Department of Urology, Mercy University Hospital, Cork, Ireland.
Department of Clinical Psychology, Mercy University Hospital, Cork, Ireland.
Urolithiasis. 2024 Oct 14;52(1):144. doi: 10.1007/s00240-024-01633-9.
Patients' beliefs about their illness are of central importance in understanding how a person adjusts to their condition and adheres to self-management recommendations. No previous studies have set out to quantitatively examine Illness beliefs in patients with kidney stones (KS). 112 patients with radiological confirmation of KS (59% male, mean (x̄) age = 50.1 years [sd14.15 years], 50.5% previous surgical treatment) attending for clinical consultation completed the Brief-Illness Perception Questionnaire alongside a range of demographic and illness related variables. Template analysis was undertaken on the free text responses of patients' beliefs about what had caused their KS. Almost a third (31.2%) of patients did not know what had caused their KS. Of those who cited a cause, dietary factors, fluid intake, medical risk factors (e.g. Inflammatory bowel disease), genetics, and psychological factors were ranked as the most important. Patients generally believed they had a reasonable understanding of KS (x̄=6.32 [sd3.21]), but reported poor levels of personal control over their KS (x̄=2.90 [sd2.93]) and high confidence in the effectiveness of treatments (x̄=8.64 [sd1.90]). Patients with a recurrence believed KS had a significantly greater impact on their life (z=-2.56, p = 0.01) and had greater emotional consequences (z=-2.77, p < 0.01). Perceptions of poor personal control over KS and a strong belief in medical/surgical treatment was evident regardless of first or recurrent stone, gender, age, previous surgical management of KS or time since diagnosis. Results highlight the need to actively increase patients' perceptions of personal control in the management and prevention of KS.
患者对自身疾病的信念在理解个体如何适应自身状况并遵循自我管理建议方面具有核心重要性。既往研究尚未定量评估肾结石（KS）患者的疾病信念。112 名经影像学证实的 KS 患者（59%为男性，平均（x̄）年龄=50.1 岁[sd14.15 岁]，50.5%曾接受过手术治疗）接受临床咨询时，除了一系列人口统计学和疾病相关变量外，还完成了简短疾病感知问卷。对患者关于导致 KS 原因的信念的自由文本回复进行模板分析。近三分之一（31.2%）的患者不知道导致 KS 的原因。在提到病因的患者中，饮食因素、液体摄入、医学危险因素（如炎症性肠病）、遗传和心理因素被认为是最重要的。患者普遍认为他们对 KS 有合理的了解（x̄=6.32[sd3.21]），但报告对 KS 的个人控制能力较差（x̄=2.90[sd2.93]），对治疗效果的信心较高（x̄=8.64[sd1.90]）。有复发史的患者认为 KS 对他们的生活有更大的影响（z=-2.56，p=0.01），并且情绪后果更严重（z=-2.77，p<0.01）。无论首次结石还是复发结石、性别、年龄、KS 的既往手术治疗或诊断后时间，对 KS 的个人控制能力差和对医疗/手术治疗的强烈信念的感知都很明显。结果强调需要积极提高患者对 KS 管理和预防的个人控制感。
