De Gucht V, Garcia F K, den Engelsman M, Maes S
Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit, The Netherlands.
Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit, The Netherlands.
J Psychosom Res. 2017 Apr;95:55-61. doi: 10.1016/j.jpsychores.2017.02.009. Epub 2017 Feb 17.
Examine to what extent changes in cognitions and changes in physical activity and behavioural regulation patterns influence fatigue severity, physical symptoms, and physical and psychological functioning of patients suffering from Chronic Fatigue Syndrome (CFS) at follow-up.
The present study is an observational longitudinal study with a 12-month follow-up. A total of 144 CFS patients participated both at baseline and at follow-up. Four separate hierarchical regression analyses were conducted with fatigue, physical symptoms, physical functioning and psychological functioning at follow-up as the dependent variables, and (changes in) illness perceptions and behavioural regulation patterns (all-or-nothing and limiting behaviour) as the independent variables. Data were collected making use of self-report questionnaires.
Increased Consequence and Identity beliefs over time, as well as increases in all-or-nothing behaviour predicted higher fatigue severity at follow-up. Both number and severity of physical symptoms and psychological functioning at follow-up were only determined by changes in illness perceptions, with increased Consequence beliefs influencing both outcomes, and increased Timeline beliefs only determining physical symptoms. Physical functioning at follow-up was predicted by changes in illness perceptions as well as increased levels of both all-or-nothing and limiting behaviour.
The findings point at a differential pattern of associations between changes in illness perceptions and behaviour regulation patterns on the one hand, and patient outcomes on the other hand. Whereas illness perceptions significantly contribute to each of the outcomes, behaviour regulation patterns contribute only to fatigue severity and physical functioning.
研究认知变化、身体活动变化及行为调节模式变化在随访时对慢性疲劳综合征（CFS）患者的疲劳严重程度、身体症状以及身体和心理功能的影响程度。
本研究为一项为期12个月随访的观察性纵向研究。共有144名CFS患者在基线期和随访期均参与研究。进行了四项独立的分层回归分析，将随访时的疲劳、身体症状、身体功能和心理功能作为因变量，将疾病认知（变化）和行为调节模式（全或无行为和限制行为）作为自变量。通过自我报告问卷收集数据。
随着时间推移，后果信念和身份信念增强，以及全或无行为增加，均预示着随访时更高的疲劳严重程度。随访时身体症状的数量和严重程度以及心理功能仅由疾病认知变化决定，后果信念增强影响这两个结果，时间线信念增强仅决定身体症状。随访时的身体功能由疾病认知变化以及全或无行为和限制行为水平增加共同预测。
研究结果表明，一方面疾病认知变化与行为调节模式之间，另一方面与患者预后之间存在不同的关联模式。虽然疾病认知对每个预后均有显著影响，但行为调节模式仅对疲劳严重程度和身体功能有影响。
