Impact Of Illness Perceptions Research Articles

The Impact of Illness Perception on Medication Adherence to Inhaler Therapy in Elderly Individuals With COPD.

Medication adherence to inhaler therapy is pivotal for optimizing the management of COPD. Individuals with COPD often have suboptimal adherence behaviors to inhaler therapy. Illness perception and beliefs about medicines have been proved to be associated with medication adherence. Nevertheless, the influence of illness perception and medication beliefs on adherence to inhaler therapy among elderly individuals with COPD in China remains unclear. A cross-sectional study was conducted in 252 elderly subjects with COPD in China from June 2022-September 2023. The Test of Adherence to Inhalers, the Brief Illness Perception Questionnaire, and the Belief About Medicines Questionnaire (BMQ) were utilized. Spearman correlations, regression analysis, and parallel mediation analysis were employed to assess the correlations and mediating effects among beliefs about medicines, illness perception, and medication adherence to inhaler therapy. Medication adherence to inhaler therapy exhibited a negative correlation with concerns beliefs, while showing positive correlations with illness perception, necessity beliefs, and total BMQ scores. Mediating effects of concerns beliefs and necessity beliefs were observed in the relationship between perception of illness and medication adherence to inhaler therapy. This study suggests that essential interventions targeting beliefs about medicines in elderly individuals with COPD should be implemented to optimize the level of their inhaler adherence, particularly in those with low levels of necessity beliefs or high levels of concerns beliefs.

Association between illness perception and medication adherence in patients with diabetes mellitus in North Shoa, Zone: cross-sectional study.

Although the impact of illness perception on medication adherence is well-established, its specific influence on medication adherence in Ethiopia remains unclear. Consequently, the objective of this study was to examine the association between illness perception and medication adherence among patients with diabetes mellitus in the North Shoa Zone. An institution-based cross-sectional study was conducted from 24 May to 25 June 2022 in the North Shoa zone. The study included a random sample of 552 individuals with diabetes from four public hospitals. Data was collected and entered into Epi Data V.3.1, and analysis was performed using SPSS version 22. Descriptive statistics were used to summarize continuous variables as means with standard deviations, while categorical variables were presented as percentages. The study variables were analyzed using binary logistic regression models to assess the associations between illness perception and medication adherence. In the bivariable analysis, variables with p-values less than 0.20 were entered into a multivariable logistic regression model. Associations with a p-value ≤0.05 and an odds ratio with a 95% confidence interval were considered statistically significant. The study results revealed that medication adherence was 64.4% (95% CI: 60.1, 67.9), while illness perception was 54.7% (95% CI, 41.2, 49.4). There was a significant and strong association between illness perception and medication adherence (p < 0.0001). In the adjusted model, the illness perception components of consequence showed a significant association with medication adherence (AOR = 3.10, 95% CI: 2.11, 4.55). Similarly, personal control (AOR = 1.77, 95% CI: 1.20, 2.61) and emotional representation of diabetes (AOR = 2.26, 95% CI: 1.54, 3.32) were also significantly associated with medication adherence in patients with diabetes. The findings of this study indicate a positive association between higher illness perception and increased medication adherence and practice. Therefore, when engaging in discussions about diabetic self-management, diabetes educators should employ psychoeducational approaches that take into account the illness perceptions of patients.

The impact of illness perception on medication adherence in pediatric patients with familial Mediterranean fever

