Maria João Figueiras

Do similar patient and spouse perceptions of myocardial infarction predict recovery

The present study examines whether the degree of congruence between the patients and the partners perceptions of myocardial infarction (MI) has an influence on a range of recovery outcomes in the patient. The MI perceptions of 70 Portuguese couples in which the male had suffered a first heart attack were assessed at 3 months after discharge from hospital, using the Illness Perception Questionnaire (IPQ). Several dimensions of patient recovery were assessed at 3, 6 and 12 months post-MI, using standardised measures of psychological well-being, return to work, disability, social functioning, sexual functioning, and indices of lifestyle changes. The degree of congruence in each couples illness perceptions was assessed and related to each outcome measure. The results suggest that the degree of congruence between patients and partners in their illness perceptions was related to different dimensions of recovery at 3, 6 and 12 months. The results revealed that in couples who had similar positive perceptions of the identity and consequences of the MI, patients showed (a) better physical and psychological functioning, (b) better sexual functioning, and (c) less impact of MI on social and recreational activities. Also, similar positive perceptions of timeline were associated with lower levels of disability, and similar positive cure/control beliefs were linked with greater dietary changes. Separate analyses showed that these effects were not confounded with marital functioning. This study provides clear evidence that the degree of match/mismatch between the patients and partners perceptions of the MI is associated with a range of recovery outcomes.

Lay perceptions of serious illnesses: An adapted version of the Revised Illness Perception Questionnaire (IPQ-R) for healthy people

The present study was undertaken to develop a version of the Revised Illness Perception Questionnaire (IPQ-R) for healthy individuals. The perceptions of AIDS, tuberculosis and skin cancer were assessed in a national sample of 1113 healthy individuals, recruited at random from different working environments. Item selection was determined by principal components analyses, which verified the factorial structure of the questionnaire. Earlier, a pilot study provided some evidence of the good internal reliability of the subscales and the retest reliability at 3 weeks. The results indicate that the factorial structure of the IPQ-R for healthy individuals (IPQ-RH) is similar to the structure for different patient groups, with an internal reliability for each illness dimension ranging from 0.64 to 0.81. The IPQ-RH dimensions account for significant variance in attitudes and intentions towards the adoption of preventive behaviours. The results lend further support for the theoretically derived dimensions of illness representations, and could be used to provide the basis for new research and interventions in health promotion.

Patients' illness schemata of hypertension: the role of beliefs for the choice of treatment

The aims of this study were (1) to investigate what are the illness perceptions of hypertensive patients and their relationship with beliefs about specific medicines, and (2) to identify different illness schemata and how they relate to the choice of medication. This was a cross-sectional study in which 191 Portuguese patients (59% females), with a hypertension diagnosis, aged over 18 years old, were recruited from a hospital clinic in the Lisbon Metropolitan area. The questionnaire included measures of choice of medication, beliefs about specific medicines (BMQ-Specific), illness perception (Brief-IPQ), and socio-demographic information. The results indicated that the components of the illness perceptions were associated with patients’ beliefs about necessity and concerns about medication. Patients seem to differ in their choice of medication (generic or brand names) according to the three illness schemata identified. Patients with more negative illness schemata were more likely to choose a brand medicine, whereas patients with a more positive perception of hypertension were more likely to choose a generic medicine. Our findings support the argument that illness perceptions and beliefs about medicines play a role in influencing patients’ preferences of medicines for the treatment of hypertension.

Assessing lay beliefs about generic medicines: Development of the generic medicines scale.

The aims of this study were to develop a scale to assess lay beliefs about generic medicines, and to investigate whether these beliefs differ according to demographic factors in an opportunistic general public sample. In the pilot study, the participants were 92 men and 136 women, and in the main study there were 314 men and 505 women. At both stages, the participants completed a questionnaire measuring beliefs about generic medicines, preference for medicines and demographic information. The scale has good face validity, showing a satisfactory level of internal consistency. An exploratory principal component analysis revealed a two-factor structure concerning beliefs about generic medicines, comprising two core themes (efficacy and similarity to brand medicines), in two different samples. Older participants showed a stronger belief in similarity with brand names than the younger group. Higher educated participants showed a stronger belief in the efficacy of generics. The opportunity to assess beliefs about generic medicines may have implications for adherence, for the implementation of health policies and for decision making about medicines.

