Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 83, Huddinge, Sweden.
Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
BMC Psychol. 2017 Jul 5;5(1):24. doi: 10.1186/s40359-017-0192-1.
Chronic widespread pain (CWP) is a disabling condition associated with a decrease in health. Illness beliefs are individual and are acquired during life. Constraining beliefs may prevent patients from regaining health. Understanding these patients' illness beliefs may be a way to improve the health care they are offered. The aim of this study was to describe illness beliefs among patients with CWP and associations with self-reported health, anxiety and depressive symptoms, and impact of pain.
In this cross-sectional study, questionnaires were sent by mail to 330 patients including socio-demographic information, the Illness Perception Questionnaire (IPQ-R), the Short-Form General Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Data were analysed using descriptive statistics, non-parametric tests and linear regression analyses.
Patients experienced and related a high number of symptoms to CWP (mean (SD) 9 (3)). The patients believed their illness to be long lasting, to affect their emotional well being, and to have negative consequences for their lives. Some 72% reported having severe or very severe pain, and impact of pain according to SF-36 was negatively correlated to several illness beliefs dimensions, anxiety- and depressive symptoms. In regression analyses, the Identity, Consequences and Personal control dimensions of IPQ-R and Anxiety- and Depressive symptoms explained 32.6-56.1% of the variance in the two component scores of SF-36.
Constraining illness beliefs in patients with CWP are related to worse health status, especially in cases of high number of physical or mental symptoms, beliefs of negative consequences or the illness affecting them emotionally. Identification and understanding of these beliefs may reduce patients' suffering if they are taken into consideration in rehabilitation programs and in development of new evidence-based interventions aimed at increasing health in patients with CWP.
慢性广泛性疼痛（CWP）是一种与健康状况下降相关的致残性疾病。疾病观念是个体的，并且是在生活中获得的。限制信念可能会阻止患者恢复健康。了解这些患者的疾病观念可能是改善他们所接受的医疗保健的一种方式。本研究的目的是描述 CWP 患者的疾病观念及其与自我报告的健康、焦虑和抑郁症状以及疼痛影响的关联。
在这项横断面研究中，通过邮件向 330 名患者发送了问卷，包括社会人口统计学信息、疾病感知问卷（IPQ-R）、简明健康调查量表（SF-36）和医院焦虑抑郁量表（HADS）。使用描述性统计、非参数检验和线性回归分析来分析数据。
患者经历并将许多症状与 CWP 相关联（平均值（SD）为 9（3））。患者认为他们的疾病持续时间长，会影响他们的情绪健康，并对他们的生活产生负面影响。约 72%的患者报告有严重或非常严重的疼痛，SF-36 评估的疼痛影响与几个疾病观念维度、焦虑和抑郁症状呈负相关。在回归分析中，IPQ-R 的身份、后果和个人控制维度以及焦虑和抑郁症状解释了 SF-36 的两个分量表得分的 32.6-56.1%的变异。
CWP 患者的限制信念与较差的健康状况相关，尤其是在存在大量身体或心理症状、负面后果信念或疾病影响情绪时。如果在康复计划中考虑到这些信念，并开发旨在增加 CWP 患者健康的新循证干预措施，识别和理解这些信念可能会减轻患者的痛苦。
