Skip to main content

Advertisement

SpringerLink
Log in

Illness Beliefs, Treatment Beliefs and Information Needs as Starting Points for Patient Information: The Evaluation of an Intervention for Patients with Depression

  • Published:
Journal of Clinical Psychology in Medical Settings Aims and scope Submit manuscript

Abstract

Patients with depression are often dissatisfied with disease- and therapy-related information. The objective of this study was to evaluate an intervention that applied the Common Sense Model to the provision of information during inpatient rehabilitation for patients with depression. The intervention was evaluated in a sequential control group design. Analyses of covariance were used to assess differences between the control and intervention groups. Changes with respect to illness and treatment beliefs (personal control, treatment control, coherence and concerns about medicines), satisfaction with information about medicines, illness and rehabilitation, and depressive burden were selected as primary outcome measures. We observed significant between-group differences indicating the intervention group’s superiority in terms of satisfaction with information regarding medicines. However, the two groups’ changes during rehabilitation did not differ in terms of the other outcomes. The intervention resulted in patients judging that their medication information needs had been more thoroughly fulfilled than those patients who received care-as-usual information. However, the intervention did not prove to be effective when the other outcome variables are considered. Taken together and bearing in mind the limitations of our study—particularly the non-randomised design—our results should be replicated in a randomised controlled trial.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Aikens, J., Nease, D., & Klinkman, M. (2008). Explaining patients’ beliefs about the necessity and harmfulness of antidepressants. Annals of Family Medicine, 6, 23–29.

    Article  PubMed  PubMed Central  Google Scholar 

  • Baines, T., & Wittkowski, A. (2012). A systematic review of the literature exploring illness perceptions in mental health utilising the self-regulation model. Journal of Clinical Psychology in Medical Settings, 20, 263–274.

    Article  Google Scholar 

  • Barney, L. J., Griffiths, K. M., & Banfield, M. A. (2011). Explicit and implicit information needs of people with depression: A qualitative investigation of problems reported on an online depression support forum. BMC Psychiatry, 11, 1–11.

    Article  Google Scholar 

  • Bortz, J. (1993). Statistics for social scientists. Heidelberg: Springer.

    Google Scholar 

  • Bowskill, R., Clatworthy, J., Parham, R., Rank, T., & Horne, R. (2007). Patients` perception of information received about medication prescribed for bipolar disorder: Implications for informed choice. Journal of Affective Disorders, 100, 253–257.

    Article  PubMed  Google Scholar 

  • Broadbent, E., Ellis, C., Thomas, J., Gamble, G., & Petrie, K. (2009). Further development of an illness perception intervention for myocardial infarction patients: A randomized controlled trial. Journal of Psychosomatic Research, 67, 17–23.

    Article  PubMed  Google Scholar 

  • Brown, C., Battista, D. R., Bruehlman, R., Sereika, S. S., Thase, M. E., & Dunbar-Jacob, J. (2005). Beliefs about antidepressant medications in primary patients: Relationship to self-reported adherence. Medical Care, 43, 1203–1207.

    Article  PubMed  Google Scholar 

  • Burra, T., Chen, E., McIntyre, R., Grace, S., Blackmore, E., & Stewart, D. (2007). Predictors of self-reported antidepressant adherence. Journal of Behavioral Medicine, 32, 127–134.

    Article  Google Scholar 

  • Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.

    Article  PubMed  CAS  Google Scholar 

  • De Ridder, D., Theunissen, N., & van Dulmen, S. (2007). Does training general practitioners to elicit patients’ illness representations and action plans influence their communication as a whole? Patient Education and Counseling, 66, 327–336.

    Article  PubMed  Google Scholar 

  • Dempster, M., McCorry, N., Brennan, E., Donnelly, M., Murray, L., & Johnston, B. (2011). Do changes in illness perceptions predict changes in psychological distress among oesophageal cancer survivors? Journal of Health Psychology, 16, 500–509.

    Article  PubMed  Google Scholar 

  • DGPPN, BÄK, KBV, AWMF, AkdÄ, BPtK, BApK, DAGSHG, DEGAM, DGPM, DGPs & DGRW (2009). S3 guideline unipolar depression. Retrieved from http://www.versorgungsleitlinien.de/themen/depression/pdf/s3_nvl_depression_lang.pdf.

  • Di Matteo, M. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine, 160, 2101–2107.

    Article  Google Scholar 

  • Ebmeier, K. P., Donaghey, C., & Steele, J. D. (2006). Recent developments and current controversies in depression. Lancet, 367, 153–167.

    Article  PubMed  Google Scholar 

  • Edwards, S., Tinning, L., Brown, J., Boradman, J., & Weinman, J. (2007). Reluctance to seek help and the perception of anxiety and depression in the United Kingdom. Journal of Nervous and Mental Disease, 195, 258–261.

    Article  PubMed  Google Scholar 

  • Fawzi, W., Abdel Mohsen, M. Y., Hashem, A. H., Moussa, S., Coker, E., & Wilson, K. C. M. (2012). Beliefs about medications predict adherence to antidepressants in older adults. International Psychogeriatrics, 24, 159–169.

    Article  PubMed  Google Scholar 

  • Fortune, G., Barrowclough, C., & Lobban, F. (2004). Illness representations in depression. British Journal of Clinical Psychology, 43, 347–364.

    Article  PubMed  Google Scholar 

  • Gaab, J., & Ehlert, U. (2005). Chronic fatigue and chronic fatigue syndrome. Göttingen: Hogrefe.

    Google Scholar 

  • Glattacker, M., Bengel, J., & Jäckel, W. H. (2009a). German version of the Illness Perception Questionnaire-revised (IPQ-R): Psychometric evaluation in patients with chronic somatic illness. Zeitschrift für Gesundheitspsychologie, 17, 158–169.

