Positive Illness Perceptions Research Articles

Pain in Biologic-Treated Rheumatoid Arthritis Patients: The Role of Illness Perception Before and After the COVID-19 Pandemic.

We aimed to assess the role of the COVID-19 pandemic in the association of clinical, physical, and psychological factors with pain in Rheumatoid Arthritis (RA) patients. We included 103 RA patients (81.6% females; mean age 56.1±13.8years). Patients filled out the VAS-pain, GAD-7, PHQ-9, MFI-20, and B-IPQ. Paired sample t-tests, correlations, and multiple regression analyses were used to analyse the data. Our results showed significantly worsened pain in the data collected post-pandemic (p≤0.05). Pre-pandemic, the final regression models showed an association between functional disability (β=0.24; p≤0.05), illness perception (β=0.34; p≤0.05) and pain. In post-pandemic models, significant associations were found between fatigue (β=0.33; p≤0.01) and illness perception (β=0.36; p≤0.01) with pain. Positive illness perception was able to alleviate the associations between fatigue and depression with pain before and after the pandemic. Findings indicate that patients with RA may have been negatively affected by the COVID-19 pandemic given their vulnerability. Even though pharmacological treatment was not interrupted, post-pandemic results showed significantly higher levels of experienced pain. Therefore, in addition to biological therapy, non-pharmacological interventions, including psychological support aimed at diminishing negative illness perception, may be beneficial in reducing RA-related pain, especially when dealing with a crisis.

Relationships between disease severity, psychological stress, and health-related quality of life among patients with acute coronary syndrome: mediation of illness perception.

Patients with acute coronary syndrome (ACS) often experience reduced health-related quality of life (HRQOL), which may be attributable to the disease severity and psychological stress. While illness perception is speculated to be a potential pathway underlying these relationships, evidence supporting this mechanism remains limited. This study aimed to investigate the relationships between disease severity, psychological stress, and HRQOL and whether these relationships are mediated by illness perception in patients with ACS. Data were collected from June to July 2019 and June to September 2020 in the cardiology departments of four public hospitals in China. Eligible patients completed measures of disease severity, psychological stress, illness perception, HRQOL, and socio-demographic and clinical characteristics. Data were analysed employing hierarchical multiple regression and structural equation modelling. This study included 405 participants (mean age 60.63 years, 67.4% male). After controlling for socio-demographic and clinical covariates, higher levels of disease severity (β = 0.115, P = 0.024) and psychological stress (β = -0.209, P＜0.001) were associated with poorer HRQOL; however, the relationships became non-significant after adding illness perception into the regression model. Structural equation modelling analysis suggested that illness perception played a mediating role between disease severity, psychological stress, and HRQOL, accounting for 45.95% and 65.79% of the total effects, respectively. This study found that illness perception mediated the relationships between disease severity, psychological stress, and HRQOL among patients with ACS. Improving patients' HRQOL should consider its important influencing factors with a focus on promoting positive illness perception.

The Perceived Meaning of Traumatic Brain Injury for Older Adults: A Longitudinal-Multiple Case Study.

The aim of this study was to explore the perceived meaning of traumatic brain injury (TBI) over the first-year postinjury among older adults and to explore if and how meaning changes. A longitudinal multiple-case study design was used. Semistructured face-to-face interviews were completed at 1 week and 1, 3, 6, and 12 months postinjury. Transcripts were analyzed using inductive thematic analysis. Fifty-five interviews were conducted with 12 participants. Four themes were identified: gratitude, vulnerability and dependence, slowing down and being more careful, and a chance for reflecting on life. Most participants' perceptions of their TBI remained either consistently positive or negative over the first-year postinjury. Nurses should elicit and support patients' positive illness perceptions regarding their brain injury, which can contribute to a higher quality of life. For those patients with negative illness perceptions, nurses should provide resources in order to support coping and resilience following brain injury. This study is the first study to explore individual perceptions over time of the meaning made from experiencing TBI among older adults. Findings can serve as a foundation for tailored supportive interventions among older adults following TBI to maximize quality of life.

