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OBJECTIVE: To explore how causal beliefs regarding non-specific low back pain (LBP) have been quantitatively investigated. METHODS: A scoping review based on the guidelines by the JBI (former Joanna Briggs Institute) was conducted. We searched Medline, Embase, Psychinfo, and CINAHL for relevant studies and included peer-reviewed original articles that measured causal beliefs about non-specific LBP among adults and reported results separate from other belief domains. RESULTS: A total of 81 studies were included, of which 62 (77%) had cross sectional designs, 11 (14%) were cohort studies, 3 (4%) randomized controlled trials, 4 (5%) non-randomized controlled trials, and 1 (1%) case control. Only 15 studies explicitly mentioned cause, triggers, or etiology in the study aim. We identified the use of 6 questionnaires from which a measure of causal beliefs could be obtained. The most frequently used questionnaire was the Illness Perception Questionnaire which was used in 8 of the included studies. The studies covered 308 unique causal belief items which we categorized into 15 categories, the most frequently investigated being causal beliefs related to "structural injury or impairment", which was investigated in 45 (56%) of the studies. The second and third most prevalent categories were related to "lifting and bending" (26 studies [32%]) and "mental or psychological" (24 studies [30%]). CONCLUSION: There is a large variation in how causal beliefs are measured and a lack of studies designed to investigate causal beliefs, and of studies determining a longitudinal association between such beliefs and patient outcomes. This scoping review identified an evidence gap and can inspire future research in this field.
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Dor Lombar , Adulto , Humanos , Estudos Transversais , Inquéritos e QuestionáriosRESUMO
Laypersons' causal beliefs about mental disorders can differ considerably from medical or psychosocial clinicians' models as they are shaped by social and cultural context and by personal experiences. This study aimed at identifying differences in causal beliefs about post-traumatic stress disorder (PTSD) by country and gender. A cross-sectional, vignette-based online survey was conducted with 737 participants from Germany, Greece, Ecuador, Mexico, and Russia. Participants were presented with a short unlabeled case vignette describing a person with symptoms of PTSD. Causal beliefs were assessed using an open-ended question asking for the three most likely causes. Answers were analyzed using thematic analysis. Afterwards, themes were transformed into categorical variables to analyze differences by country and by gender. Qualitative analyses revealed a wide range of different causal beliefs. Themes differed by gender, with women tending to mention more external causal beliefs. Themes also differed between the five countries but the differences between countries were more pronounced for women than for men. In conclusion, causal beliefs were multifaceted among laypersons and shared basic characteristics with empirically derived risk factors. The more pronounced differences for women suggest that potential gender effects should be considered in cross-cultural research.
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Transtornos de Estresse Pós-Traumáticos , Estudos Transversais , Equador/epidemiologia , Feminino , Alemanha , Grécia , Humanos , Masculino , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologiaRESUMO
The present study is a randomised pilot study that evaluated a culturally tailored video promoting information about cervical cancer (CC), developed with Amazonian women in treatment for CC. The sample included 63 patients in treatment for CC who were randomly assigned to three groups of 21 patients. The experimental group watched an informative video about CC. The active control group watched a video on healthy habits and the passive control group received no intervention. The groups were compared in terms of change in knowledge and illness perceptions, over time. The results showed that the experimental group was the only one with a significant increase in knowledge (ß = .166; p = .03) that was not maintained over time (ß = -.195; p = .04). Threatening illness perceptions about the disease increased in all groups over time (ß = .105; p = .001). Future studies should replicate the results testing the efficacy of an audiovisual strategy in a larger sample, in health services that serve populations with similar social and cultural characteristics. This study emphasises the importance of interprofessional oncology teams providing clear information regarding CC, during all stages of the disease, and patients' treatment.Impact StatementWhat is already known on this subject? Latin American countries, such as Brazil, the low coverage of screening for CC can be related to the low education of women and their difficulty of access to health care. Hence, educational interventions may be a good strategy to reinforce the importance of screening and increase knowledge about illness prevention and treatment.What the results of this study add? An audiovisual informational intervention on CC was developed, addressing prevention, causes, control, consequences and treatment while respecting the patients' cultural and social reality through an approach that is simple and easy to understand. The group that watched the informative video was the only one that increased knowledge, revealing that it was a good CC informational strategy.What are the implications of these findings for clinical practice and/or further research? This study confirmed the importance of developing informational and educational strategies that are appropriate to patients' social and cultural reality. The video is now available to health teams in primary, secondary and tertiary care units, as a strategy for health promotion and CC prevention.
