Drives that may influence the severity of somatic symptoms in inflammatory rheumatic and musculoskeletal diseases: A concept mapping study
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Introduction: Inflammatory rheumatic and musculoskeletal diseases (IRMD) influence adversely patients' physical and psychological functioning. However, individuals use drives as resilient factors in order to adjust to the context of their disease. The aim of this study was to identify the drives that people with IRMD have and may help them alleviate their symptoms. Methods: Online questionnaires yielded a comprehensive overview of drives that were sorted in a card sorting task according to similarity of meaning by 53 patients with IRMD (51 female, 2 male; mean age 52.7 (range 27-68) years). Hierarchical cluster analysis (squared Euclidean distances, Ward's method) was used to obtain a structured overview of the drives. Perceived importance of the clusters was examined using repeated measures analysis of variance and the association between the severity of symptoms measured by Patient Health Questionnaire (PHQ-15) scores and the perceived importance of drives using multiple regression analysis. Results: The hierarchical structure of drives showed 40 drives, classified in four broad categories: Belonging, Resilience, Personal Development and A calm life. On average, participants perceived Belonging as the most important drive and A calm life as the least beneficial one. We found no association between the severity of physical symptoms and the perceived importance of drives. Conclusion: This study offers an encompassing overview of drives that may enhance quality of life and foster the adjustment to the disease. In clinical practice, the clusters of drives can be used as targets of self-management and psychological interventions tailored to treat people with IRMD.