Objective: Poor adherence to medications is an important problem, especially in patients with chronic diseases such as familial Mediterranean fever (FMF). In this study, we aimed to evaluate medication adherence in pediatric FMF patients and investigate the relationship between disease perception and treatment compliance. Method: Pediatric patients (&lt;18 years old) with a diagnosis of FMF and at least six months of follow-up period participated in the study. Patient perceptions of illness and medication adherence were measured via a brief illness perception questionnaire (brief IPQ) and the Medication Adherence Scale in FMF Patients (MASIF), respectively. Results: A total of 50 patients (46% girls, n: 23) with a median age of 9.9 (IQR 5.9-15.8) years were included. The median age at diagnosis was 5.4 (IQR 3.2-10.1) years. Twenty-eight patients (56%) had good medication adherence (the MASIF score&gt;60), while 44% of the patients were non-adherent to the treatment. Patients aged under 12 years of age were more adherent to colchicine treatment than those over 12 years of age (68.2% vs. 25.0%, p= 0.002). The comparison of the illness perception and medication adherence revealed higher brief IPQ total scores in patients who adhered to the treatment (median 48.5 vs 52.5, p=0.037). We found significant differences in timeline scores between patients who were adherent and those who were non-adherent to the treatment (p=0.01). Conclusion: Non-adherence to medication is an important and widespread problem, particularly among adolescent patients. Perceptions of the illness and beliefs about the duration of the disease may affect adherence to treatment. Medication adherence should be routinely assessed at follow-up visits and educational interventions might improve adherence to the treatment.

Impact of Illness Perceptions on Poststroke Activity Engagement and the Moderating Role of Gender.

Beyond existing knowledge of demographic and performance skill factors, establishing relationships between poststroke activity engagement and illness perceptions sets the stage for the development of more effective intervention strategies. To describe the illness perceptions of community-dwelling people with stroke in the first 2 yr poststroke; specifically, to examine whether illness perceptions are associated with activity engagement and to explore the moderating role of gender in these relationships. Cross-sectional study. Participants were recruited from eight rehabilitation settings in Beijing, China. 202 community dwellers with stroke. Activity engagement and illness perceptions were measured with the Mandarin version of the Assessment of Life Habits and the Chinese version of the Stroke-Specific Illness Perceptions Questionnaire-Revised, respectively. Participants' demographic information, cognitive status, and motor function were also collected. Stronger perceptions of consequences and controllability were related to better performance in activity engagement at the personal level, and stronger perceptions of illness coherence were related to better performance in activity engagement at the societal level. In addition, gender differences in the relationship between illness perceptions and activity engagement were described. How people with stroke perceived their conditions dictated their levels of activity engagement in their community of residence. The findings suggest that understanding clients' illness perceptions may assist practitioners in developing comprehensive, targeted interventions to improve activity engagement and maximize recovery after stroke. Future studies are needed to explore the gender effect of illness perceptions on activity engagement in people with stroke. What This Article Adds: This study identified the relationships between illness perceptions and level of activity engagement in real-life environments in people with stroke. In addition to motor and cognitive interventions, providing opportunities for clients to gain a better understanding of stroke would facilitate their activity engagement in their real-life environment.

Shared decision-making for renal replacement treatment and illness perception in patients with advanced chronic kidney disease

BackgroundCurrent healthcare trends emphasize the use of shared decision-making (SDM) for renal replacement treatment (RRT) in patients with chronic kidney disease (CKD). This is crucial to understand the relationship between SDM and illness perception of CKD patients. Few studies have focused on SDM and illness perception status of CKD patients and the impact of illness perception on RRT after SDM.MethodsIn this cross-sectional study, we used a questionnaire with purposive sampling from March 2019 to February 2020 at the nephrology outpatient department of a medical center in southern Taiwan. The nephrology medical team in this study used the SHARE five-step model of SDM to communicate with the patients about RRT and Brief Illness Perception Questionnaire (BIPQ) was applied to evaluate illness perception of these patients at the beginning of SDM. According to the SDM decision time, the study participants were classified general and delayed SDM groups. The distribution between SDM groups was estimated using independent two sample t-test, chi-squared test or Fisher’s exact test. The correlation between illness perception and SDM decision time were illustrated and evaluated using Spearman’s correlation test. A p-value less than 0.05 is statistically significant.ResultsA total of 75 patients were enrolled in this study. The average time to make a dialysis decision after initiating SDM was 166.2 ± 178.1 days. 51 patients were classified as general group, and 24 patients were classified as delayed group. The median SDM decision time of delayed group were significantly longer than general group (56 vs. 361 days, P < 0.001). Our findings revealed that delayed group was significantly characterized with not created early surgical assess (delayed vs. general: 66.7% vs. 27.5%, p = 0.001) compared to general group. The average BIPQ score was 54.0 ± 8.1 in our study. We classified the patients into high and low illness perception group according to the median score of BIPQ. The total score of BIPQ in overall participants might increase by the SDM decision time (rho = 0.83, p = 0.830) and the linear regression line also showed consistent trends between BIPQ and SDM decision time in correspond cohorts. However, no statistically significant findings were found.ConclusionsThe patients with advanced chronic kidney disease took an average of five and a half months to make a RRT decision after undergoing SDM. Although there is no statistical significance, the trend of illness perception seems correlated with decision-making time. The stronger the illness perception, the longer the decision-making time. Furthermore, shorter decision times may be associated with earlier establishment of surgical access. We need more research exploring the relationship between illness perception and SDM for RRT in CKD patients.