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Neoplasias do Colo do Útero , Brasil , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Programas de Rastreamento , Projetos Piloto , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controleRESUMO
Multimorbidity requires complex and ongoing care. Understanding the subjective illness experience is critical to effective care. Literature isn't clear about illness perception in patients with multimorbidity followed in services of high complexity. This study aims to investigate the illness experience based on narratives about daily living and symptoms of patients with multimorbidity and pain in a tertiary health care service. METHODS: Qualitative narrative inquiry design with framework analysis from semi-structured interviews at a tertiary internal medicine outpatient clinic. Patients with Elixhauser comorbidity index â§3 or and pain during the last week were included. Framework analysis was performed using 3 main patterns of illness experience from a previous study: "Gliding swan" (Resilience); "Stormy Seas" (Vulnerability); and "Stuck adrift" (Disruption); and identifying subthemes. One case study was selected from each main category. 43 patients, 14 classified as "gliding swan," 12 as "stormy seas" and 17 as "stuck adrift." Within the "gliding swan" group, positive examples of how to navigate through physical and emotional factors to sustain their wellbeing based on comprehension; In the "stormy seas" group, themes revolved around vulnerability, burden and ambiguity in relation to the health team. In the "stuck adrift" group the main content was about overwhelmed feelings and limitations. CONCLUSIONS: Narratives brought the content about lacking personalized understanding of diseases, with great emotional repercussion. Some meaningful anchors were highlighted. This study reinforces multimorbidity and pain interact and that healthcare professional should be aware of the turbulences that can disturb navigation in the raging seas of long-term multimorbid conditions.
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RATIONALE: Familial Hypercholesterolemia (FH) is a genetic condition that predisposes patients to substantially increased risk of early-onset atherosclerotic cardiovascular disease. FH risks can be minimized through regular participation in three self-management. BEHAVIORS: physical activity, healthy eating, and taking cholesterol lowering medication. OBJECTIVE: The present study tested the effectiveness of an integrated social cognition model in predicting intention to participate in the self-management behaviors in FH patients from seven countries. METHOD: Consecutive patients in FH clinics from Australia, Hong Kong, Brazil, Malaysia, Taiwan, China, and UK (total Nâ¯=â¯726) completed measures of social cognitive beliefs about illness from the common sense model of self-regulation, beliefs about behaviors from the theory of planned behavior, and past behavior for the three self-management behaviors. RESULTS: Structural equation models indicated that beliefs about behaviors from the theory of planned behavior, namely, attitudes, subjective norms, and perceived behavioral control, were consistent predictors of intention across samples and behaviors. By comparison, effects of beliefs about illness from the common sense model were smaller and trivial in size. Beliefs partially mediated past behavior effects on intention, although indirect effects of past behavior on intention were larger for physical activity relative to taking medication and healthy eating. Model constructs did not fully account for past behavior effects on intentions. Variability in the strength of the beliefs about behaviors was observed across samples and behaviors. CONCLUSION: Current findings outline the importance of beliefs about behaviors as predictors of FH self-management behaviors. Variability in the relative contribution of the beliefs across samples and behaviors highlights the imperative of identifying sample- and behavior-specific correlates of FH self-management behaviors.
