A review of instruments to assess illness cognitions in rheumatology

Background: It is increasingly recognized that functional and mental outcomes in a patients with a health disorder are influenced by the models the patients create to make sense of the illness. Such models are referred to as illness perceptions or illness cognitions.

Objectives: To critically appraise instruments available in the literature that assess patient''s illness cognitions and that are generic or specific for rheumatic diseases. To evaluate if these instruments were applied in rheumatic diseases.

Methods: First, a systematic review of the literature was performed including a search of Medline and PsychInfo databases and contact with experts in the field. Secondly, critical appraisal of the retrieved instruments was performed using the criteria list of the Association of Rheumatology Health Professionals (ARHP) Outcome Measures Task Force. Thirdly, Medline and PsychInfo were searched to identify original studies in rheumatic diseases using these instruments.

Results: Five instruments were found. Name and language of the instrument, the first author and the year of the original publication are presented in the table. All instruments were generic but for the IPQ and IPQ-R disease specific adaptations are available or can be added. All instruments, were largely based on the concept of Leventhal and Lau, except for the MIQ which is based on the concept of Folkman and Lazarus. Description and scoring of the instruments, psychometric information and use in rheumatology are reported in the table. For each instruments sum-scores can only be applied to subscales but norm values are not proposed. Translations in other languages are available for the ICQ (English) and for the IPQ and IPQ-R (several languages) but are not always validated.