The impact of illness perception on functionality, pain, stiffness, and activity of daily living after total hip replacement surgery

ObjectiveAccording to the Common Sense Model (CSM), cognitive and emotional representations influence recovery. We used groups of individuals grouping multiple cognitive representations (schemas) to predict the recovery process after total hip arthroplasty (THR). MethodsThe aim of this prospective cohort study with three collection time points was to examine the significance of these schemas for functionality three and six months after THR. We assessed illness perception with the Illness Perception Questionnaire-Revised and the functionality with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Data were collected four weeks before (n = 317), three (n = 268), and six months after (n = 292) primary THR. Groups of individuals with the same schemas were identified using a two-step cluster analysis across cognitive representations. Controlling for WOMAC variables (functionality, stiffness, pain, and activities of daily living) before THR, we calculated the regression of schemas and emotional representations before THR on WOMAC variables after THR. ResultsBefore THR, two cognitive schemes were found: Schema One: medium identity, long duration, many consequences, low personal and treatment control, and low coherence; Schema Two: low identity, short timeline, low consequences, and high personal and treatment control. Patients with Schema Two had better functionality and lower pain and stiffness three months after surgery compared to those with Schema One. After three months, the influence of cognitive schemas was stronger on functionality than that of emotional representation (f2: 0.04 /0.02). ConclusionFurther study is needed to determine whether a psychological intervention can change Schema One.

The Impact of Illness Perceptions on Depressive Symptoms Among Benign Prostatic Hyperplasia Patients with Lower Urinary Tract Symptom.

ObjectiveThis study aimed at exploring whether illness perceptions may mediate the relationship between depressive symptoms and lower urinary tract symptoms (LUTS) among benign prostatic hyperplasia (BPH) patients.MethodsThe Patient Health Questionnaire (PHQ-9) for depression, the International Prostate Symptom Score (IPSS) for the severity of LUTS and the brief Illness Perception Questionnaire (B-IPQ) for illness perceptions (IPs) were used among the 157 BPH patients with LUTS. Pearson’s correlation test and hierarchical regression analyses were used to assess the correlations between LUTS, depressive symptoms and IPs.ResultsOur study found that the severity of LUTS was associated with depressive symptoms and subscales of illness perception; meanwhile, IPs were associated with the level of education. A positive relationship was found between the scores of PHQ9 and the B-IPQ subscales of illness consequences, identity, timeline, concern and emotion; thus, a negative correlation was found between scores of PHQ9 and the B-IPQ subscales of illness coherence, personal control and treatment control. The hierarchical regression analysis showed IPSS and the B-IPQ subscales of illness consequences, concern and emotion were significantly associated with depression, and explained 85.1% of the variance in depressive symptoms (R2 = 0.851, p < 0.05).ConclusionThe relationship between LUTS and depressive symptoms may be mediated by the negative IPs, including consequences, concern and emotions. Clinicians should not only focus on the LUTS but also on the IPs to improve depressive symptoms among BPH patients.

