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NDT Advance Access originally published online on April 21, 2009
Nephrology Dialysis Transplantation 2009 24(10):3183-3185; doi:10.1093/ndt/gfp184
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Patients’ representations of their end-stage renal disease: relation with mortality

Sandra van Dijk1, Margreet Scharloo1, Adrian A. Kaptein1, Melissa S. Y. Thong2, Elisabeth W. Boeschoten3, Diana C. Grootendorst2, Raymond T. Krediet4, Friedo W. Dekker2 and for the NECOSAD Study Group*

1 Department of Medical Psychology 2 Department of Clinical Epidemiology, Leiden University Medical Center, Leiden 3 Hans Mak Institute, Naarden 4 Department of Nephrology, Amsterdam Medical Center, Amsterdam, The Netherlands

Correspondence and offprint requests to: Sandra van Dijk; E-mail: dijk{at}lumc.nl



  Abstract

Background. Self-regulation theory explains how patients’ illness perceptions influence self-management behaviour (e.g. via adherence to treatment). Following these assumptions, we explored whether illness perceptions of ESRD-patients are related to mortality rates.

Methods. Illness perceptions of 182 patients participating in the NECOSAD-2 study in the period between December 2004 and June 2005 were assessed. Cox proportional hazard models were used to estimate whether subsequent all-cause mortality could be attributed to illness perception dimensions.

Results. One-third of the participants had died at the end of the follow-up. Mortality rates were higher among patients who believed that their treatment was less effective in controlling their disease (perceived treatment control; RR = 0.71, P = 0.028). This effect remained stable after adjusting for sociodemographic and clinical variables (RR = 0.65, P = 0.015).

Conclusions. If we consider risk factors for mortality, we tend to rely on clinical parameters rather than on patients’ representations of their illness. Nevertheless, results from the current exploration may suggest that addressing patients’ personal beliefs regarding the effectiveness of treatment can provide a powerful tool for predicting and perhaps even enhancing survival.

Keywords: adherence; end-stage renal disease; illness perceptions; mortality; self-regulation

* A.J. Apperloo, J.A. Bijlsma, M. Boekhout, W.H. Boer, P.J.M. van der Boog, H.R. Büller, M. van Buren, F.Th. de Charro, C.J. Doorenbos, M.A. van den Dorpel, A. van Es, W.J. Fagel, G.W. Feith, C.W.H. de Fijter, L.A.M. Frenken, J.A.C.A. van Geelen, P.G.G. Gerlag, W. Grave, J.P.M.C. Gorgels, R.M. Huisman, K.J. Jager, K. Jie, W.A.H. Koning-Mulder, M.I. Koolen, T.K. Kremer Hovinga, A.T.J. Lavrijssen, A.J. Luik, J. van der Meulen, K.J. Parlevliet, M.H.M. Raasveld, F.M. van der Sande, M.J.M. Schonck, M.M.J. Schuurmans, C.E.H. Siegert, C.A. Stegeman, P. Stevens, J.G.P. Thijssen, R.M. Valentijn, G.H. Vastenburg, C.A. Verburgh, H.H. Vincent, P.F. Vos.

Received for publication: 10.10.08
Accepted in revised form: 30. 3.09


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