self-management behaviors of hypertensive patients. The findings highlight that a concrete assessment of illness representations is an essential task when developing nursing interventions to facilitate active self-management of hypertension.

The relation between illness perceptions and psychiatric morbidity among patients with vitiligo, in Al-Madinah, Saudi Arabia

Background: Vitiligo is a prevalent macular skin depigmentation that can impose significant psychiatric morbidity in terms of depression and anxiety. Patients with vitiligo, as well as other chronic diseases, react to their illness by developing their own beliefs and perceptions that might affect their health and well-being. Objective: This study aimed to assess the rate of depression and anxiety among patients with vitiligo, and to evaluate the relation between patients’ perceptions regarding vitiligo and the increased likelihood of depression and anxiety. Materials and Methods: This cross-sectional study included consecutive adult patients with vitiligo who attended the Laser and Skin Clinic in King Fahd Hospital, in Al-Madinah, Saudi Arabia. Participants were invited to respond to the Arabic versions of the Hospital Anxiety and Depression Scale (HADS), and the Revised-Illness Perceptions Questionnaire (IPQ-R). Patients’ sociodemographic characteristics were recorded. Results: Out of 132 patients, 49 (37.1%) had depression and 56 (42.4%) had anxiety. Pearson’s correlation showed significant association between depression and anxiety, and various dimensions of the patients’ poor illness perceptions (P < 0.05). Multivariate logistic regression analysis revealed that poor personal control over illness was the most significant independent variable associated with psychiatric morbidity (OR = 11.7; 95% CI, 2.9–48.2 for depression; and OR = 17.6; 95% CI 3.7–84.6 for anxiety), followed by patients’ beliefs in serious consequences, more perceived severity, and less trust in treatment effect. The risk of psychiatric morbidity was associated with patient’s younger age, female gender, being unmarried, and unemployed. Conclusion: Poor illness perceptions were clearly adversely affecting the psychological well-being of patients with vitiligo with a resulting increased rate of depression and anxiety.

Validation of the revised illness perception questionnaire for migraine patients and the effects of earthquake experience on perception of disease

The aim of this study was to investigate the reliability of the Revised Illness Perception Questionnaire (IPQ) and to determine the effects of earthquake experience on the perception in migraine patients. The sample was composed of 62 outpatients, consisting of with migraine diagnosis who were in Erciş during earthquake (n=33) and who had never had any earthquake experience (n=29).The interview form, IPQ-R and Beck Depression Scale (BDS) were applied. The study was carried out on migraine patients whose mean age was 31 and who had been diagnosed since 7.8 years. Comparison of groups with earthquake experience (group1) and without experience (group 2) there were no difference in point of demographic findings and disease severity (p>0.05). In the part concerning the manifestations of the disease, the most frequently manifestations were found pain, headache and fatige. The test was determined to be reliable. Illness coherence and timeline (cyclic) subscale scores (p<0.05) and BDS score (z: -2.006, p<0.05)were significantly higher in group 1. Although an earthquake caused an increase in depression scores did not cause much change in the IPQ-R scores. Group1 understand disease better and realize of the cyclical nature of the disease. Other perception parameters of the disease were same in both groups. A severe life event such as an earthquake did not much change IPQ-R scores in migraine patients. The results of this study demonstrated that IPQ could be used reliably in the Turkish migraine patients.