IMPACT OF ILLNESS PERCEPTION AND COPING STRATEGIES ON QUALITY OF LIFE AMONG MIGRAINEURS

Objectives: To find out the impact of illness perception and coping strategies on quality of life among migraineurs.&#x0D; Study Design: Correlational study.&#x0D; Place and Duration of Study: The sample was selected from different hospitals of Hazara Division, from Mar to Jul 2018.&#x0D; Methodology: The sample of 300 migraineurs with age range 18-55 years was selected from hospitals of Hazara Division through purposive sampling technique. Brief illness perception questionnaire, The World Health Organization Quality of Life Scale (WHOQOL-BREF) and brief cope scale were used for data collection.&#x0D; Results: Illness perception significantly predicted (p=0.002) quality of life in positive direction. The results also explored that positive coping (p≤0.001) and problem focused coping strategies (p=0.002) predict quality of life significantly positively; whereas active avoidance coping strategies (p≤0.001) significantly negative predict quality of life; while religious denial coping was non-significant predictor of quality of life.&#x0D; Conclusion: Illness perception has significant negative relationship with quality of life, problem-focus coping (PFC), and positive coping (PC). Illness perception has significant positive relationship with religious denial coping (RDC) and active avoidance coping (AAC).

Impact of Illness Perception on the Health-Related Quality of Life of Patients Receiving Dialysis: A Cross-Sectional Study.

BackgroundEnd-stage renal disease (ESRD) is a major health problem worldwide that is increasing in incidence, prevalence, and cost. Both the disease itself and negative illness perceptions negatively affect patients' health-related quality of life (HRQoL), morbidity, and mortality. This study assessed the relationship between illness perception and HRQoL.MethodsThis cross-sectional study was conducted among 342 patients at five dialysis centers in Jeddah, Saudi Arabia. We used a self-administered questionnaire that containing demographic questions, the Revised Illness Perception Questionnaire, and the Short Form 36 Health Survey Questionnaire. The data were analyzed using t-tests, analyses of variance, Pearson's correlation coefficients, and multiple linear regression analyses.ResultsThe mean (SD) age was 46.1 (16.5) years and the majority were men (53.8%). Except for treatment control, all domains of illness perception were significantly correlated with HRQoL; however, the correlations were positive only for personal control and illness coherence. Identity, disease timeline (acute/chronic), consequences, illness coherence, and emotional representations were independent predictors of HRQoL; together explaining 35% of the variance. Lower emotional response was the only domain of illness perception significantly associated with better HRQoL in both dialysis modalities across all dialysis centers.ConclusionThere were clear effects of illness perception on HRQoL, with emotional representations being the strongest predictor. As such, emotional representations should be targeted in interventions.

The Impact of Illness Perceptions and Coping Strategies on Use of Supportive Care for Cancer.

Simple SummaryCancer survivorship support programmes improve wellbeing, but most oncology patients and survivors do not use them. The current study examined whether people who saw themselves as having greater personal control over their illness used more problem-focused coping strategies, and if this resulted in higher use of survivorship support services. The study also examined the possibility that use of supportive care services was higher amongst those patients who used more emotion-focused coping strategies and who were experiencing greater emotional distress about their cancer. We found that people using more survivorship support services tended to have a greater belief in their ability to do something to control their cancer but were not emotionally distressed.Despite evidence that survivorship support programmes enhance physical and psychosocial wellbeing, cancer patients and survivors often do not use these supportive care services. This study investigated the utility of the Common Sense Model of Self-Regulation for predicting supportive care use following cancer, and the mediating role of coping strategies. Cancer patients and survivors (n = 336 from Australia, n = 61 from the UK; 191 males, 206 females) aged 20–83 years (Mean (M) = 62.73, Standard Deviation (SD) = 13.28) completed an online questionnaire. Predictor variables were cognitive and emotional representations of cancer, as measured by the Illness Perception Questionnaire—Revised (IPQ-R), and problem- and emotion-focused coping strategies, as measured by the Brief-Coping Orientation to Problems Experienced inventory (Brief-COPE). The outcome variable was survivorship support programme use within the preceding month. Perceived personal control over cancer predicted supportive care use, but cancer-related emotional distress did not. Coping was an inconsistent mediator of the relationships. Problem-focused coping mediated the relationship between personal control and supportive care use; emotion-focused coping did not mediate between emotional responses to cancer and the uptake of survivorship support programmes. The Common Sense Model provides a useful framework for understanding survivorship support programme use. However, more clarity around the relationship between illness beliefs and coping is required.

