A longitudinal study on illness perceptions in hem dialysis patients: changes over time

Introduction: Self-regulatory theory explains how patients' illness representations influence self-management behavior. The aim of this study was to examine the changes that occur in disease perceptions after 6 years in hemodialysis patients. Material and methods: A total of 81 clinically stable patients (53.6% males, mean-age 54 +/-12.54 years, mean hemoglobin level 11 +/-1.52 g/dl, mean Kt/V 1.49 +/-0.21) who were treated with hemodialysis three times weekly completed questionnaires on illness representations in 2005, and then at follow-up, in December 2011, 47 patients. IPQ-R (Illness Perceptions Questionnaire-Revised) was used to assess patients' illness perceptions. Results: After a long period of years (6 years), patients had a stronger perception of a chronic course of the disease (timeline; p < 0.001), considered hemodialysis more efficient in controlling end stage renal disease (ESRD) (treatment control; p < 0.05), considered that their disease had less serious consequences for their life (consequences; p < 0.05), and also registered a less intense emotional response to their illness (emotional representation; p < 0.05). Two of the seven components of illness representations (personal control, cyclical symptoms) remained unchanged. Treatment control perceptions were also predictive of mortality after controlling for covariates (age, gender, dialysis vintage, blood hemoglobin level and Kt/V) (HR = 0.13, 95% Cl: 0.02-0.75, p = 0.022). Conclusions: Our results show that patients' illness perceptions vary over a significantly long follow-up period, in the sense of having more optimistic views towards their illness perceptions.