Illness Perceptions in Patients With Osteoarthritis: Change Over Time and Association With Disability
Illness Perceptions in Patients With Osteoarthritis: Change Over Time and Association With Disability
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DOI：
10.1002/art.24674
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发表时间：
2009-08-15
期刊：
影响因子：
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通讯作者：
Kloppenburg, M.
中科院分区：
文献类型：
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作者：
Bijsterbosch, J.;Scharloo, M.;Kloppenburg, M.
Objective.研究骨关节炎（OA）患者疾病感知的变化及其与残疾的关系，并确定疾病感知对残疾的预测价值。分别使用修订的疾病感知问卷（IPQ-R）和健康评估问卷（HAQ）在基线和6年后测量了241例多部位OA患者（平均年龄59.0岁，82.2%为女性）的疾病感知和残疾。报告了每个IPQ-R维度的平均变化，并与残疾进展相关，定义为HAQ评分变化的最高四分位数。使用逻辑回归评估基线疾病感知对6年残疾的预测价值（高度残疾定义为HAQ评分的最高四分位数）。随着时间的推移，对疾病的看法发生了变化，这些变化与残疾的进展有关。与无残疾进展的患者相比，残疾进展的患者因OA引起的症状、感知后果、感知疾病慢性化、与OA相关的负面情绪和关于免疫作为因果因素的信念增加，感知控制和理解OA减少。此外，在基线时，OA引起的更多症状、更少的控制感和更多的OA后果可预测6年后的高残疾。随着时间的推移，OA患者的疾病感知发生变化，这些变化与结局相关。此外，疾病的看法是残疾的预测。这可能意味着旨在改变疾病观念的干预措施有助于改善功能结局。
Objective. To investigate changes in illness perceptions in patients with osteoarthritis (OA) and the association of those changes with disability, and to determine the predictive value of illness perceptions in disability.Methods. Illness perceptions and disability were measured at baseline and after 6 years in 241 patients with OA at multiple sites (mean age 59.0 years, 82.2% women) using the revised Illness Perception Questionnaire (IPQ-R) and the Health Assessment Questionnaire (HAQ), respectively. Mean changes for each IPQ-R dimension were reported and related to progression of disability, defined as the highest quartile of HAQ score change. The predictive value of baseline illness perceptions in disability at 6 years (with high disability defined as the highest quartile of HAQ score) was assessed using logistic regression.Results. Illness perceptions changed over time, and these changes were related to the progression of disability. Patients with progression of disability had an increase in symptoms attributed to OA, perceived consequences, perceived disease chronicity, negative emotions associated with OA and beliefs about immunity as causal factor, and a decrease in perceived control and understanding of OA compared with patients without progression of disability. Moreover, a higher number of symptoms attributed to OA, less perceived control, and more perceived consequences of OA at baseline were predictive of high disability after 6 years.Conclusion. Illness perceptions in patients with OA changed over time, and these changes were related to outcome. Moreover, illness perceptions were predictive of disability. This may imply that interventions aimed at changing illness perceptions can contribute to better functional outcome.