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Conhecimentos, Atitudes e Prática em Saúde , Hiperlipoproteinemia Tipo II/psicologia , Intenção , Participação do Paciente/psicologia , Autogestão/psicologia , Austrália , Brasil , China , Estudos Transversais , Feminino , Hong Kong , Humanos , Hiperlipoproteinemia Tipo II/complicações , Hiperlipoproteinemia Tipo II/terapia , Malásia , Masculino , Participação do Paciente/métodos , Participação do Paciente/estatística & dados numéricos , Autogestão/métodos , Autogestão/estatística & dados numéricos , Inquéritos e Questionários , Taiwan , Reino UnidoRESUMO
As doenças cardiovasculares representam a principal causa de morte no Mundo, podendo sua etiologia estar ligada a fatores psicológicos, como a Personalidade Tipo D. Indivíduos com esse tipo de personalidade apresentam vivência crônica de afetividade negativa associada à inibição social. Outro fator importante no adoecimento é a maneira como os sujeitos percebem sua saúde, pois esta resultará na implementação de estratégias para lidar com sua condição. Nesse sentido, o objetivo do trabalho foi avaliar, pela aplicação dos instrumentos Brief IPQ e DS-14, a relação entre a percepção de doença e a prevalência de Personalidade Tipo D em 80 pacientes com DAC , durante internação hospitalar. Na comparação das médias, pode-se verificar que os sujeitos com PTD tendem a perceber maior severidade em sua doença. Foram encontrados, também, índices baixos de entendimento dos fatores causais e temporalidade da doença. Ressalta-se o papel das estratégias psicoeducativas como fundamentais na atenção a esses pacientes.
Cardiovascular diseases are the main cause of death in Brazil, multiple factors are related to the etiology of this condition, including those of psychological origin, such as Type D Personality, that seems to predispose subjects to a chronic stress state that would increase the risk of developing CVDs. Another factor with influence in the disease is the way individuals perceive their health status, being this perception responsible for the way they create devices to deal with their condition. In this sense, the objective of the present study was to evaluate, using Brief IPQ and DS-14 Scale, the relationship between the perception of disease and the prevalence of Type D Personality in 80 patients with CAD during hospitalization. It can be observed that, although no statistical correlations were found between the variables, subjects with TDP tend to perceive greater severity in their disease. We also found low levels of understanding and the temporality of the disease. The role of psychoeducational strategies is highlighted.
Las enfermedades cardiovasculares representan la principal causa de muerte en el mundo, pudiendo su etiología estar ligada a factores psicológicos, como la Personalidad Tipo D. Otro factor importante en los contextos de enfermedad es la manera en que los sujetos perciben su salud, ya que resultará en la implementación de estrategias para lidiar con su condición. En este sentido el objetivo del presente trabajo fue evaluar por la aplicación de los instrumentos Brief IPQ y DS-14, la relación entre la percepción de enfermedad y la prevalencia de Personalidad Tipo D en 80 pacientes con DAC durante internación hospitalaria. Aunque, no significativamente entre las variables, los sujetos con PTD tienden a percibir mayor severidad en su enfermedad. Se encontraron, también, índices bajos de entendimiento de los factores causales y de la temporalidad de la enfermedad. Se resalta el papel de las estrategias psicoeducativas como fundamentales en la atención a estos pacientes.
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OBJECTIVES: To identify clusters of chronic obstructive pulmonary disease (COPD) patients with distinct beliefs about their illness in terms of symptoms, health-related quality of life (HRQoL), self-efficacy, and daily life physical activity (DLPA). METHODS: This cross-sectional study included 150 COPD outpatients. The patients' illness perceptions, clinical control, HRQoL, self-efficacy, and DLPA (accelerometry) were evaluated. A cluster analysis was conducted using data from the Illness Perceptions Questionnaire - Revised to establish groups of patients with distinct illness perceptions. Differences between clusters were tested using a T-test or a Mann-Whitney U test. RESULTS: The cluster analysis revealed two groups: distressed ( n = 95) and coping ( n = 55). Despite the fact that both clusters presented similar pulmonary function, between-cluster differences were observed in their self-efficacy, dyspnea, HRQoL, clinical control ( p < 0.001), and educational level ( p = 0.002). The levels of DLPA did not differ between the clusters. DISCUSSION: We observed that clinically stable COPD patients who displayed higher emotional representations and less coherence had heightened symptoms, poorer HRQoL, worse self-efficacy, and lower educational levels. These results emphasize the need to routinely evaluate illness perceptions in COPD patients to target and tailor the proper treatment to improve these important health outcomes.