Fatigue among Patients with Type 2 Diabetes Mellitus: The Impact of Spirituality and Illness Perceptions.

Type 2 Diabetes Mellitus (T2DM) can cause fatigue, negatively affecting the daily functioning and health of individuals. The purpose of this study was to investigate the impact of spirituality and illness perceptions on fatigue among patients with Type 2 Diabetes Mellitus. In this cross-sectional, descriptive study, 100 patients with Type 2 Diabetes Mellitus completed the Fatigue Assessment Scale, the FACIT Sp-12 scale, and the Illness Perception Questionnaire-Revised assessing fatigue, spirituality, and illness perceptions, respectively. The mean age of the sample was 52.18 ± 15.53 years and 65% were insulin-treated patients. The mean score for the FACIT Sp-12 scale was 31.86 ± 7.7, for the FAS 27.0 ± 7.63, and for the Consequences and Emotional Representations of IPQ-R 25.5 ± 5.3. Statistically negative significant correlations were observed between the FACIT Sp-12 total score and the FAS subscales (r = -0.44 to -0.48, p < 0.01) and positive correlations between the "IP-Consequences and Emotional Representations" subscales and FAS scores. The total score of the FACIT Sp-12 (β = -0.35) was a negative predictor while Consequences and Emotional Representations (β = 0.28) were positive predictors of the total FAS Score. Participants scored moderate levels of total fatigue. Spirituality and positive illness perceptions may have a protective effect on the fatigue of patients with Type 2 Diabetes Mellitus.

Posttraumatic growth and illness perception in survivors of adolescent and young adult cancer

BackgroundAdolescents and young adults (AYAs) are diagnosed with cancer during a challenging period of life. We aimed to (1) describe positive changes (posttraumatic growth; PTG) and illness perception, and (2) determine associations between PTG and illness perception, sociodemographic, and cancer-related characteristics in Swiss AYA cancer survivors.MethodsWe conducted a population-based survey among AYA cancer survivors diagnosed 1990–2005 at age 16–25 years, who had survived ≥ 5 years. We used the Posttraumatic Growth Inventory (PTGI) and the Brief Illness Perception Questionnaire (BIPQ). Data were analyzed using descriptive statistics and linear regressions.ResultsAmong 389 contacted survivors, 160 responded (61.3% male; mean age = 34 years, SD = 5.8). The mean PTG sum score was 54.63 (SD = 20.24; range: 8–101). Survivors reported high PTG especially in the domains Appreciation of life (mean = 3.23; 95% confidence interval, 3.05–3.40), Personal strength (2.94; 2.77–3.12), and Relating to others (2.57; 2.40–2.74). Neither sociodemographic nor cancer-related characteristics were associated with PTG. Survivors who perceived follow-up care as helpful (p < 0.001) and those with high concerns about the consequences of the illness (p < 0.001) reported higher PTG.ConclusionsFinding ways to promote PTG and to identify and address maladaptive illness perceptions may help survivors transform their experience into something meaningful for their future life.

Social support mediates the relationship between illness perception and psychosocial adaptation among young and middle-aged kidney transplant recipients in China.

