Patients' representations of their end-stage renal disease: relation with mortality.
BACKGROUND
Self-regulation theory explains how patients' illness perceptions influence self-management behaviour (e.g. via adherence to treatment). Following these assumptions, we explored whether illness perceptions of ESRD-patients are related to mortality rates.


METHODS
Illness perceptions of 182 patients participating in the NECOSAD-2 study in the period between December 2004 and June 2005 were assessed. Cox proportional hazard models were used to estimate whether subsequent all-cause mortality could be attributed to illness perception dimensions.


RESULTS
One-third of the participants had died at the end of the follow-up. Mortality rates were higher among patients who believed that their treatment was less effective in controlling their disease (perceived treatment control; RR = 0.71, P = 0.028). This effect remained stable after adjusting for sociodemographic and clinical variables (RR = 0.65, P = 0.015).


CONCLUSIONS
If we consider risk factors for mortality, we tend to rely on clinical parameters rather than on patients' representations of their illness. Nevertheless, results from the current exploration may suggest that addressing patients' personal beliefs regarding the effectiveness of treatment can provide a powerful tool for predicting and perhaps even enhancing survival.
van Dijk
Sandra
S
Department of Medical Psychology, Leiden University Medical Center, Leiden, The Netherlands. dijk@lumc.nl
Scharloo
Margreet
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Kaptein
Adrian A
AA
Thong
Melissa S Y
MS
Boeschoten
Elisabeth W
EW
Grootendorst
Diana C
DC
Krediet
Raymond T
RT
Dekker
Friedo W
FW
Apperloo
A J
AJ
Bijlsma
J A
JA
Boekhout
M
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Boer
W H
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van der Boog
P J M
PJ
Büller
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HR
van Buren
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de Charro
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FT
Doorenbos
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van Es
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Gerlag
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PG
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JP
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RM
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K J
KJ
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Koning-Mulder
W A H
WA
Koolen
M I
MI
Hovinga
T K Kremer
TK
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A T J
AT
Luik
A J
AJ
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J
Parlevliet
K J
KJ
Raasveld
M H M
MH
van der Sande
F M
FM
Schonck
M J M
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Schuurmans
M M J
MM
Siegert
C E H
CE
Stegeman
C A
CA
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Thijssen
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JG
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R M
RM
Vastenburg
G H
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Verburgh
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PF
D000368:Aged; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000523:psychology*; D008297:Male; D011795:Surveys and Questionnaires