Onbegrip voor reumatische aandoeningen geassocieerd met fysiek functioneren en mentaal welbevinden
Rossum, I. van
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Objectives: Previous research has shown that the absence of social support and the presence of negative interactions are associated with lowered physical functioning and mental well-being and with more pain. The experience of invalidation, which includes both ‘discounting’ and ‘lack of understanding’, is a combination of the absence of social support and the presence of negative interactions. The first research question of the present study was to examine invalidation for patients with fibromyalgia, rheumatoid arthritis, arthrosis, ankylosing spondylitis, sjögren’s syndrome, systemic lupus erythematosus (SLE), and psoriatic arthritis. The second research question was to examine invalidation from the sources spouses, family, medical professionals, colleagues, and people in social services. The third research question was to examine whether invalidation was associated with self-reported symptoms. Furthermore the predictors of invalidation were examined. Methods: 203 patients with fibromyalgia, 106 patients with rheumatoid arthritis, 66 patients with arthrosis, 82 patients with ankylosing spondylitis, 17 patients with sjögren syndrome, 42 patients with SLE, and 33 patients with psoriatic arthritis completed the questionnaires. Invalidation was measured with the Illness Invalidation Inventory (3*I). To measure health status, which includes both physical functioning and mental well-being, the RAND-36 item Health Survey was used. Results: Patients with fibromyalgia experienced more invalidation than patients with other rheumatic diseases. Patients experienced more invalidation from their family, colleagues, and social services than from their spouses and medical professionals. Invalidation was associated with more self-reported symptoms. Type of rheumatic disease was the main predictor of invalidation. A younger age, being female, receiving a psychological treatment, being treated for back pain, and no comorbidity, were minor predictors of invalidation. Conclusions: Future research is needed to replicate these results and should clarify the clinical impact of invalidation.