No research has yet been done on social support's influence on the association between illness perception and psychosocial adaptation among young and middle-aged kidney transplant recipients in China. Accordingly, it remains unclear how medical personnel can assist patients in successfully adjusting to the early postoperative period and improving their health. This study sought to explore the influence of illness perception and social support on the psychosocial adaptation of young and middle-aged recipients of kidney transplants in China during the early postoperative period. This study adopted a cross-sectional design. The study included 236 young and middle-aged kidney transplant recipients from a tertiary hospital in China. Demographic and disease-related data were collected. Additionally, the Psychosocial Adjustment to Illness Scale-Self-Report, the Brief Illness Perception Questionnaire, and the Multidimensional Scale of Perceived Social Support were used to assess participants' psychosocial adaptation, illness perception, and social support, respectively. The model was examined using descriptive analysis, Pearson's correlation analysis, hierarchical multiple regression analysis, and the PROCESS Macro in SPSS 26.0. A total of 176 (74.56%) participants reported an average psychosocial adaptation score >50, which is relatively negative. Marital status, education level, residence, per capita monthly income (in Chinese yuan), medical insurance, work status, post-transplant time, body mass index, creatinine status, and complications were all related to psychosocial adaptation (p < 0.05). The more negative their illness perception and the worse their social support, the worse the psychosocial adaptation of young and middle-aged kidney transplant recipients. Further, the effect of illness perception on psychosocial adaptation was partially mediated by social support (36.56%). In general, the psychosocial adaption level of young and middle-aged kidney transplant recipients was negative during the early postoperative period. Healthcare teams should assist patients in building a positive illness perception shortly following kidney transplantation, while also providing psychological care and support to help them cope with the onset of psychosocial issues.

Influencing factors of self-disclosure and its impact on quality of life in patients with systemic lupus erythematosus.

Self-disclosure may enhance positive illness perceptions, whereas patients with systemic lupus erythematosus (SLE) always facing negative illness perceptions due to multiple reasons, so elucidation of factors affecting self-disclosure may facilitate the development of quality of life. A total of 161 hospitalized patients with SLE were recruited. Scales on demographic and clinical characteristics, self-disclosure, psychosocial status (e.g. Social Support Rating Scale - SSRS) and quality of life were used to collect related information from clients. Univariate analysis was performed by Kruskal-Wallis rank-sum test or chi-square test, and multivariate analysis by ordinal logistic regression. Social support, drinking, depression and cause of hospitalization were found to be influencing factors of self-disclosure. Multiple logistic regression analyses revealed that the significant and independent factors associated with self-disclosure in patients with SLE were social support, drinking and depression. Domains of LupusQoL, except physical health and fatigue, were positively correlated with self-disclosure. With the increase of social support, the level of self-disclosure become worse, drinking, depression and cause of hospitalization are risk factors for it. Moreover, the level of self-disclosure is positively related to the LupusQoL. Medical staff should formulate effective measures according to the results to improve self-disclosure in patients with SLE and promote their quality of life.

Post-Stroke Activity Engagement in Community Dwellers: Association with Illness Perceptions and Perceived Environment

<h3>Research Objectives</h3> To test the hypothesis that post-stroke individuals' activity engagement is associated with their perceptions of stroke, as well as their perceptions of their physical and social environment. <h3>Design</h3> This study used a cross-sectional design. <h3>Setting</h3> Various rehabilitation settings in Beijing, China, including 4 hospital-based rehabilitation outpatient clinics, 2 rehabilitation centers, and 2 community rehabilitation health stations. <h3>Participants</h3> A convince sample of 202 dyads of Chinese community-dwellers with stroke and their caregivers participated in this study. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> We used: the Assessment of Life Habits, Mandarin version, to assess activity engagement; the Stroke-Specific Illness Perceptions Questionnaire–Revised to assess stroke individuals' and caregivers' illness perceptions; and the Social Support Survey and abbreviated Neighborhood Environment Walkability Scale to assess stroke individuals' perceived social and physical environment. <h3>Results</h3> In our participating samples, stroke individuals with positive illness perceptions performed better in their personal level activity engagement, and those who believed their neighborhoods positively support their daily lives performed better in their societal level activity engagement, after controlling for demographic and performance skill factors. <h3>Conclusions</h3> Post-stroke activity engagement is associated not only with stroke individuals' performance skills but also with their perceptions of stroke, and how they perceive their physical environment. The findings of this study may assist clinicians' decision making when developing comprehensive, targeted interventions for improving activity engagement and maximizing recovery after stroke. <h3>Author(s) Disclosures</h3> The authors declare that there is no conflict of interest.

