Page 77 - THE PERCEPT STUDY Illness Perceptions in Physiotherapy Edwin de Raaij
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Introduction
Musculoskeletal pain (MSP) is recognized worldwide as a main cause of increased years lived with disability. This illustrates clearly that Musculoskeletal pain (MSP) is a burden on patients as MSP is a major cause of pain and limitations in physical functioning29. These limitations include problems in the mobility of patients but also limitations in the ability to work and problems in actively participating in all aspects of life18. In addition, MSP is also a burden to society. Direct health care costs, social compensation, retirement pensions, and other indirect costs contribute to this load31.
Understanding the associations between various patient and disease characteristics in MSP is one important challenge in order to be able to improve the management for MSP and to reduce the burden of MSP, both to patients and society.
Patients’ beliefs about their pain, is one of these patient characteristics that may be associated with the intensity of pain and limitations in physical functioning in MSP8. Across 15 cross- sectional studies on 9 different musculoskeletal conditions, the researchers found limited to moderate evidence for a consistent direction of the relationship of illness perceptions with pain intensity and physical function. Higher dysfunctional illness perceptions imply stronger pain intensity and more limitation in physical function.
A framework which explores patients’ beliefs about their MSP is the Common Sense Model of Self-Regulation of health and illness17. This CSM is based on a parallel processing model, describing individual representations in response to health threats. These representations are called Illness Perceptions (IPs). Based on initial clinical research, five IP dimensions were identified (Box 1).
A cross-sectional study
    Box 1. Illness Perception dimensions
   1. Identity: the label or name given to the condition by patients and the symptoms that are perceived to go with it 2. Timeline Chronic: how long the patient believes the illness will last
3. Consequences: how strong the impact is of patients’ illness on e.g. pain or physical functioning
4. Causal beliefs: patient’s beliefs about what causes the illness
5. Control beliefs: patient’s beliefs about how to control or recover from the illness
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