Rheumatology Advance Access originally published online on February 17, 2007
Rheumatology 2007 46(6):944-951; doi:10.1093/rheumatology/kem015
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The illness perceptions associated with health and behavioural outcomes in people with musculoskeletal hand problems: findings from the North Staffordshire Osteoarthritis Project (NorStOP)
Primary Care Musculoskeletal Research Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG and 1Department of Oral Health and Development, School of Clinical Dentistry, Claremont Crescent, University of Sheffield, Sheffield S10 2TA, UK
Correspondence to: S. Hill, Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire ST5 5BG, UK. E-mail: s.hill{at}cphc.keele.ac.uk
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Abstract |
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Objective. Illness perceptions may influence health outcomes, including pain. The objective of the study was to investigate the illness perceptions associated with health and behaviour in a population of older adults with musculoskeletal hand problems.
Methods. A two-stage cross-sectional postal survey was sent to individuals aged 50 yrs and over, registered with three general practices in North Staffordshire. Stage 1, a Health Survey questionnaire, was sent to 11 230 individuals and enquired about general health status, including anxiety and depression. Individuals reporting hand problems at Stage 1 were sent Stage 2, a detailed hand questionnaire. The hand questionnaire included: the Arthritis Impact Measurement Scales 2 (AIMS2) (hand and finger function, pain and medication scales), and questions on self-reported diagnoses and general practitioner (GP) consultation. Perceptions were measured by the Illness Perceptions Questionnaire-Revised (IPQ-R), and an item on perceived frustration with their hand problems. Of the 7878 responders to the Health Survey questionnaire 3749 (47.6%) reported ‘hand problems’ and 2695 (71.9%) gave permission to be re-contacted. The hand questionnaire was completed by 2113 (adjusted response rate 78.6%).
Results. A belief that their hand problem had a profound impact on life, caused a range of symptoms and made them frustrated were the perceptions most strongly and consistently associated with health and behaviour. There was little difference between individuals who did and those who did not report their hand problem to be osteoarthritis with respect to perceptions or between perceptions associated with health and behaviour.
Conclusions. The results suggest that older people who consider their musculoskeletal hand problem to have negative effects on their life will be more likely to encounter difficulties that may lead them to consult, take medication or both. Understanding the illness perceptions of these individuals may identify opportunities for intervention.
KEY WORDS: Population survey, Illness perceptions, Musculoskeletal
Submitted 26 July 2006;
revised version accepted 9 January 2007.
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