Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands.
Department of Rheumatology, Amsterdam University Medical Centre, Amsterdam, The Netherlands.
Musculoskeletal Care. 2020 Jun;18(2):177-186. doi: 10.1002/msc.1453. Epub 2020 Jan 26.
This study explores illness perceptions, risk perceptions and degree of worry in patients with recently diagnosed systemic sclerosis (SSc). Specifically, it aims to answer whether and how early diagnosis in a stage that disease is relatively mild can impact patients' lives, and if and how disease severity associates with illness perceptions and risk perception.
Patients with a diagnosis of SSc <2 years were invited to participate in a focus group discussion for in-depth exploration of illness perceptions, risk perceptions and worry. In addition, illness perceptions, risk perceptions and worries were evaluated with the use of questionnaires. To explore how patients perceive SSc, we asked them to draw their disease. Physician global assessment of disease severity was used to measure disease severity. Associations between disease severity, illness/risk perceptions, drawings and elements of the focus group were assessed.
We observed three dimensions of illness perception as most relevant for patients: personal control, concern and consequences. Patients with SSc experienced many symptoms and felt low personal control. Concerns about the future were often mentioned, and the majority of patients scored high on the worry questionnaire. None of the patients was preoccupied with prognosis or death. All drawings illustrate the impact of SSc on daily life and psychological well-being. Illness perceptions were highly variable between patients and did not associate with disease severity.
This study showed that a diagnosis of early SSc had a significant impact on patients' lives, also in the absence of severe disease complications.
本研究探讨了近期诊断为系统性硬化症(SSc)患者的疾病感知、风险感知和担忧程度。具体而言,本研究旨在回答早期诊断在疾病相对较轻的阶段是否以及如何影响患者的生活,以及疾病严重程度是否与疾病感知和风险感知相关。
邀请诊断为 SSc<2 年的患者参加焦点小组讨论,深入探讨疾病感知、风险感知和担忧。此外,还使用问卷评估疾病感知、风险感知和担忧。为了探索患者如何感知 SSc,我们要求他们画出自己的疾病。使用医生总体疾病严重程度评估来衡量疾病严重程度。评估疾病严重程度、疾病/风险感知、绘画以及焦点小组各要素之间的关联。
我们观察到三个与患者最相关的疾病感知维度:个人控制、关注和后果。SSc 患者经历了许多症状,感到个人控制能力较低。对未来的担忧经常被提及,大多数患者在担忧问卷上的得分较高。没有患者过分关注预后或死亡。所有的绘画都说明了 SSc 对日常生活和心理健康的影响。患者之间的疾病感知差异很大,与疾病严重程度无关。
本研究表明,早期 SSc 的诊断对患者的生活有重大影响,即使没有严重的疾病并发症。