Pagels Agneta A, Söderquist Birgitta Klang, Heiwe Susanne
Department of Medicine, Karolinska Institute, Stockholm, Sweden.
Department of Neurobiology, Karolinska Institutet, Care Sciences and Society, Stockholm, Sweden.
J Ren Care. 2015 Sep;41(3):146-55. doi: 10.1111/jorc.12117. Epub 2015 Mar 5.
To explore the impact of chronic kidney disease (CKD) on individual illness representations, including symptoms and causal attributions.
Fifty-four patients responded to the Illness Perception Questionnaire (IPQ-R) and a further seven patients undertook cognitive interviews regarding the IPQ-R. All respondents had CKD stage 2-5, not undergoing renal replacement therapy.
Those in earlier CKD stages and those with fewer symptoms perceived a significantly different understanding of their condition than those in more advanced disease stages or with more symptoms. Behavioural and psychological attributions were commonly referred to as contributing causes to CKD. These attributions were associated to negative illness representations. An uncertainty assessing symptoms attributed to CKD was indicated, especially in earlier disease stages.
Illness representations differ with CKD stages and symptom burden. The patients in earlier disease stages or with fewer symptoms did not hold as strong beliefs about their illness as being a threat as those in advanced stages or with more symptoms. Self-blame emerged as a common causal attribution. Patients did not always relate symptoms to CKD, therefore this study identifies a gap in patients' disease knowledge, especially in earlier stages of the condition.
探讨慢性肾脏病（CKD）对个体疾病认知的影响，包括症状和因果归因。
54名患者对疾病认知问卷（IPQ-R）进行了回应，另有7名患者就IPQ-R接受了认知访谈。所有受访者均处于CKD 2-5期，未接受肾脏替代治疗。
处于CKD早期阶段且症状较少的患者对自身病情的认知与处于疾病更晚期或症状更多的患者明显不同。行为和心理归因通常被认为是CKD的促成原因。这些归因与负面的疾病认知相关。表明存在对归因于CKD的症状的不确定性评估，尤其是在疾病早期阶段。
疾病认知因CKD阶段和症状负担而异。处于疾病早期阶段或症状较少的患者对自身疾病作为威胁的信念不如处于晚期阶段或症状较多的患者强烈。自责成为一种常见的因果归因。患者并不总是将症状与CKD联系起来，因此本研究发现了患者疾病知识方面的差距，尤其是在疾病早期阶段。
