Illness beliefs among patients with chronic widespread pain - associations with self-reported health status, anxiety and depressive symptoms and impact of pain.

P Järemo, M Arman, B Gerdle, B Larsson, K Gottberg
Author Information
  1. P Järemo: Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 83, Huddinge, Sweden. pirjo.jaremo@ki.se. ORCID
  2. M Arman: Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 83, Huddinge, Sweden.
  3. B Gerdle: Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
  4. B Larsson: Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
  5. K Gottberg: Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 83, Huddinge, Sweden.

Abstract

BACKGROUND: 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.
METHOD: 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.
RESULTS: 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.
CONCLUSION: 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.

Keywords

References

  1. Curr Opin Anaesthesiol. 2014 Oct;27(5):520-7 [PMID: 25188218]
  2. Ann Behav Med. 2015 Oct;49(5):769-75 [PMID: 25697136]
  3. J Psychosom Res. 1999 Dec;47(6):555-67 [PMID: 10661603]
  4. Eur J Pain. 2012 Sep;16(8):1084-93 [PMID: 22362638]
  5. Pain. 2009 Jan;141(1-2):119-26 [PMID: 19059720]
  6. J Clin Epidemiol. 1998 Nov;51(11):1105-13 [PMID: 9817128]
  7. J Neuroendocrinol. 2001 Dec;13(12):1009-23 [PMID: 11722697]
  8. Compr Psychiatry. 2012 Oct;53(7):962-7 [PMID: 22534032]
  9. Patient Educ Couns. 2009 Jan;74(1):53-60 [PMID: 18815004]
  10. Clin J Pain. 2001 Mar;17(1):52-64 [PMID: 11289089]
  11. Psychol Health. 2013;28(1):84-102 [PMID: 22891727]
  12. Arthritis Rheum. 2009 Aug 15;61(8):1054-61 [PMID: 19644904]
  13. Clin J Pain. 2007 Sep;23(7):558-64 [PMID: 17710004]
  14. Phys Ther. 2013 Apr;93(4):435-48 [PMID: 23162040]
  15. Eur J Pain. 2008 Aug;12(6):742-8 [PMID: 18160318]
  16. Soc Sci Med. 1995 Nov;41(10):1349-58 [PMID: 8560302]
  17. Acta Psychiatr Scand. 1983 Jun;67(6):361-70 [PMID: 6880820]
  18. Br J Health Psychol. 2007 Nov;12(Pt 4):621-38 [PMID: 17931477]
  19. BMC Musculoskelet Disord. 2008 Jul 15;9:102 [PMID: 18627605]
  20. J Cardiovasc Nurs. 2010 Mar-Apr;25(2):E1-E10 [PMID: 20168186]
  21. BMC Musculoskelet Disord. 2014 Jun 20;15:213 [PMID: 24951013]
  22. Scand J Psychol. 2011 Dec;52(6):573-9 [PMID: 21722137]
  23. Am J Med Sci. 2014 Oct;348(4):271-6 [PMID: 24751421]
  24. Int J Nurs Pract. 2011 Aug;17(4):370-9 [PMID: 21781216]
  25. Arthritis Rheum. 2008 Nov;58(11):3618-26 [PMID: 18975315]
  26. Pain Manag Nurs. 2015 Feb;16(1):60-8 [PMID: 25179423]
  27. Arthritis Care Res. 1995 Mar;8(1):43-50 [PMID: 7794981]
  28. J Rehabil Med. 2014 Feb;46(2):173-80 [PMID: 24322580]
  29. Br J Health Psychol. 2010 May;15(Pt 2):367-87 [PMID: 19646332]
  30. Head Neck. 2005 Oct;27(10):857-63 [PMID: 16114002]
  31. Pain. 2013 Sep;154(9):1846-55 [PMID: 23752177]
  32. Arthritis Rheum. 1990 Feb;33(2):160-72 [PMID: 2306288]
  33. Ann Rheum Dis. 2009 Mar;68(3):305-9 [PMID: 19213747]
  34. Phys Ther. 2016 Mar;96(3):275-83 [PMID: 26183588]
  35. Chronic Illn. 2013 Dec;9(4):283-301 [PMID: 23585633]
  36. J Clin Epidemiol. 1998 Nov;51(11):1095-103 [PMID: 9817127]
  37. Acta Psychiatr Scand. 1997 Oct;96(4):281-6 [PMID: 9350957]
  38. J Rheumatol. 1996 Sep;23(9):1628-32 [PMID: 8877936]
  39. Pain. 2016 Jan;157(1):55-64 [PMID: 26270591]

MeSH Term

Adult
Aged
Aged, 80 and over
Anxiety
Chronic Pain
Cross-Sectional Studies
Depression
Emotions
Female
Health Status
Humans
Male
Mental Health
Middle Aged
Perception
Quality of Life
Self Report
Surveys and Questionnaires
Young Adult