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January 30, 2012
Your Perception About Your Illness Is What Makes The Difference In The Outcome

There are many different factors that come together to influence the course of our illness. We typically assume that additional medical conditions, stress, and social support all have an impact on our health and well-being, especially when we are ill. But a new report suggests that what you think about your illness may matter more than any other factor in determining your health outcomes.

Exploring how certain people feel about or perceive the internal states of their body may help researchers understand why they perceive their body-image or health in ways that serve as a detriment to their long-term health.

In the February issue of Current Directions in Psychological Science, a journal of the Association for Psychological Science, Keith Petrie, of the University of Auckland, and John Weinman, of the Institute of Psychiatry at King’s College, review the existing literature on patients’ perceptions of illness. The authors find that people’s illness perceptions bear a direct relationship to several important health outcomes, including their level of functioning and ability, utilization of health care, adherence to treatment plans laid out by health care professionals, and even overall mortality.

In fact, some research suggests that how a person views his illness may play a bigger role in determining his health outcomes than the actual severity of his disease.

A report appearing last year in the Proceedings of the Royal Society B led by Dr Manos Tsakiris from Royal Holloway, University of London, suggests that the way we experience the internal state of our body may also influence how we perceive our body from the outside, as for example in the mirror.

In general, our illness perceptions emerge out of our beliefs about illness and what illness means in the context of our lives. So, we might have beliefs about how an illness is caused, how long it will last, how it will impact us or our family members, and how we can control or cure it. The bottom line, says Petrie, is that “patients’ perceptions of their illness guide their decisions about health.” If, for example, we feel like a prescribed treatment isn’t making us feel better we might stop that treatment.

Research on illness perceptions suggest that effective health care treatment plans are about much more than having a competent physician. According to Petrie, “a doctor can make accurate diagnoses and have excellent treatments but if the therapy doesn’t fit with the patient’s view of their illness, they are unlikely to keep taking it.” A treatment that does not consider the patient’s view is likely to fail, he argues.

"This is perhaps one of the biggest pitfalls when it comes to mainstream medicine," said medical analyst Josephine Drew. "Most physicians are not concerned about how a treatment is tailored towards a patient since they have an all-in-one template based mentality," she added.

The authors conclude that understanding illness perceptions and incorporating them into health care is critical to effective treatment. Asking patients about how they view their illness gives health practitioners the opportunity to identify and correct any inaccurate beliefs patients may have.

Once a patient’s illness perceptions are clearly laid out, a progressive health practitioner can try to nudge those beliefs in a direction that is more compatible with prevention initiatives and natural treatments rather than medications. Such conversations can help practitioners identify patients that are at particular risk of coping poorly with the demands of their illness.

"Negative emotions affected the perception of pain more than positive emotions," said Quoc Viet Huynh Bao from the University of Montreal. Patients feel that pain is more unpleasant when they are experiencing fear, depression or anger, Huynh Bao reported. "With positive emotions there was a reduction in pain," he added.

Research confirms that brief, straightforward psychoeducational interventions can modify negative illness beliefs and lead to improvements over a range of different health outcomes. But this research is still new and scientists don’t know much about how our illness perceptions develop in the first place. With mounting pressure to lower the costs of healthcare, continued research on illness perceptions will help practitioners design effective interventions that are able to reach a large number of patients.


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