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Doença Pulmonar Obstrutiva Crônica/psicologia , Qualidade de Vida , Autoeficácia , Índice de Gravidade de Doença , Adaptação Psicológica/fisiologia , Idoso , Análise por Conglomerados , Estudos Transversais , Progressão da Doença , Exercício Físico , Feminino , Humanos , Masculino , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Inquéritos e QuestionáriosRESUMO
Objective Leprosy has rarely been the subject of health psychology research despite its substantial impact. Our aim was to explore illness perceptions in patients and their health care providers in Surinam. The Common Sense Model (CSM) was the guiding theoretical model. Design Patients with biomedically cured leprosy and their health care providers completed the B-IPQ and took part in semi-structured interviews. The literature on illness perceptions in patients with leprosy was reviewed. Main outcome measures Patients' B-IPQ scores were compared with samples of patients with other (chronic) illnesses, and with health care providers completing the questionnaire as if they were visibly disfigured patients. Quotations from the semi-structured interviews were used to contextualise the illness perceptions. Results Patients' B-IPQ scores reflected the chronic nature of leprosy and were comparable with those with other chronic illnesses. Health care providers perceived leprosy to have a greater negative impact than did the patients. Perceived understanding of causes differed considerably between patients and health care providers. Conclusion Leprosy continues to be experienced as an illness with major psychological and social consequences such as stigmatisation, even after biomedical cure. Interventions that target patients, health care providers, and society at large may help reduce perceived shame and stigma. The CSM is a helpful theoretical model in studying this population.
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Doença Crônica/psicologia , Hanseníase/psicologia , Efeitos Adversos de Longa Duração/psicologia , Doenças Musculoesqueléticas/psicologia , Adulto , Idoso , Feminino , Humanos , Hanseníase/complicações , Hanseníase/terapia , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/microbiologia , Percepção , Pesquisa Qualitativa , Estigma Social , Suriname , Inquéritos e Questionários , Fatores de TempoRESUMO
BACKGROUND: Insight and illness perception are two concepts of interest in the study of factors related to clinical outcome in patients with psychosis. Insight implies a risk of emotional distress for the patient. Illness perceptions, regardless of their accuracy, might be favorable or not to illness. Literature provides evidence of significant correlates of these factors with clinical outcome, but they are rarely included in a single study. OBJECTIVES: 1) assessing insight and illness perception in a sample of Mexican patients who have experienced psychosis and, 2) analyzing how insight and illness perception relate to each other and how they relate to clinical status (i.e., positive, negative, and general psychopathology, depression, and anxiety). METHODS: Sixty-one participants (55.7% females) were recruited from a public psychiatric hospital; insight and illness perceptions were assessed with the SUMD and the Brief-IPQ, respectively. Clinical status was assessed with the PANSS, CDS and BAI scales. RESULTS: Participants showed good insight, favorable illness perceptions for the cognitive and comprehension dimensions, but unfavorable for the emotional dimension. Clinical status of sample was characterized by mild symptoms. Poor insight related to positive symptoms and general psychopathology. Cognitive and emotional perceptions of illness were significantly associated to most clinical status parameters, whereas comprehension showed no significant results. CONCLUSIONS: The study not only replicates the significant association on insight and illness perception with clinical outcome, but shows how their patterns of interactions are different, reinforcing the idea that they are two distinct factors worthy of being habitually acknowledged in research and clinical practice.
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The mechanisms underlying the association between expressed emotion (EE) and the prognosis in early psychosis are still not well understood. Based on the attributional model, this study investigated the association of criticism and Emotional Over-Involvement (EOI) with symptoms and functioning in At-Risk Mental State (ARMS) and First-Episode Psychosis (FEP) patients, and whether these associations were mediated by relatives׳ attributions of control and blame. Forty-four patients (20 ARMS and 24 FEP) and their relatives were included. Findings indicated that relatives׳ criticism was associated with positive, negative, and general symptoms. EOI was related to negative and general symptoms. Both indices were related with impaired functioning. Most of the relations between EE indices and illness severity were mediated by relatives׳ attributions of blame toward the patient. Relatives׳ self-blaming attributions and attributions of control over the disorder by either relatives or patients were not associated with patients׳ variables or EE. Findings highlight the importance of family emotional environment in the early stages of psychosis, as well as the mediating role that relatives׳ beliefs can exert in those relationships. Family interventions aimed to assist relatives to change attributions that blame patient should be included in clinical protocols in order to prevent the entrenchment of high-EE.