Impact of illness perception, mental adjustment, and sociodemographic characteristics on return to work in patients with head and neck cancer

To examine the effects of emotional distress, illness perception, and mental adjustment on return to work (RTW) among patients with head and neck cancer (HNC) and identify factors associated with RTW. A cross-sectional study with convenience sampling was conducted in Taiwan. Structured questionnaires were used to collect data on RTW status and to explore possible factors related to RTW. RTW status was assessed by a single question. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, illness perception was assessed by the Brief Illness Perception Questionnaire, and mental adjustment was assessed using the Mini-mental Adjustment to Cancer Scale. Sociodemographic and disease background data were also collected and analyzed. Factors related to RTW were identified by multivariate logistic regression. A total of 150 patients with HNC were recruited into the study. Of them, 58 (38.7%) returned to work after treatment. Compared to those who did not RTW, patients who did RTW had lower levels of emotional distress (anxiety and depression), better illness perception (cognitive illness representations and illness comprehensibility), and better mental adjustment (hopelessness and helplessness, anxious preoccupation, avoidance, and fatalism). Multivariable analysis indicated that anxiety (OR = 0.863, p < 0.05), avoidance (OR = 1.280, p < 0.001), cognitive illness representations (OR = 0.891, p < 0.01), illness comprehensibility (OR = 1.271, p < 0.05), higher education level (OR = 3.048-3.609, p < 0.05), married status (OR = 5.220, p < 0.05), tumor site in oral cavity (OR = 5.057, p < 0.05), and no reconstruction (OR = 3.415, p < 0.05) were significantly associated with RTW. The issue of RTW among patients with HNC is related to multidimensional factors, including sociodemographic, psychological, and disease-related situations. We suggest that programs for emotional rehabilitation and occupational counseling need to be developed to assist patients with HNC to RTW at an early stage.

Evidence, theory and context: using intervention mapping in the development of a community-based self-management program for chronic low back pain in a rural African primary care setting - the good back program

BackgroundRural Nigeria has one of the greatest burdens of low back pain but there are no effective evidence-based interventions to manage it in this population. This paper presents the application of the intervention mapping (IM) approach in the development of a complex behavior change intervention – The Good Back program, aimed at reducing non-specific chronic low back pain (CLBP) disability in rural Nigeria.MethodsThe first four steps of IM were applied. A critical review of the literature, 2 qualitative studies and a population-based cross-sectional study in rural Nigeria helped to identify two key program objectives in order to reduce CLBP disability in this population: reduce the impact of illness perceptions, fear avoidance beliefs, catastrophising, anxiety and depression by targeting maladaptive illness perceptions about CLBP; and facilitate the adoption of exercises and good posture to limit disability. A systematic review plus these studies, identified the personal and environmental determinants of the performance objectives including health literacy, self-awareness, self-efficacy, personal preference, health professional skills, health facility structure and family/community support. The theory, techniques and strategies for modifying personal and environmental determinants were also identified from these studies. Intervention components and materials were then produced for practical application. The initial developed intervention was described.ResultsThe feasibility and acceptability of the developed program was then tested using a small pragmatic non-randomised controlled study incorporating qualitative exit feedback interviews in a rural Nigerian primary health care centre. The program appeared feasible and acceptable when delivered by a highly trained physiotherapist. There were promising clinical outcomes in disability, pain intensity, illness perceptions, fear avoidance beliefs and pain medication use. Suggestions for program improvement included shorter but ongoing sessions, video demonstration of exercises/good posture, spacious exercise/demonstration rooms, and community legitimisation of exercise as treatment for back pain. Subsequent modifications to program content and delivery were then described. Theoretical modification included the addition of aspects of the social cognitive theory to the Leventhal’s self-regulatory model of illness cognitions.ConclusionsIM appears to be a suitable framework for designing complex behavior change interventions in rural Nigeria. The need for further testing of the intervention was highlighted.

Exploring the relationship between illness perceptions and depression in patients with chronic kidney disease: A systematic literature review.