Illness perception and perceived benefits of illness among persons with type 1 diabetes

BackgroundIllness perception is assigned an increasing role in the control of chronic disease. This study examines illness perception and perceived benefits related to illness in persons with type 1 diabetes mellitus. We used quantitative and qualitative methods for a more in-depth analysis.Participants and procedureThe participants (N = 110; mean age: 31.52 years; 80.9% women) completed online questionnaires: the Brief Illness Percep-tion Questionnaire (B-IPQ), the perceived benefits subscale of the Illness Cognition Questionnaire (ICQ) and the Hospital Anxiety and Depression Scale (HADS). Interpretative phenomenological analysis (IPA) was used to analyze patients’ re-sponses to an open-ended question regarding perceived benefits.ResultsPerceived benefits score was positively correlated with personal (ρ = .20) and treatment control: life-style (ρ = .25) and co-herence (ρ = .22). Negative correlations were noted between B-IPQ total score (ρ = –.30), concern (ρ = –.30), depression (ρ = –.35), anxiety (ρ = –.32) and irritability (ρ = –.19). 52.7% of participants reported at least one benefit of having type 1 diabetes. Patients who reported at least one benefit had statistically significantly higher scores in the perceived benefits subscale (p &lt; .001), personal control (p = .005) and treatment control (p = .030) and lower scores in consequences (p = .023), identity (p = .045), concern (p &lt; .001), emotional response (p &lt; .001), and illness perception total score (p &lt; .001) than those who did not report any benefit. IPA revealed four main themes: personal benefits, health-related benefits, social contacts and economic benefits.ConclusionsThe study revealed that in patients with type 1 diabetes perceived disease benefits are closely related to more positive illness perception and lower levels of depression, anxiety and irritability. The findings suggest that addressing potential benefits related to illness may influence the emotional state.

Illness Perceptions and Illness Identity in Adolescents and Emerging Adults With Neuromuscular Disorders.

Neuromuscular disorders (NMD) are intrusive medical conditions with implications for psychosocial development. This paper explores illness perceptions and illness identity dimensions of youth with NMD. First, we compare illness identity outcomes and illness perceptions of NMD patients with a comparison group of adolescents with type 1 diabetes mellitus (DM). Second, we report about the relationships between NMD-related variables and illness perceptions and illness identity. Scores on the Brief Illness Perception Questionnaire and the Illness Identity Questionnaire were compared between a group of NMD patients (N = 59; 12-22years) and an age- and gender-matched group of DM patients (N = 118). NMD-related variables included time since diagnosis, prognosis, wheelchair use, and physical limitations. Youth with NMD scored significantly higher on two of the four illness identity dimensions than youth with DM. NMD patients reported significantly less positive illness perceptions, experienced more physical symptoms, and had a lower score on understanding of their illness. Within the NMD group, wheelchair-users have a better understanding of their disease than those who are not wheelchair-bound. The present study is the first to investigate illness identity and illness perceptions in NMD. More research is needed to provide insight in the identity formation process of the growing group of adolescents with NMDs.

Psychosocial Adaptation Among Inflammatory Bowel Disease Patients and Associated Factors: A Cross-Sectional Study.

PurposePatients with inflammatory bowel disease (IBD) suffer from physical symptoms and psychosocial issues. This generates risks of psychosocial maladjustment that is closely linked with self-care ability and health-related quality of life. The study aimed to explore psychosocial adaptation of IBD patients in China and the influencing factors from individual and family levels.Patients and MethodsUsing a cross-sectional design, 191 Chinese patients with IBD were recruited from October 2020 to September 2021. General information questionnaire, general family functioning scale, resilience scale for IBD, and psychosocial adaptation questionnaire for IBD were used for investigation. Multivariate linear regression was used to identify predictive factors of psychosocial adaptation.ResultsIBD patients reported a moderate level of psychosocial adaptation. Regression analysis showed that personal resilience especially the three dimensions (i.e., positive illness perception, disease management, and support from fellow IBD patients), general family functioning, and disease conditions (i.e., extra-intestinal manifestations and current disease status) were the main contributing factors of psychosocial adaptation, explaining 49.3% of the total variance.ConclusionThe findings suggest that healthcare providers could focus on improving patients’ illness perception about IBD and strengthening their disease management abilities, together with optimizing patients’ family functioning to enhance their psychosocial adaptation level.

