Wendy Damman1, Rani Liu1, Ad A Kaptein2, Andrea W M Evers3,4, Henriët van Middendorp3, Frits R Rosendaal5, Margreet Kloppenburg1,5. 1. Department of Rheumatology, Leiden University Medical Center, The Netherlands. 2. Department of Medical Psychology, Leiden University Medical Center, The Netherlands. 3. Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, The Netherlands. 4. Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. 5. Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Abstract
Objective: To investigate the association between illness perceptions and disability both cross-sectionally and over 2 years in patients with hand OA. Methods: Illness perceptions and self-reported disability were assessed at baseline and after 2 years in 384 patients with primary hand OA (mean age 61 years, 84% women, n = 312 with follow-up) with the Illness Perception Questionnaire - Revised (IPQ-R), Functional Index for Hand OA, Australian/Canadian Hand OA Index and HAQ. Risk ratios for high disability (highest quartile) at both time points were estimated for tertiles of IPQ-R dimensions, using Poisson regression. The mean IPQ dimension change difference between patients with and without disability progression (change Functional Index for Hand OA ⩾ 1, Australian/Canadian Hand OA Index > 1.4, HAQ > 0.22) was estimated with linear regression. Analyses were adjusted for age, Doyle index and baseline score. Results: At baseline, stronger negative illness perceptions were associated with high disability. Baseline illness perceptions were also associated with high disability after 2 years, although adjustment made apparent that these associations were confounded by baseline disability status. Most illness perceptions changed over 2 years; understanding increased, OA was regarded as more chronic and fewer emotions and consequences and less personal and treatment control were experienced. The 2 year change in disability was different between patients with and without progression for the illness perceptions of more perceived consequences, symptoms, treatment control and emotions. Conclusion: Illness perceptions seemed to be implicated in disability and its progression. Our results suggest that interventions could focus on improving baseline disability, potentially using illness perceptions to accomplish this goal.
Objective: To investigate the association between illness perceptions and disability both cross-sectionally and over 2 years in patients with hand OA. Methods: Illness perceptions and self-reported disability were assessed at baseline and after 2 years in 384 patients with primary hand OA (mean age 61 years, 84% women, n = 312 with follow-up) with the Illness Perception Questionnaire - Revised (IPQ-R), Functional Index for Hand OA, Australian/Canadian Hand OA Index and HAQ. Risk ratios for high disability (highest quartile) at both time points were estimated for tertiles of IPQ-R dimensions, using Poisson regression. The mean IPQ dimension change difference between patients with and without disability progression (change Functional Index for Hand OA ⩾ 1, Australian/Canadian Hand OA Index > 1.4, HAQ > 0.22) was estimated with linear regression. Analyses were adjusted for age, Doyle index and baseline score. Results: At baseline, stronger negative illness perceptions were associated with high disability. Baseline illness perceptions were also associated with high disability after 2 years, although adjustment made apparent that these associations were confounded by baseline disability status. Most illness perceptions changed over 2 years; understanding increased, OA was regarded as more chronic and fewer emotions and consequences and less personal and treatment control were experienced. The 2 year change in disability was different between patients with and without progression for the illness perceptions of more perceived consequences, symptoms, treatment control and emotions. Conclusion: Illness perceptions seemed to be implicated in disability and its progression. Our results suggest that interventions could focus on improving baseline disability, potentially using illness perceptions to accomplish this goal.
Authors: Robbert M Wouters; Ana-Maria Vranceanu; Harm P Slijper; Guus M Vermeulen; Mark J W van der Oest; Ruud W Selles; Jarry T Porsius Journal: Clin Orthop Relat Res Date: 2019-12 Impact factor: 4.176
Authors: Julia Blackburn; Mark J W van der Oest; Ruud W Selles; Neal C Chen; Reinier Feitz; Ana-Maria Vranceanu; Jarry T Porsius Journal: Clin Orthop Relat Res Date: 2019-12 Impact factor: 4.176
Authors: Elisabeth Marie Ginnerup-Nielsen; Marius Henriksen; Robin Christensen; Berit Lilienthal Heitmann; Roy Altman; Lyn March; Anthony Woolf; Hanne Karlsen; Henning Bliddal Journal: BMJ Open Date: 2019-09-04 Impact factor: 2.692