title: Juvenile-onset inflammatory arthritis: a study of adolescents' beliefs about underlying cause.
abstract: OBJECTIVE
  Patients' beliefs regarding the cause of illness may influence treatment adherence and long-term outcome. Little is known of adolescents' beliefs regarding the cause of JIA. This study aims to identify adolescents' beliefs about the underlying cause of their arthritis at first presentation to the paediatric rheumatology department.
  
  
  METHODS
  One hundred and twenty-two adolescents aged ≥11 years participating in the larger prospective Childhood Arthritis Prospective Study, an inception cohort of childhood-onset inflammatory arthritis, were asked to complete a questionnaire regarding underlying beliefs about their arthritis. The top-listed causes were identified, and associations between beliefs and characteristics of the adolescents and their arthritis were compared across the different causal beliefs.
  
  
  RESULTS
  The most common causal beliefs were genetics (27.1%), the immune system (21.3%), accident or injury (15.6%) and infection (13.1%). Association between causal beliefs and gender, disease duration, International League Against Rheumatism subtype and source of referral was observed, although small numbers prevented robust statistical comparisons.
  
  
  CONCLUSIONS
  This first report on adolescents' beliefs about the cause of their juvenile arthritis found the most common causal beliefs to be related to genes or the immune system. Brief assessments of adolescents' beliefs at presentation will enable providers to modify or adapt potentially unhelpful beliefs and provide age-appropriate information regarding arthritis.
authors.affiliation: School of Community-Based Medicine, University of Manchester, Manchester, UK.
authors.forename: Lis
authors.initials: L
authors.lastname: Cordingley
authors.forename: Tiffany
authors.initials: T
authors.lastname: Vracas
authors.forename: Eileen
authors.initials: E
authors.lastname: Baildam
authors.forename: Alice
authors.initials: A
authors.lastname: Chieng
authors.forename: Joyce
authors.initials: J
authors.lastname: Davidson
authors.forename: Helen E
authors.initials: HE
authors.lastname: Foster
authors.forename: Janet
authors.initials: J
authors.lastname: Gardner-Medwin
authors.forename: Lucy R
authors.initials: LR
authors.lastname: Wedderburn
authors.forename: Wendy
authors.initials: W
authors.lastname: Thomson
authors.forename: Kimme L
authors.initials: KL
authors.lastname: Hyrich
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001171:Arthritis, Juvenile / Q000209:etiology / Q000523:psychology*; D001294:Attitude to Health; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012737:Sex Factors