Effect of social support on illness perception in patients with atrial fibrillation during "Blanking Period": Mediating role of sense of mastery.

To explore whether sense of mastery can mediate the relationship between social support and illness perception in patients with atrial fibrillation (AF) who were at the "Blanking Period." A cross-sectional design. 405 patients with AF who were at the "Blanking Period" in the Affiliated Hospital of Qingdao University were recruited; they completed a set of questionnaires, including the Perceived Social Support Scale, the Personal Mastery Scale and the Brief Illness Perception Questionnaire. Social support and sense of mastery were both adversely connected to illness perception. The indirect effect of social support on illness perception through sense of mastery was negative, accounting for 86.04% of the total effect. During the "Blanking Period," better social support and sense of mastery contribute to a positive illness perception of AF patients. Social support also can influence patients' illness perception indirectly via the mediator of sense of mastery.

Clinical trial perceptions among patients with gastrointestinal (GI) cancer in an academic cancer center.

e18579 Background: Clinical trials (CTs) are essential for advancing care for individuals with cancer, yet a minority of patients participate in CTs. We conducted an exploratory analysis of CT perceptions (knowledge, attitudes, and barriers) among patients with GI cancer. Methods: We prospectively surveyed a convenience sample of patients treated for GI cancer at Massachusetts General Hospital from 11/2020–12/2021. We obtained sociodemographic/clinical characteristics via patient report and chart review. We assessed CT perceptions, communication confidence (Perceived Efficacy in Patient-Physician Interactions Questionnaire, PEPPI, range 0-50; higher score indicates higher confidence), and illness perceptions (Brief Illness Perceptions Questionnaire, BIPQ, range 0-80; higher score indicates more negative perceptions). Using descriptive statistics, we examined associations of CT perceptions with patient characteristics, communication confidence, and illness perceptions. Results: We enrolled 80 patients (median age = 66 years [range 24-85], 54% men, 93% white, 48% had metastatic disease, 69% had college/postgraduate degrees, 15% had participated in CTs [25% phase I, 75% phase II-III]). Cancer types were pancreatic (38%), colorectal/bowel (23%), hepatobiliary (18%), gastroesophageal (16%), and other (6%). Median PEPPI was 43 (range 16-50). Median BIPQ was 44 (range 1-66); 63% reported negative illness perceptions (BIPQ≥40). Most (89%) agreed CTs are essential to improving standard treatment, yet only 42% had discussed CTs during care. Overall, 38% reported a clear idea of what a CT means, and 8% thought most people are cured on CTs. Unmarried patients were more likely to think most people are cured on CTs (21% vs 4%, p = .017). Most (76%) saw CTs as opportunities to obtain new treatment; only 15% believed enrolling would mean missing out on standard care. Only 16% thought most patients like them enroll in CTs. Younger patients (≤65 years) were more likely to think most patients like them enroll (25% vs 8%, p = .046). Most (61%) felt confident differentiating a CT from other treatments. Older patients (&gt; 65 years) were more likely than younger patients to agree/strongly agree that they feel confident differentiating a CT from other treatments (74% vs 49%, p = .025), as were men versus women (76% vs 43%, p = .003). Those with higher communication confidence (Medians [M]: 44 vs 40, p = .04) or more positive illness perceptions (M: 41 vs 50, p = .003) were also more likely to be confident differentiating a CT. Conclusions: In this exploratory analysis of CT perceptions among patients with GI cancer, we found high levels of CT knowledge and positive CT perceptions. We demonstrated hypothesis-generating associations among patient factors and CT perceptions, underscoring the need for future research to confirm our findings and to develop interventions to enhance CT decision-making and participation.

Evaluation of the Perception of Illness and Quality of Life in Patients with Acute Myocardial Infarction.