The prevalence of depression is found to increase from early stages to later stages of chronic kidney disease. Research on illness perceptions in patients undergoing dialysis has confirmed that patients' beliefs are associated with important outcomes; one of the most significant being depression. However, the association between illness perceptions and depression in patients in pre-dialysis care remains unclear. The main objective of this systematic review was to explore the associative relationship between illness perceptions and depression in patients with CKD prior to the commencement of dialysis. The inclusion criteria for papers in this review were studies investigating illness perceptions and depression in patients diagnosed with CKD. Eligible studies were identified by searching the following electronic databases; Medline, CENTRAL, Embase, Psych INFO, Web of Science and Scopus. Data on the participants and the severity of kidney disease, illness perceptions and depression were extracted. Sixty-four studies met the criteria for full text review and of these, only four studies met the inclusion criteria following data extraction and quality assessment. Consistent with the common sense model, disease severity was found to be significantly associated with illness perceptions, and both were found to be associated with depression CONCLUSIONS: The results from this review provide further evidence that the illness perceptions and disease severity play a crucial role in the adaption to CKD. This review highlights the lack of research in this area and concludes that more studies are needed to determine the nature and impact of illness perceptions in relation to depression in pre-dialysis CKD.

0575 Impact of Illness Perception with Obstructive Sleep Apnea

0575 Impact of Illness Perception with Obstructive Sleep Apnea

Patients´ Variations of Reflection About and Understanding of Long-Term Illness- Impact of Illness Perception on Trust in Oneself or Others.

Background:Patients' understanding of their illness is of great importance for recovery. Lacking understanding of the illness is linked with the patients' level of reflection about and interest in understanding their illness.Objective:To describe patients’ variations of reflection about and understanding of their illness and how this understanding affects their trust in themselves or others.Method:The study is based on the “Illness perception” model. Latent content analysis was used for the data analysis. Individual, semi-structured, open-ended and face-to-face interviews were conducted with patients (n=11) suffering from a long-term illness diagnosed at least six months prior to the interview. Data collection took place in the three primary healthcare centres treating the participants.Results:The results show variations in the degree of reflection about illness. Patients search for deeper understanding of the illness for causal explanations, compare different perspectives for preventing complication of their illness, trust healthcare providers, and develop own strategies to manage life.Conclusion:Whereas some patients search for deeper understanding of their illness, other patients are less reflective and feel they can manage the illness without further understanding. Patients' understanding of their illness is related to their degree of trust in themselves or others. Patients whose illness poses an existential threat are more likely to reflect more about their illness and what treatment methods are available.

Type of treatment of cardiac disorders – quality of life and heart-focused anxiety: The mediating role of illness perceptions

The aim of the present research was to investigate the impact of illness perceptions on quality of life and heart-focused anxiety, in patients with cardiovascular disease (N = 106) admitted in the hospital, undergoing medication or who had undergone surgery. The influence of the type of treatment on the heart-focused anxiety and on the quality of life was mediated by illness perceptions. Consequently, patients who have undergone cardiac surgery have a better quality of life and lower levels of heart-focused anxiety than those relying only on medication to treat their illness.

A methodology for evaluating change and impact of illness perceptions among patients with memory complaints and their next of kin during the diagnosis process.

Memory complaints (MCs) are experienced by a large proportion of middle-aged and older adults and are often a source of distress and worry. Because of the perceived threat of Alzheimer's disease (AD), MCs are known to be associated with depression, anxiety, and poor quality of life (QoL). Generally, these MCs are part of a normal aging process but may also reflect mild cognitive impairment (MCI) or the onset of dementia. Although the literature is unclear about evolution of patients with MCs, there is growing evidence that suggests that MCs are associated with an increased risk of dementia. The potential importance of MCs is furthermore reflected in the new diagnostic criteria proposed for early AD (Dubois et al., 2007).

