Strong Illness Identity Research Articles

Living with Huntington's disease: Illness perceptions, coping mechanisms, and patients' well-being.

OBJECTIVES: To describe the illness perceptions and coping mechanisms of patients with Huntington's disease (HD), and to assess their role in the well-being of these individuals. DESIGN: A single group, cross-sectional study. METHODS: In 77 individuals with a clinically confirmed diagnosis of HD, illness perceptions, coping mechanisms, motor and cognitive performance, and well-being were assessed by means of questionnaire-guided interviews, and subjected to correlational analyses, t-tests and two-stage regression analyses. RESULTS: HD patients' illness perceptions were characterized by a strong illness identity, combined with beliefs about a long duration of HD, perceived negative consequences for their daily lives, and little hope for cure or improvement of their symptoms. In turn, the coping strategies that HD patients reported adopting to deal with their disease were comparable with those adopted by reference individuals dealing with everyday life stressful situations. Where the well-being of HD patients is concerned, compared with Dutch community sample, HD patients scored significantly lower on measures of physical well-being and general health. Both illness perceptions and coping mechanisms were significant predictors of patients' well-being. CONCLUSIONS: More systematic research within a health psychology framework is justified in order to assess the role of illness perceptions and coping mechanisms in the well-being of HD patients.

Patients' illness perceptions and coping as predictors of functional status in psoriasis: a 1-year follow-up.

In a longitudinal study (two measurements with a 1-year interval), 69 patients with psoriasis completed the Illness Perception Questionnaire, the Medical Outcomes Study SF-20 Health Survey, and the Hospital Anxiety and Depression Scale. Data on coping (Utrecht Coping List) and severity of illness (body surface scores) were also collected. The results of regression analyses indicated that a strong illness identity was associated with more visits to the outpatient clinic, and worse outcome on physical health, social functioning, mental health, health perceptions and depression. Strong beliefs that the disease is controllable/curable and that the disease has disabling consequences were also related to more clinic visits and more negative perceived health, respectively. Patients who initially engaged in coping characterized by more expression of emotions, seeking more social support, seeking more distraction, and less passive coping were prescribed a lower number of different therapies, were less anxious, less depressed, and had a better physical health 1 year later. These results have implications for the management of patients with psoriasis, which reinforces current views on integrating psychosocial aspects into clinical care.

Illness perceptions, coping and functioning in patients with rheumatoid arthritis, chronic obstructive pulmonary disease and psoriasis

The present cross-sectional study analyzed the extent to which illness perceptions and coping strategies (as measured by the Illness Perception Questionnaire and the Utrecht Coping List, respectively) are associated with levels of daily functioning, as indicated by the Medical Outcomes Study SF-20, and disease-specific measures in 244 adults: 84 with rheumatoid arthritis (RA); 80 with chronic obstructive lung disease (COPD); and 80 with psoriasis. The results of stepwise regression analyses indicated that a strong illness identity, passive coping, belief in a long illness duration, belief in more severe consequences, and an unfavorable score on medical variables were associated with worse outcome on disease-specific measures of functioning and on general role and social functioning. Coping by seeking social support and beliefs in controllability/curability of the disease were significantly related to better functioning. The implications of these findings for future interventions and research are discussed.

Role of patients' view of their illness in predicting return to work and functioning after myocardial infarction: longitudinal study

To examine whether patients' initial perceptions of their myocardial infarction predict subsequent attendance at a cardiac rehabilitation course, return to work, disability, and sexual dysfunction. Patients' perceptions of their illness were measured at admission with their first myocardial infarction and at follow up three and six months later. Two large teaching hospitals in Auckland, New Zealand. 143 consecutive patients aged under 65 with their first myocardial infarction. Attendance at rehabilitation course; time before returning to work; measures of disability with sickness impact profile questionnaire for sleep and rest, social interaction, recreational activity, and home management; and sexual dysfunction. Attendance at the rehabilitation course was significantly related to a stronger belief during admission that the illness could be cured or controlled (t = 2.08, P = 0.04). Return to work within six weeks was significantly predicted by the perception that the illness would last a short time (t = 2.52, P = 0.01) and have less grave consequences for the patient (t = 2.87, P = 0.005). Patients' belief that their heart disease would have serious consequences was significantly related to later disability in work around the house, recreational activities, and social interaction. A strong illness identity was significantly related to greater sexual dysfunction at both three and six months. Patients' initial perceptions of illness are important determinants of different aspects of recovery after myocardial infarction. Specific illness perceptions need to be identified at an early stage as a basis for optimising outcomes from rehabilitation programmes.

Functioning in chronic fatigue syndrome: Do illness perceptions play a regulatory role?

The relationships between illness perceptions, coping and adjustment were investigated in the context of chronic fatigue syndrome (CFS). Self‐reported illness perceptions, coping, disability levels and psychological well‐being were assessed in a national sample of 233 CFS sufferers. A series of regression analyses indicated that illness perceptions explained a greater percentage of the variance in levels of disability and psychological well‐being than did the coping strategies used by the participants to manage their illness. The illness perception components of illness identity, emotional causes, controllability and consequences had the strongest overall association with adjustment such that participants with a strong illness identity, who believed their illness was out of their control, caused by stress and had very serious consequences were most disabled and psychologically impaired. Disengagement coping strategies and venting emotions were also associated with greater disability and poorer psychological well‐being, while positive reinterpretation and seeking social support were positively related to psychological well‐being. The potential role of illness perceptions in the maintenance of CFS is discussed.