This study aimed to evaluate the illness perception and quality of life of patients who had an acute myocardial infarction. This descriptive and correlational study included 301 patients diagnosed with acute myocardial infarction at the cardiology outpatient clinic of a hospital. The data were collected using Illness Perception Questionnaire-Revised and Myocardial Infarction Dimensional Assessment Scale. The mean age of the patients was 59.04 ± 5.56 years and 51% were female. The evaluation of subdimension mean scores according to the scores of the patients from the Illness Perception Questionnaire-Revised showed that the highest mean score was obtained from the consequences subscale under the Illness Representation dimension whereas the lowest mean score was from the illness coherence subscale. The overall Myocardial Infarction Dimensional Assessment Scale score (49.43 ± 11.40) of the patients was observed to be moderate. The Illness Perception Questionnaire-Revised subdimensions were observed to have a positive and significant correlation with Myocardial Infarction Dimensional Assessment Scale total score and subscales mean scores. According to the regression analysis results, treatment control, illness coherence, and emotional representations subscales under the Illness Representation dimension and immunity subscale under the Causal Representation dimension were observed to predict the quality of life, and patients obtaining higher scores from these dimensions had higher quality of life. On the other hand, the consequences subscale under Illness Representation dimension and psychological attributions under Causal Representation dimension were found to be factors decreasing the quality of life. This study showed that patients thought some of the symptoms were related to their illness, the level of comprehension of the disease is low, and their quality of life was moderate. Patients should have a positive illness perception to have a higher quality of life.

Evaluation of the Perception of Illness and Quality of Life in Patients with Acute Myocardial Infarction.

This study aimed to evaluate the illness perception and quality of life of patients who had an acute myocardial infarction.This descriptive and correlational study included 301 patients diagnosed with acute myocardial infarction at the cardiology outpatient clinic of a hospital. The data were collected using Illness Perception Questionnaire-Revised and Myocardial Infarction Dimensional Assessment Scale.The mean age of the patients was 59.04 ± 5.56 years and 51% were female. The evaluation of subdimension mean scores according to the scores of the patients from the Illness Perception Questionnaire-Revised showed that the highest mean score was obtained from the consequences subscale under the Illness Representation dimension whereas the lowest mean score was from the illness coherence subscale. The overall Myocardial Infarction Dimensional Assessment Scale score (49.43 ± 11.40) of the patients was observed to be moderate. The Illness Perception Questionnaire-Revised subdimensions were observed to have a positive and significant correlation with Myocardial Infarction Dimensional Assessment Scale total score and subscales mean scores. According to the regression analysis results, treatment control, illness coherence, and emotional representations subscales under the Illness Representation dimension and immunity subscale under the Causal Representation dimension were observed to predict the quality of life, and patients obtaining higher scores from these dimensions had higher quality of life. On the other hand, the consequences subscale under Illness Representation dimension and psychological attributions under Causal Representation dimension were found to be factors decreasing the quality of life.This study showed that patients thought some of the symptoms were related to their illness, the level of comprehension of the disease is low, and their quality of life was moderate. Patients should have a positive illness perception to have a higher quality of life.

Illness Perception and Quality of Life in Patients with Breast Cancer.

