Effects of illness perception on negative emotions and fatigue in chronic rheumatic diseases: Rumination as a possible mediator

doi:10.12998/wjcc.v10.i34.12515

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World Journal of Clinical Cases

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Case Control Study

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.

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
Processing time: 211 Days and 8.1 Hours

ARTICLE HIGHLIGHTS

Research background

Although illness perception is proposed to be associated with psychological health in patients with rheumatic diseases, empirical evidence is lacking to support this hypothesis. Furthermore, the contribution of ruminative coping style to this relationship is unclear yet.

Research motivation

Psychological symptoms observed in patients with rheumatic diseases in clinical practice.

Research objectives

This study aimed to investigate the association of illness perception and fatigue and negative emotions in patients with chronic rheumatic diseases and the potential mediating effects of rumination.

Research methods

Illness perception, rumination, fatigue and negative emotions 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.

Research results

All the subscales of illness perception were found significantly associated with fatigue and negative emotions. In mediational analysis, rumination mediated three components of illness perception (the identity, cyclical nature, and consequences of illness) and negative emotions/fatigue.

Research conclusions

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. Psychological intervention should target rumination to improve physical and emotional well-being of patients with chronic rheumatic diseases.

Research perspectives

Identification of the mediating role of rumination in the relationship between illness perception and negative emotions and fatigue has important implications clinically for developing cognitive interventions for patients with rheumatoid arthritis and systemic lupus erythematosus.