Scientific Article| Volume 45, ISSUE 5, P455.e1-455.e8, May 2020

Illness Perceptions of Patients With First Carpometacarpal Osteoarthritis, Carpal Tunnel Syndrome, Dupuytren Contracture, or Trigger Finger

Published:December 04, 2019DOI:


      Previous studies indicate that patients with a more negative perception of their illness tend to respond less favorably to treatment, but little is known about whether illness perceptions differ based on the type of hand or wrist conditions. Therefore, we compared illness perceptions between patients scheduled to undergo surgery for 4 illnesses in hand surgery: carpometacarpal osteoarthritis (CMC OA), Dupuytren disease, carpal tunnel syndrome (CTS), and trigger finger syndrome (TFS). We hypothesized there would be differences in illness perception between these patient groups.


      Before surgery, patients were asked to complete the Brief Illness Perception Questionnaire (Brief-IPQ) as part of routine outcome measurement in a specialized hand and wrist surgery clinic. The Brief-IPQ is a validated questionnaire to rapidly assess the cognitive and emotional representation of illness. Differences in illness perception between the 4 diagnostic groups, corrected for age, sex, hand dominance, and work type, were examined. Cohen D effect sizes were calculated for the between-group differences.


      We included 514 patients in the analyses: 87 with CMC OA, 146 with Dupuytren disease, 129 with CTS, and 152 with TFS. On a scale ranging from 0 (most positive perception) to 80 (most negative perception) the Brief-IPQ sum scores for these subgroups were 42.0, 28.2, 38.8, and 33.3, respectively. Corrected for age, sex, hand dominance, and work type, patients with Dupuytren disease had a more positive perception of their illness than patients with CMC OA and CTS. Compared with CMC OA patients, the effect sizes for Dupuytren, CTS, and TFS patients were, respectively, 1.28, 0.32, and 0.81.


      In these patients with various hand/wrist disorders, differences were found in their preoperative perceptions of illness. Interventions that directly target negative illness perceptions might improve treatment outcomes for CMC OA and CTS.

      Clinical relevance

      These differences should be considered during preoperative medical consultations and/or when investigating surgical outcomes.