Simple SummaryThe declining average age of cancer patients may become a serious problem for health care systems and societies in general in the near future. For this reason, there is a need to fully understand the factors determining health-related quality of life in breast cancer patients, beyond clinical characteristics and sociodemographic factors. In our study, we aimed to demonstrate the relationship between illness perception and quality of life in breast cancer patients. The results of our study confirm the beneficial effect of positive illness perception on the intensity of symptoms related to cancer and treatment, as well as functional domains of EORTC QLQ-C30.Introduction. In 2020, breast cancer was the most frequently diagnosed malignancy worldwide. The QoL level plays a role in assessing the effectiveness of the diagnosis and therapy and is a significant prognostic factor. The subject that is relatively less often addressed in the literature is the impact of psycho-social factors and health-related beliefs on QoL in breast cancer patients. The aim of the study was to assess the association of illness perception, the sense of coherence, and illness acceptance with QoL in breast cancer patients. Methods. The study included 202 women (mean age 53.0 ± 10.3) treated surgically for breast cancer at the Lower Silesian Oncology Centre. The following standardized questionnaires were used: Acceptance of Illness Scale (AIS), Mental Adjustment to Cancer (Mini-MAC), Quality of Life Questionnaires (EORTC QLQ-C30 and QLQ-BR23), The Multidimensional Essence of Disease and Illness Scale (MEDIS), and Life Orientation Test (LOT-R). Results. There is a statistically significant association between illness acceptance and QoL. There is a statistically significant association between the sense of coherence (life optimism—LOT-R) and QoL among breast cancer patients. There is a statistically significant association between illness perception and QoL. There was a statistically significant correlation between the increasing importance of illness as a dysfunction, decreasing QoL, and increasing intensity of symptoms and complaints. Conclusions. Patients with a high level of illness acceptance, with an optimistic disposition, and with a positive illness perception have better QoL within all the functional domains and experience lower intensity of cancer- and treatment-related symptoms as compared to those with low level of illness acceptance, with moderate optimism or a pessimistic disposition, and with neutral or negative illness perception.

Association Between Perceived Access to Healthcare and the Perception of Illness Among Peruvian Adults with Chronic Diseases During COVID-19 Pandemic.

The COVID-19 pandemic has greatly affected the provision of care for patients with chronic diseases. Due to social restrictions and reductions in contact with health services, the negative perception of chronic disease is expected to have increased. The aim of this study was to determine the association between perceived access to healthcare and the perception of illness among Peruvian population with chronic disease. It was a cross-sectional analytical study, with a sample of 987 inhabitants to whom the questionnaires “Coverage of health services” and “The Brief Illness Perception Questionnaire” (BIPQ) were applied. Having health insurance (PRa = 0.683; 95% CI = 0.613-0.761) acts as a protective factor for a positive illness perception of chronic disease, however, a waiting time greater than 3 months to obtain a medical appointment (PRa = 1.417; 95% CI = 1.319-1.522) and poor access to health services (PRa = 1.435; 95% CI = 1.226-1.681) resulted in the probability of a negative illness perception of chronic disease. Thus, there is an association between perceived poor access to healthcare and the negative illness perception of chronic disease in Peruvian population during pandemic COVID-19.

Factors influencing self-management among Indonesian patients with early-stage chronic kidney disease: A cross-sectional study.

The purpose of this study was to explore the self-management of patients with early-stage chronic kidney disease (CKD) and its influencing factors. A convenient sample of 226 patients with early-stage CKD was recruited from 63 Public Health Centers in Indonesia, from June to September 2020. Demographic characteristics, health literacy, illness perception, self-efficacy and self-management were assessed using self-reported questionnaires. Stepwise multiple linear regression analysis was performed to identify the factors influencing self-management. This study adhered to the EQUATOR checklist, STROBE. The mean estimated glomerular filtration rate was 63.45ml/min/1.73m2 (standard deviation [SD] = 15.34). The average scores for health literacy, illness perception, self-efficacy and self-management were 32.11 (SD =4.46), 4.57 (SD =1.46), 183.64 (SD =38.23) and 76.92 (SD = 9.45), respectively. The influencing factors were education level, monthly income, family history of comorbidity, health literacy and self-efficacy, which accounted for 45% of total self-management score. Indonesian patients with early-stage CKD showed low level of health literacy, but positive illness perception and self-efficacy; these factors significantly affected CKD self-management. Health literacy was found to influence all dimensions of self-management: self-integration, problem-solving, seeking social support and adherence to the recommended regimen. Adherence to the recommended regimen is the most challenging dimension of CKD self-management. Health literacy was found to be a major determinant of self-management. Improving health literacy and motivation of patients with early-stage CKD may help sustain positive illness perception and self-efficacy, and improve self-management.