Development of a Multimorbidity Illness Perceptions Scale (MULTIPleS)

BackgroundIllness perceptions are beliefs about the cause, nature and management of illness, which enable patients to make sense of their conditions. These perceptions can predict adjustment and quality of life in patients with single conditions. However, multimorbidity (i.e. patients with multiple long-term conditions) is increasingly prevalent and a key challenge for future health care delivery. The objective of this research was to develop a valid and reliable measure of illness perceptions for multimorbid patients.MethodsCandidate items were derived from previous qualitative research with multimorbid patients. Questionnaires were posted to 1500 patients with two or more exemplar long-term conditions (depression, diabetes, osteoarthritis, coronary heart disease and chronic obstructive pulmonary disease). Data were analysed using factor analysis and Rasch analysis. Rasch analysis is a modern psychometric technique for deriving unidimensional and intervally-scaled questionnaires.ResultsQuestionnaires from 490 eligible patients (32.6% response) were returned. Exploratory factor analysis revealed five potential subscales ‘Emotional representations’, ‘Treatment burden’, ‘Prioritising conditions’, ‘Causal links’ and ‘Activity limitations’. Rasch analysis led to further item reduction and the generation of a summary scale comprising of items from all scales. All scales were unidimensional and free from differential item functioning or local independence of items. All scales were reliable, but for each subscale there were a number of patients who scored at the floor of the scale.ConclusionsThe MULTIPleS measure consists of five individual subscales and a 22-item summary scale that measures the perceived impact of multimorbidity. All scales showed good fit to the Rasch model and preliminary evidence of reliability and validity. A number of patients scored at floor of each subscale, which may reflect variation in the perception of multimorbidity. The MULTIPleS measure will facilitate research into the impact of illness perceptions on adjustment, clinical outcomes, quality of life, and costs in patients with multimorbidity.

Change and Impact of Illness Perceptions among Patients with Non-cardiac Chest Pain or Benign Palpitations Following Three Sessions of CBT

Many patients with non-cardiac chest pain or benign palpitations have poor prognosis in terms of symptom persistence, limitations in everyday activities, and reduced health-related quality of life (HRQOL). The aims of the study were to evaluate the changes and impact of illness perceptions during a three-session cognitive behavioural therapy (CBT) intervention for patients with non-cardiac chest pain or benign palpitations. Patients with persistent complaints 6 months after a negative cardiac evaluation were invited to participate in a randomized controlled trial. Patients in the intervention group (n = 21) received three manualized sessions with CBT, including one physical activity exposure session; the control group (n = 19) received usual care from their general practitioner. Brief Illness Perception Questionnaire (BIPQ) was used to measure illness perceptions. Patients were assessed at start and end of the intervention and at 3- and 12-month follow-up. The intervention and control group differed significantly on five of the eight items of BIPQ at least at one follow-up assessment. At end of treatment and at 3-month follow-up change in illness concern (Item 6 in BIPQ) mediated about 40% of the change in depression from baseline, and at 12-month follow-up about 50% of the change in depression was mediated by change in personal control (Item 3 in BIPQ). Illness perceptions measured with BIPQ may mediate the short and long term treatment effects of a three-session CBT-programme for patients with non-cardiac chest pain and benign palpitations.

The impact of illness perceptions on sexual functioning in patients with systemic lupus erythematosus

ObjectiveSexual problems are common in patients with chronic illnesses. However, few studies have investigated problems with sexual functioning in patients with systemic lupus erythematosus (SLE). The present cross-sectional study assessed the influence of SLE on sexual functioning and its associations with illness perceptions and medical and socio-demographic characteristics. MethodThe study included 106 SLE patients who used at least one immunosuppressive agent to control their SLE. Sexual functioning was measured using the Physical Disability Sexual and Body Esteem and the Medical Impact Scale from the Sexual Functioning Questionnaire. Patients' illness perceptions were assessed using the Brief Illness Perception Questionnaire. Results49.1% of patients agreed that their SLE had a negative influence on their sexual functioning. In addition, treatment for SLE seemed to play an important role in the negative impact on sexual functioning. Patients' illness perceptions were more important predictors of sexual functioning than medical and socio-demographic characteristics. SLE patients appear to report a lower sexual functioning than patients with other chronic illnesses. ConclusionSLE in general and immunosuppressive treatment for SLE specifically have a negative influence on sexual functioning. Patients' illness perceptions appear to play a more important role in the negative impact on sexual functioning than medical characteristics such as disease activity. The high prevalence of sexual problems highlights the need to more frequently address and aim to improve sexual functioning in patients with SLE. Patients may benefit from methods such as illness perception modification and coping style interventions to reduce their sexual problems.