The Illness Belief Network Questionnaire: Development and Evaluation of a Psychosomatic Assessment Tool

Objective: Patients’ beliefs and emotions toward an illness can influence their coping responses, illness behaviors, adherence to treatment, quality of life, and even the psychoneuroimmune responses. The aim of present study was to develop and validate a novel questionnaire assessing both rational and irrational beliefs of patients regarding their illness. Method: In a cross sectional methodological study, the items of the Illness Belief Network (IBN) were developed regarding patients and clients’ opinions about and attribution of their disease extracted from 400 clinical interviews and were coded based on Leventhal’s self-regulation model. An expert panel coded the items. A total of 400 patients with different medical conditions completed the questionnaire. Participants additionally rated the Illness Perceptions Questionnaire in its revised form (IPQ-R) to assess convergent validity. Construct validity was examined by conducting exploratory and confirmatory factor analysis. The Cronbach alpha and Intracluster Correlation Coefficient (ICC) were used for examining Internal consistency and test-retest reliability of the IBN. Results: The IBN questionnaire was finalized with 84 items, and the results of factor analysis revealed 5 factors: psychosocial causes, environmental causes, control, meaning, and consequence/timeline; extracted factors were confirmed by confirmatory factor analysis. Cronbach’s α coefficient for scale was 0.92 and it ranged from 0.79 to 0.89 for the subscales. IBN indicated excellent test-retest reliability results based on ICC 0.842(95%CI: 0.798-0.846). The correlation coefficients of all items exceeded the prespecified acceptable value of 0.40, indicating satisfactory item discriminant validity, and correlation between IBN and IPQ-R subscales were statistically significant (all p values < 0.01), indicating acceptable convergent validity. Conclusion: The IBN questionnaire is a valid and reliable phenomenological, non-judging, and clinical tool to assess patient’s rational and irrational or faith-based beliefs about the illness. This tool can be used to improve doctor-patient communication by exploring the complex nature of human thinking.

I Illness Belief dan Illness Representation pada Pasien Diabetes Mellitus: Study Phenomenologhy

Latar Belakang: Diabetes Mellitus (DM) merupakan salah satu penyakit kronis yang membutuhkan strategi untuk dalam pengelolaan penyakitnya. Berbagai pengalaman dan pengetahuan pasien selama sakit dapat membentuk illness belief dan illness representation yang berbeda-beda pada pasien. Kesesuaian illness belief dan illness representation dapat menjadi salah satu kunci keberhasilan dalam pengelolaan penyakit ini. Tujuan: Studi ini merupakan studi pendahuluan yang bertujuan untuk mengetahui illness belief dan illness representation pada pasien DM. Metode: Metode dalam studi pendahuluan ini menggunakan design kualitatif dengan pendekatan phenomenology yang melibatkan sepuluh perawat dan sepuluh pasien di di Rumah Sakit Umum Daerah Dr. Soeroto Ngawi dan Rumah Sakit Widodo Ngawi. Pengambilan data dilakukan dengan indepth interview semistructure selanjutnya dianalisa menggunakan content analysis. Hasil: Tiga tema telah dididapatkan dalam studi ini, yaitu persepsi pasien tentang illness belief dan illness representation vs kelalaian pasien, persepsi perawat tentang illness belief dan illness representation vs tindakan mandiri perawat, serta dampak positif illness belief dan illness representation. Kesimpulan: Illness belief dan illness representation yang dimiliki oleh pasien DM memiliki pengaruh besar pasien DM. Tindakan perawat terkait dengan illness belief dan illness representation perlu ditingkatkan lagi sehingga dapat meningkatkan kesejahteraan pasien. Keywords : Illness belief, illness representation, diabetes mellitus

Older Adults and Their Families: An Interactional Intervention That Brings Forth Love and Softens Suffering

When assisting older adults and their families, the most useful family nursing conceptual skill is embracing the belief that “illness is a family affair.” This illness belief summons a systemic or interactional focus specifically on relationship communication patterns. Uncovering maladaptive and distressing familial interactions, a family nurse can intervene and offer ideas for more loving and caring interactional patterns. Three brief and one detailed clinical case example, illustrating how to conceptualize interactional patterns and how to intervene, are offered. This article also presents the author’s firsthand caregiving experience with its accompanying joys and pitfalls. Despite her decades of clinical practice and professional assistance to numerous elderly families, the caregiving and interactions with her father held no guarantee of being filled with consistent care and love. Although not easily applicable to one’s own family, focusing on the interrelationships with the elderly and their families, the embedded interactional patterns become the crucial ingredient to facilitate more satisfying and loving relationships.

Do individual versus illness belief schema differ in the prediction of post-stroke recovery?

This longitudinal observational study examined how individual versus illness belief schema compare as predictors of post-stroke recovery. A total of 42 stroke survivors (mean age = 66.9 years/range = 29–96 years; 68% male) were involved. The primary outcome, Health-Related Quality of Life was measured using EQ-5D-5L, mood using Patient Health Questionnaire-9 and disability using Nottingham Extended Activities of Daily Living Scale. Stroke Illness Perception Questionnaire-Revised measured illness beliefs. Linear regressions showed that individual illness beliefs significantly explained more of the variance in 3-month post-stroke recovery than schema (7.4%–22.5% versus 1.9%–9.9%). Individual versus illness belief schema predict outcomes differently, but which approach predicts outcomes better remains unclear.