Arat Seher, Verschueren Patrick, De Langhe Ellen, Smith Vanessa, Vanthuyne Marie, Diya Luwis, Van den Heede Koen, Blockmans Daniel, De Keyser Filip, Houssiau Frédéric A, Westhovens René
Department of Rheumatology, University Hospitals Leuven, KU Leuven, Belgium.
Musculoskeletal Care. 2012 Mar;10(1):18-28. doi: 10.1002/msc.223. Epub 2011 Nov 11.
The aim of the present study was to evaluate the association between illness perceptions and the ability to cope with physical and mental health problems in a large cohort of systemic sclerosis (SSc) patients.
This was a cross-sectional study in 217 systemic sclerosis patients from the Belgian Systemic Sclerosis Cohort. Illness perception and coping were measured by the Revised Illness Perception Questionnaire and a coping questionnaire--the Coping Orientation of Problem Experience inventory (COPE). Physical and mental health-related quality of life was measured by the 36-item short-form health survey (SF-36), as were disease activity and several severity parameters. The relationship between illness perceptions and the ability to cope with physical/mental health problems was examined using multiple linear regression analysis.
According to LeRoy's classification, 49 patients had limited SSc (lSSc), 129 had limited cutaneous SSc (lcSSc) and 39 had diffuse cutaneous SSc (dcSSc). Median disease duration was five years and the modified Rodnan skin score was 4. Good physical health was significantly associated with the lcSSc subtype and low disease activity (p < 0.01 and p < 0.05, respectively). The perception of 'serious consequences' and strong 'illness identity' correlated with poor physical health (p < 0.001). Good mental health was associated with low illness identity scores and low 'emotional response' scores (p < 0.001). Coping variables were less significantly correlated with physical and mental health compared with the illness perception items.
Illness representations contribute more than classical disease characteristics to physical and mental health.
本研究旨在评估一大群系统性硬化症（SSc）患者的疾病认知与应对身心健康问题能力之间的关联。
这是一项对来自比利时系统性硬化症队列的217名系统性硬化症患者进行的横断面研究。通过修订后的疾病认知问卷和一份应对问卷——问题体验应对取向量表（COPE）来测量疾病认知和应对方式。使用36项简短健康调查问卷（SF-36）测量与身心健康相关的生活质量，同时测量疾病活动度和几个严重程度参数。采用多元线性回归分析来检验疾病认知与应对身心健康问题能力之间的关系。
根据勒罗伊分类法，49例患者为局限性系统性硬化症（lSSc），129例为局限性皮肤型系统性硬化症（lcSSc），39例为弥漫性皮肤型系统性硬化症（dcSSc）。疾病中位病程为5年，改良罗德南皮肤评分是4分。良好的身体健康状况与lcSSc亚型和低疾病活动度显著相关（分别为p < 0.01和p < 0.05）。“严重后果”的认知和强烈的“疾病认同”与身体健康状况差相关（p < 0.001）。良好的心理健康与低疾病认同得分和低“情绪反应”得分相关（p < 0.001）。与疾病认知项目相比，应对变量与身心健康状况的相关性较弱。
疾病表征对身心健康的影响比经典的疾病特征更大。
