TY - JOUR
T1 - Exploring the illness representations of people with psoriatic arthritis
T2 - A secondary analysis of focus group data
AU - On behalf of the PROMPT Study Group
AU - Erskine, George
AU - Dures, Emma
AU - McHugh, Neil
AU - Hewlett, Sarah
AU - Tillett, William
AU - Shaddick, Gavin
AU - Nightingale, Alison
AU - Harris, Helen
AU - Helliwell, Philip
AU - Coates, Laura
AU - Fernandez, Catherine
AU - Davies, Claire
AU - Brown, Sarah
AU - Packham, Jon
AU - Bojke, Laura
AU - Spackman, Eldon
AU - Smith, Catherine
AU - Barton, Anne
AU - Fitzgerald, Oliver
AU - Madhok, Vishnu
AU - Brooke, Melanie
AU - James, Jana
AU - Parkinson, Andrew
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Background. PsA is an inflammatory arthritis associated with psoriasis, affecting the joints and connective tissue. According to the common-sense model (CSM), patients develop illness beliefs when faced with new symptoms, which determine their emotional and behavioural response to the condition. The CSM includes five beliefs: identity, consequence, cause, time line and control. These are important determinants of outcomes and have been shown to influence adherence to medication. Methods. A secondary analysis of eight focus groups held across five hospital sites and including 41 participants was undertaken. Participants were sampled for a range of phenotypes and domains of disease activity: men = 20 and women = 21; mean (S.D.): age = 58 (11.4) years; disease duration = 9 (8.3) years; and HAQ = 1 (0.7). Results. The analysis provided evidence to support the existence of the five illness beliefs among patients with PsA and evidence that these representations affected the way patients engaged with their condition. The results showed that many participants experienced high levels of uncertainty in relationship to the illness representation. The role of external social and environmental factors was also shown to influence participants' illness representations and the way they made sense of their PsA. Conclusion. This research highlights a new theme of uncertainty within illness representations and how this impacts on the way in which people living with PsA manage their condition. A greater understanding of the uncertainty that patients might have about their condition and its treatment could provide clinicians with an opportunity to address misinformed illness representations.
AB - Background. PsA is an inflammatory arthritis associated with psoriasis, affecting the joints and connective tissue. According to the common-sense model (CSM), patients develop illness beliefs when faced with new symptoms, which determine their emotional and behavioural response to the condition. The CSM includes five beliefs: identity, consequence, cause, time line and control. These are important determinants of outcomes and have been shown to influence adherence to medication. Methods. A secondary analysis of eight focus groups held across five hospital sites and including 41 participants was undertaken. Participants were sampled for a range of phenotypes and domains of disease activity: men = 20 and women = 21; mean (S.D.): age = 58 (11.4) years; disease duration = 9 (8.3) years; and HAQ = 1 (0.7). Results. The analysis provided evidence to support the existence of the five illness beliefs among patients with PsA and evidence that these representations affected the way patients engaged with their condition. The results showed that many participants experienced high levels of uncertainty in relationship to the illness representation. The role of external social and environmental factors was also shown to influence participants' illness representations and the way they made sense of their PsA. Conclusion. This research highlights a new theme of uncertainty within illness representations and how this impacts on the way in which people living with PsA manage their condition. A greater understanding of the uncertainty that patients might have about their condition and its treatment could provide clinicians with an opportunity to address misinformed illness representations.
KW - Behaviour
KW - Common-sense model
KW - Illness representation
KW - Patient attitude to health
KW - Psychology and social phenomena
KW - Rheumatic diseases
KW - Spondylarthropathies
UR - http://www.scopus.com/inward/record.url?scp=85063184923&partnerID=8YFLogxK
U2 - 10.1093/rap/rky023
DO - 10.1093/rap/rky023
M3 - Article
AN - SCOPUS:85063184923
SN - 2514-1775
VL - 2
SP - 1
EP - 7
JO - Rheumatology Advances in Practice
JF - Rheumatology Advances in Practice
IS - 2
ER -