Lay views about medicines: The influence of the illness label for the use of generic versus brand

The aim of this cross-sectional study was to investigate how different types of prescriptions using different illness labels may influence lay views about the use of generic or brand medicines. The participants were 882 Portuguese (both sexes) recruited from the general population, who completed a self-administered questionnaire. A vignette methodology was used in which different prescriptions (generic versus brand) were given for the same label (flu, hypertension, asthma and angina pectoris). The dependent variables were for each illness label: (a) the level of agreement with the prescription, (b) beliefs about the efficacy of a medicine and (c) beliefs about the relief of symptoms. There were main effects of the label and the type of prescription upon beliefs about the use of medicines. There were interactions between illness label and type of medicines. Labels which were perceived as more serious were associated with a lower belief in generic medicines. These results raise important questions concerning the need to consider illness perceptions of lay people (including perceived severity) and its relationship with perceptions of treatment for different conditions. Furthermore, these results may have implications for health-related behaviour in general, and in particular for communication between lay people and health professionals, prescribing behaviour, health costs and adherence to treatment.

Effects of Textual and Pictorial Information Upon Perceptions of Down Syndrome: An Analogue Study

Abstract The aim of this analogue study is to determine whether presenting information about Down syndrome (DS) using text or pictures has different effects upon perceptions of the Down syndrome and behavioural expectations about using prenatal tests and terminating an affected pregnancy. A 4 × 3 between participants factorial design was used, in which 814 undergraduates were provided with information about Down syndrome in different forms (textual information: positive, negative, neutral and no information × pictorial information: positive, negative or no picture). There were main effects of the textual and pictorial information upon some of the dependant variables. There were no interactions between these two types of information. Photographs, whether depicting positive or negative images of DS, increased concern about having a child with Down syndrome compared with the responses of those not receiving a photograph. The negative photograph increased expectations to undergo prenatal tests and to terminat...

The relationship between illness perceptions and cardiac misconceptions after Myocardial Infarction

Research about cardiac misconceptions has focused on identifying the most common erroneous beliefs and understanding their impact on patients’ outcomes. However, less is known about the underlying structure of cardiac misconceptions and how they relate to other belief dimensions. The aims of the present study were: (a) to characterize illness perceptions and cardiac misconceptions in a sample of Myocardial Infarction (MI) patients; (b) to analyse the structure of an experimental Portuguese version of the York Cardiac Beliefs Questionnaire (YCBQ); and (c) to examine whether illness perceptions are likely to influence cardiac misconceptions. This cross-sectional study included 127 first-MI patients from both sexes, aged up to 70 years old. Confirmatory factor analysis and structural equation modelling were performed with AMOS. The main results showed that a two-dimension (stress avoidance and exercise avoidance) version of the YCBQ offered the best fit to the data. A significant impact of psychological attributions was observed on cardiac misconceptions, as well as a moderate impact of emotional response explaining 26% of the variance. Although exploratory, this study gives a significant contribution to research in this field, as clarification on the different concepts and the way they relate is needed. Our findings suggest that further investigation into the concepts of cardiac knowledge and cardiac misconceptions may have an important role in understanding health behaviours in the context of heart disease.

Discerning the impact of personal and situational variables in risk perception of coronary heart disease

Research into how people perceive risk has highlighted the interaction between the available information and personal variables and their impact on judgement. This study sought to identify demographic and health variables that influenced risk and the influence of individual risk assessment, dispositional optimism and negative affect on judgement. A total of 476 participants were asked to make risks judgements of 24 vignettes depicting hypothetical risk scenarios. The findings showed that while people are able to correctly recognise, in others, relevant risk factors for coronary heart disease, risk perception is likely to imply a personal consideration of the same risk factors in themselves.

Illness Perception, Knowledge and Self-Care about Cervical Cancer

Prevention plays a central role in early detection of cervical cancer. Common Sense Model proposes that the nature and organization of illness representations can guide actions related to health and how self-care is exercised. The aim of this study was to describe and compare illness perception, knowledge and self-care in women with and without cancer precursor lesions. Participants were 92 women (aged 18-59) from primary care unity divided into two groups: women with and without premalignant lesion. Measures for illness perception, knowledge and self-care were used. There was no statistically significant difference (t test e chi-square test) between groups in the variables analyzed. Despite the risk for cervical cancer, women with precursor lesions do not adjust their illness perceptions, knowledge and self-care to the situation. These data show the need to warn women against the cervical cancer risks, because their distorted perceptions and lack of knowledge about the disease may hamper the screening and control of cervical cancer.

Cardiac misconceptions among healthy adults: implications for the promotion of health in the community

This study sought to confirm the structure and to investigate the psychometric properties of an experimental Portuguese version of the York Cardiac Beliefs Questionnaire (YCBQ) in a general population sample. It also set out to identify the prevalent misconceptions in the community and to assess the differences according to socio-demographic characteristics. It involved a cross-sectional survey in which both test and validation samples were collected (n = 476), including participants aged between 18 and 40, recruited via e-mail and social networks. The Confirmatory Factor Analysis on both samples suggested a shorter, three factor version of the YCBQ. Also, misconceptions differed significantly according to sociodemographic variables. The validation of the YCBQ for samples in the community constitutes an important starting point to promote research on misconceptions held in the community by specific groups, as well as to provide key points for health promotion.