title: Illness perceptions predict survival in haemodialysis patients.
abstract: BACKGROUND
  Illness perceptions have been shown to be important determinants of functional and psychosocial outcomes, including quality of life and treatment adherence in end-stage renal disease patients. The aim of this prospective study was to determine whether haemodialysis patients' illness perceptions impact upon survival.
  
  
  METHODS
  Haemodialysis patients from a UK renal service completed the Revised Illness Perception Questionnaire. Over the study period (May 2007 to December 2010), all-cause mortality was recorded as the endpoint.
  
  
  RESULTS
  223 patients were followed up for a median of 15.9 months (min. 10 days, max. 42.7 months). The median dialysis vintage was 17.6 months (min. 4 days, max. 391.3 months). Treatment control perceptions demonstrated a significant association with mortality (HR = 0.91, 95% CI: 0.83-0.99, p = 0.03). After controlling for covariates, including age, albumin, extra renal comorbidity and depression scores, perception of treatment control remained a significant predictor of mortality (HR = 0.89, 95% CI: 0.80-0.99, p = 0.03).
  
  
  CONCLUSIONS
  Patients' perceptions of treatment control (dialysis therapy) predict survival independently of survival risk factors, including comorbidity. Studies are required to test whether psychological interventions designed to modify maladaptive illness perceptions influence clinical outcomes in this patient setting.
authors: School of Psychology, University of Hertfordshire, Hatfield, UK. j.chilcot@herts.ac.uk
authors: Joseph
authors: J
authors: Chilcot
authors: David
authors: D
authors: Wellsted
authors: Ken
authors: K
authors: Farrington
mesh_terms: D000368:Aged; D000418:Albumins / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D011446:Prospective Studies; D011788:Quality of Life; D006435:Renal Dialysis / Q000379:methods* / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D000418:Albumins; D002097:C-Reactive Protein