ILLNESS PERCEPTION AND PERCEIVED STRESS AS PREDICTORS OF QUALITY OF LIFE AMONG OUTPATIENTS OF FEDERAL NEURO- PSYCHIATRIC HOSPITAL, YABA, LAGOS.

Purpose: Empirical evidence have shown that psychiatric out-patients often experience difficulties with getting back to normal family and work routines and relapse. This stimulated this study and made it imperative to examine the extent to which illness perception and perceived stress are implicated in fostering successful re-integration of out-patients back into the society, enhance total adherence to intake of prescribed medications, and increase being compliant to attending check-up at due time, among others.&#x0D; Methodology: The study investigated illness perception and perceived stress as predictors of quality of life among psychiatric patients in Federal Neuro-Psychiatric Hospital Yaba, using predictive design. The research sample consisted of sixty-one (61) out-patients at Federal Neuro-Psychiatric Hospital, Yaba. This comprised of thirty-nine (39; 63.9%) males and twenty two (22; 36.1%) females with mean age of 34.29, S.D 5.60, respectively. The participants were selected by the researcher using purposive sampling technique. They were individually administered the World Health Organization Quality of Life (WHOQOL) – Brief scale, Illness Perception Questionnaire-revised (IPQ-R), and Perceived Stress Scale (PSS). Multiple linear regression statistics was used for testing research hypothesis.&#x0D; Findings: The result revealed significant positive influence of illness perception on quality of life (R2= .048, R2 (adjusted) = .015; β = .205, p&lt;.05). It further revealed that perceived stress significant predicted quality of life (R2= .048, R2 (adjusted) = .015; β = .061, p&lt;.05). The researcher attributed these findings to the fact that psychiatric out-patients may by virtue of their health conditions might still not come to terms with their re-integration. &#x0D; Recommendation: As a result of the study findings, psychiatric outpatients should be exposed to programmes and psycho-education capable of promoting positive view of their health. Doing so will result to having positive illness perception leading to improve quality of life, since the two variables shared positive relationship. It also recommends that the process of re-integrating psychiatric outpatients back into the society should be done very well, amidst equipping them with required skills and knowledge they will need in handling the stressors they will face, positively.

Associations between positive treatment outcome expectations, illness understanding, and outcomes: a cohort study on non-operative treatment of first carpometacarpal osteoarthritis

Purpose More positive outcome expectations and illness perceptions are associated with better outcomes for patients with several osteoarthritic orthopedic conditions. However, it is unknown whether these factors also influence outcomes of non-operative treatment for first carpometacarpal osteoarthritis (CMC-1 OA). Therefore, we assess the role of pre-treatment outcome expectations and illness perceptions in reports of pain and hand function 3 months after non-operative treatment for CMC-1 OA. Materials and methods We conducted a cohort study with 219 patients treated non-operatively for CMC-1 OA between September 2017 and October 2018. Patients were included in the study if they completed measures of pain and hand function, illness perceptions (scale: 0–10), and expectations (scale: 3–27) as part of routine outcome measurements. Pain and hand function were measured before treatment and 3 months after starting treatment using the Dutch version of the Michigan Hand Outcomes Questionnaire. Multivariable linear regression analysis was used to assess the influence of outcome expectations and illness perceptions on pain and hand function. Results Both positive outcome expectations (B = 0.64; 95% CI [0.1–1.2]) and a better illness understanding (an illness perception subdomain; B = 1.53; 95% CI [0.2–2.9]) at baseline were associated with less pain at 3 months. For hand function, similar estimates were found. Conclusions We found that positive outcome expectations and a better illness understanding, were associated with a better outcome of non-operative treatment for CMC-1 OA. IMPLICATIONS FOR REHABILITATION Non-operative treatment can often be successful for patients with arthritis of the thumb. Outcome expectations and illness perceptions are associated with pain and hand function 3 months after non-operative treatment for thumb base osteoarthritis. Improving the outcome expectations and illness perceptions of patients through better education could improve the outcome of non-operative treatment.