Lu Y, Jin X, Feng LW, Tang C, Neo M, Ho RC. Effects of illness perception on negative emotions and fatigue in chronic rheumatic diseases: Rumination as a possible mediator. World J Clin Cases 2022; 10(34): 12515-12531 [PMID: 36579115 DOI: 10.12998/wjcc.v10.i34.12515]
Corresponding Author of This Article
Li-Wei Feng, College of Education for the Future, Beijing Normal University, No. 18 Jinfeng Road, Xiangzhou District, Zhuhai 519087, Guangdong Province, China. flw4511272@163.com
Research Domain of This Article
Behavioral Sciences
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 6, 2022; 10(34): 12515-12531 Published online Dec 6, 2022. doi: 10.12998/wjcc.v10.i34.12515
Effects of illness perception on negative emotions and fatigue in chronic rheumatic diseases: Rumination as a possible mediator
Yanxia Lu, Xia Jin, Li-Wei Feng, CSK Tang, Michelle Neo, Roger C Ho
Yanxia Lu, Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
Xia Jin, The Third Hospital of Jinan, Jinan 250132, Shandong Province, China
Li-Wei Feng, College of Education for the Future, Beijing Normal University, Zhuhai 519087, Guangdong Province, China
CSK Tang, Department of Obstetrics and Gynecology, National University of Singapore, The Chinese University of Hong Kong, Singapore 117570, Singapore
Michelle Neo, Roger C Ho, Department of Psychological Medicine, National University of Singapore, Singapore 119228, Singapore
Author contributions: Lu Y acquired the funding, performed data analysis and wrote the manuscript; Ho RC and Tang C designed the study and corrected the manuscript; Neo M performed the majority of experiments; and all authors reviewed and approved the final version of the manuscript.
Institutional review board statement: The study was approved by the National Healthcare Group Ethics Committee (reference number: DSRB E/10/228) and written informed consent was obtained from all participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Original data are available by contacting the corresponding author of this paper.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Wei Feng, College of Education for the Future, Beijing Normal University, No. 18 Jinfeng Road, Xiangzhou District, Zhuhai 519087, Guangdong Province, China. flw4511272@163.com
Received: May 5, 2022 Peer-review started: May 5, 2022 First decision: July 14, 2022 Revised: August 6, 2022 Accepted: November 2, 2022 Article in press: November 2, 2022 Published online: December 6, 2022
Abstract
BACKGROUND
Illness perception has long been hypothesized to be linked to psychological well-b eing in patients with rheumatic diseases, although substantial evidence is lacking, and the contribution of ruminative coping style to this relationship is unclear.
AIM
To investigate the roles of illness perception and rumination in predicting fatigue and negative emotions in patients with chronic rheumatic diseases.
METHODS
Illness perception, rumination, fatigue and negative emotions (i.e. depression, anxiety and stress) were assessed by the Illness Perception Questionnaire-Revised, Stress Reactive Rumination Scale, Multidimensional Assessment of Fatigue, and the Depression, Anxiety and Stress Scale respectively. Multivariate regression analysis, the Sobel test, and the bootstrap were used to identify the mediating effect of rumination.
RESULTS
All five subscales of illness perception, including perceived illness identity, chronicity, cyclical nature, consequences and coherence of illness, were significantly associated with fatigue and negative emotions. In mediational analysis, rumination was found to mediate three components of illness perception (the identity, cyclical nature and consequences of illness) and negative emotions/fatigue.
CONCLUSION
Perceived identity, cyclical nature, and consequences of illness are significantly associated with fatigue and negative emotions in patients with chronic rheumatic diseases and these associations are mediated by rumination. Our findings suggest that psychological intervention should target rumination to improve physical and emotional well-being of patients with chronic rheumatic diseases.
Core Tip: The present study investigated the association of multiple components of illness perception and psychological outcomes (fatigue and negative emotions) in patients with chronic rheumatic diseases, as well as the potential mediating role of rumination in this relationship. The results showed that perceived identity, chronicity and consequences of illness were significantly associated with fatigue and negative emotions, and these associations were mediated by rumination. Identification of the mediating role of rumination has important implications clinically for developing cognitive interventions for patients with rheumatoid arthritis and systemic lupus erythematosus.