      Key words

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        • Kaptein A.A.
        • Bijsterbosch J.
        • Scharloo M.
        • Hampson S.E.
        • Kroon H.M.
        • Kloppenburg M.
        Using the common sense model of illness perceptions to examine osteoarthritis change: a 6-year longitudinal study.
        Health Psychol. 2010; 29: 56-64
        • Arat S.
        • De Cock D.
        • Moons P.
        • Vandenberghe J.
        • Westhovens R.
        Modifiable correlates of illness perceptions in adults with chronic somatic conditions: a systematic review.
        Res Nurs Health. 2018; 41: 173-184
        • Gehrt T.B.
        • Wisbech Carstensen T.B.
        • Ornbol E.
        • Fink P.K.
        • Kasch H.
        • Frostholm L.
        The role of illness perceptions in predicting outcome after acute whiplash trauma: a multicenter 12-month follow-up study.
        Clin J Pain. 2015; 31: 14-20
        • Zelber-Sagi S.
        • Bord S.
        • Dror-Lavi G.
        • et al.
        Role of illness perception and self-efficacy in lifestyle modification among non-alcoholic fatty liver disease patients.
        World J Gastroenterol. 2017; 23: 1881-1890
        • Leventhal H.
        • Phillips L.A.
        • Burns E.
        The Common-Sense Model of Self-Regulation (CSM): a dynamic framework for understanding illness self-management.
        J Behav Med. 2016; 39: 935-946
        • Meyer D.
        • Leventhal H.
        • Gutmann M.
        Common-sense models of illness: the example of hypertension.
        Health Psychol. 1985; 4: 115-135
        • Weinman J.P.
        • Petrie K.J.
        • Moss-Morris R.
        • Horne R.
        The Illness Perception Questionnaire: a new method for assessing illness perceptions.
        Psychol Health. 1996; : 431-446
        • de Raaij E.J.
        • Schroder C.
        • Maissan F.J.
        • Pool J.J.
        • Wittink H.
        Cross-cultural adaptation and measurement properties of the Brief Illness Perception Questionnaire—Dutch Language Version.
        Man Ther. 2012; 17: 330-335
        • Broadbent E.
        • Petrie K.J.
        • Main J.
        • Weinman J.
        The Brief Illness Perception Questionnaire.
        J Psychosom Res. 2006; 60: 631-637
        • Moss-Morris R.
        • Weinman J.
        • Petrie K.J.
        • Horne R.
        • Cameron L.D.
        • Buick D.
        The Revised Illness Perception Questionnaire (IPQ-R).
        Psychol Health. 2002; 17: 1-16
        • Bland J.M.
        • Altman D.G.
        Cronbach's alpha.
        BMJ. 1997; 314: 572
        • Sawilowsky S.S.
        New effect size rules of thumb.
        J Mod Appl Stat Methods. 2009; 8
        • Hagger M.S.
        • Orbell S.
        A meta-analytic review of the common-sense model of illness represenations.
        Psychology Health. 2003; 18: 141-184
        • Scharloo M.
        • Kaptein A.A.
        • Weinman J.
        • et al.
        Illness perceptions, coping and functioning in patients with rheumatoid arthritis, chronic obstructive pulmonary disease and psoriasis.
        J Psychosom Res. 1998; 44: 573-585
        • Schiaffino K.M.
        • Shawaryn M.A.
        • Blum D.
        Examining the impact of illness representations on psychological adjustment to chronic illnesses.
        Health Psychol. 1998; 17: 262-268
        • Orbell S.
        • Johnston M.
        • Rowley D.
        • Espley A.
        • Davey P.
        Cognitive representations of illness and functional and affective adjustment following surgery for osteoarthritis.
        Soc Sci Med. 1998; 47: 93-102
        • Heijmans M.
        • de Ridder D.
        Assessing illness representations of chronic illness: explorations of their disease-specific nature.
        J Behav Med. 1998; 21: 485-503
        • Lee B.O.
        • Chien C.S.
        • Hung C.C.
        • Chou P.L.
        Effects of an in-hospital nursing intervention on changing illness perceptions in patients with injury.
        J Adv Nurs. 2015; 71: 2540-2550
        • Siemonsma P.C.
        • Stuive I.
        • Roorda L.D.
        • et al.
        Cognitive treatment of illness perceptions in patients with chronic low back pain: a randomized controlled trial.
        Phys Ther. 2013; 93: 435-448
        • Goulding L.
        • Furze G.
        • Birks Y.
        Randomized controlled trials of interventions to change maladaptive illness beliefs in people with coronary heart disease: systematic review.
        J Adv Nurs. 2010; 66: 946-961
        • Zale E.L.
        • Ring D.
        • Vranceanu A.M.
        The future of orthopaedic care: promoting psychosocial resiliency in orthopaedic surgical practices.
        J Bone Joint Surg Am. 2018; 100: e89
        • Bethge M.
        • Bartel S.
        • Streibelt M.
        • Lassahn C.
        • Thren K.
        Illness perceptions and functioning following total knee and hip arthroplasty [in German].
        Z Orthop Unfall. 2010; 148: 387-392
        • Mosleh S.M.
        • Almalik M.M.
        Illness perception and adherence to healthy behaviour in Jordanian coronary heart disease patients.
        Eur J Cardiovasc Nurs. 2016; 15: 223-230
        • Hsiao C.Y.
        • Chang C.
        • Chen C.D.
        An investigation on illness perception and adherence among hypertensive patients.
        Kaohsiung J Med Sci. 2012; 28: 442-447
        • Reagan L.A.
        • Walsh S.J.
        • Shelton D.
        Relationships of illness representation, diabetes knowledge, and self-care behaviour to glycemic control in incarcerated persons with diabetes.
        Int J Prison Health. 2016; 12: 157-172
        • Var F.A.
        • Rajeswaran J.
        Perception of illness in patients with traumatic brain injury.
        Indian J Psychol Med. 2012; 34: 223-226
        • Wouters R.M.
        • Tsehaie J.
        • Hovius S.E.R.
        • Dilek B.
        • Selles R.W.
        Postoperative rehabilitation following thumb base surgery: a systematic review of the literature.
        Arch Phys Med Rehabil. 2018; 99: 1177-1212.e2
        • Turesson C.
        • Kvist J.
        • Krevers B.
        Patients' needs during a surgical intervention process for Dupuytren's disease.
        Disabil Rehabil. 2019; 41: 666-673
        • Engstrand C.
        • Kvist J.
        • Krevers B.
        Patients' perspective on surgical intervention for Dupuytren's disease—experiences, expectations and appraisal of results.
        Disabil Rehabil. 2016; 38: 2538-2549
        • Bakri K.
        • Moran S.L.
        Thumb carpometacarpal arthritis.
        Plast Reconstr Surg. 2015; 135: 508-520
        • Beleckas C.M.
        • Wright M.
        • Prather H.
        • Chamberlain A.
        • Guattery J.
        • Calfee R.P.
        Relative prevalence of anxiety and depression in patients with upper extremity conditions.
        J Hand Surg Am. 2018; 43: 571.e1-571.e8