Bijsterbosch J, Scharloo M, Visser A W, Watt I, Meulenbelt I, Huizinga T W J, Kaptein A A, Kloppenburg M
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Arthritis Rheum. 2009 Aug 15;61(8):1054-61. doi: 10.1002/art.24674.
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.
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.
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.
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.
研究骨关节炎（OA）患者疾病认知的变化及其与残疾的关联，并确定疾病认知对残疾的预测价值。
分别使用修订后的疾病认知问卷（IPQ-R）和健康评估问卷（HAQ），对241例多部位OA患者（平均年龄59.0岁，女性占82.2%）在基线和6年后的疾病认知和残疾情况进行测量。报告IPQ-R各维度的平均变化，并将其与残疾进展相关联，残疾进展定义为HAQ评分变化的最高四分位数。使用逻辑回归评估基线疾病认知对6年后残疾情况（高残疾定义为HAQ评分的最高四分位数）的预测价值。
疾病认知随时间变化，且这些变化与残疾进展相关。与无残疾进展的患者相比，残疾进展患者归因于OA的症状、感知后果、感知疾病慢性、与OA相关的负面情绪以及将免疫作为病因的信念增加，而对OA的感知控制和理解减少。此外，基线时归因于OA的症状数量更多、感知控制更少以及OA的感知后果更多可预测6年后的高残疾情况。
OA患者的疾病认知随时间变化，且这些变化与预后相关。此外，疾病认知可预测残疾情况。这可能意味着旨在改变疾病认知的干预措施有助于改善功能结局。