    Article  Google Scholar 

  • Glattacker, M., Heyduck, K., & Meffert, C. (2009b). Development of a questionnaire to assess treatment representations in rehabilitation patients. Die Rehabilitation, 48, 345–353.

    Article  PubMed  CAS  Google Scholar 

  • Glattacker, M., Heyduck, K., & Meffert, C. (2009c). Satisfaction with information about illness and treatment in patients with chronic back pain and depression. Zeitschrift für Allgemeinmedizin, 85, 83–84.

    Google Scholar 

  • Glattacker, M., Heyduck, K., & Meffert, C. (2010b). Development, implementation and use of an intervention procedure for providing needs-based patient information for rehabilitation patients. Die Rehabilitation, 49, 292–300.

    Article  PubMed  CAS  Google Scholar 

  • Glattacker, M., Heyduck, K., & Meffert, C. (2012). Illness beliefs, treatment beliefs and information needs as starting points for patient information: Evaluation of an intervention for patients with chronic back pain. Patient Education and Counseling, 86, 378–389.

    Article  PubMed  Google Scholar 

  • Glattacker, M., Heyduck, K., & Meffert, C. (2013). Illness beliefs and treatment beliefs as predictors of short and middle term outcome in depression. Journal of Health Psychology, 18, 139–152.

    Article  PubMed  Google Scholar 

  • Glattacker, M., Meixner, K., Farin, E., & Jäckel, W. H. (2007). Development and psychometric testing of a rehabilitation specific comorbidity score. Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin, 17, 260–270.

    Article  Google Scholar 

  • Glattacker, M., Opitz, U., & Jäckel, W. H. (2010a). Illness representations in women with fibromyalgia. British Journal of Health Psychology, 15, 367–387.

    Article  PubMed  CAS  Google Scholar 

  • Goulding, L., Furze, G., & Birks, Y. (2010). Randomized controlled trials of interventions to change maladaptive illness beliefs in people with coronary heart disease: Systematic review. Journal of Advanced Nursing, 66, 946–961.

    Article  PubMed  Google Scholar 

  • Hagger, M. S., & Orbell, S. (2003). A meta-analytic review of the common sense model of illness representation. Psychology & Health, 18, 141–184.

    Google Scholar 

  • Hautzinger, M., & Bailer, M. (1993). Allgemeine depressionsskala (ADS). The German version of CES-D. Weinheim: Beltz Test.

    Google Scholar 

  • Higbed, L., & Fox, J. R. E. (2010). Illness perceptions in anorexia nervosa: A qualitative investigation. British Journal of Clinical Psychology, 49, 307–325.

    Article  PubMed  Google Scholar 

  • Horn, A. B., Kneisler, L., Schuster, H., & Traue, H. C. (2010). Subjective illness representations in depressive disorder: A longitudinal study. Zeitschrift für Gesundheitspsychologie, 18, 40–51.

    Article  Google Scholar 

  • Horne, R. (1999). Patients’ beliefs about treatment: The hidden determinant of treatment outcome? Journal of Psychosomatic Research, 47, 491–495.

    Article  PubMed  CAS  Google Scholar 

  • Horne, R. (2003). Treatment perceptions and self-regulation. In L. Cameron & H. Leventhal (Eds.), The self-regulation of health and illness behavior (pp. 138–153). London: Routledge.

    Google Scholar 

  • Horne, R., Hankins, M., & Jenkins, R. (2001). The satisfaction with information about medicines scale (SIMS): A new measurement tool for audit and research. Quality and Safety in Health Care, 10, 135–140.

    Article  CAS  Google Scholar 

  • Horne, R., Weinman, J., & Hankins, M. (1999). The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychology & Health, 14, 1–24.

    Article  Google Scholar 

  • Hou, R., Cleak, V., & Peveler, R. (2010). Do treatment and illness beliefs influence adherence to medication in patients with bipolar affective disorder? A preliminary cross-sectional study. European Psychiatry, 25, 216–219.

    Article  PubMed  CAS  Google Scholar 

  • Jansen, D., Heijmans, M., Rijken, M., & Kaptein, A. (2011). The development of and first experiences with a behavioural self-regulation intervention for end-stage renal disease patients and their partners. Journal of Health Psychology, 16, 274–283.

    Article  PubMed  Google Scholar 

  • Kelly, M., Sereika, S., Battista, D., & Brown, C. (2007). The relationship between beliefs about depression and coping strategies: Gender differences. British Journal of Clinical Psychology, 46, 315–332.

    Article  PubMed  Google Scholar 

  • Lee, T., Cameron, L., Wünsche, B., & Stevens, C. (2011). A randomized trial of computer-based communications using imagery and text information to alter representations of heart disease risk and motivate protective behaviour. British Journal of Health Psychology, 16, 72–91.

    Article  PubMed  Google Scholar 

  • Leventhal, H., Brisette, I., & Leventhal, E. A. (2003). The common-sense model of self-regulation of health and illness. In L. Cameron & H. Leventhal (Eds.), The self-regulation of health and illness behaviour (pp. 42–65). London: Routledge.

    Google Scholar 

  • Leventhal, H., Leventhal, E. A., & Cameron, L. (2001). Representations, procedures, and affect in illness self-regulation: A perceptual-cognitive model. In A. Baum, T. A. Revenson & J. E. Singer (Eds.), Handbook of Health Psychology (pp. 19–48). Mahwah, NJ: Lawrence Erlbaum.

    Google Scholar 

  • Leventhal, H., Meyer, D., & Nerenz, D. (1980). The common sense representation of illness danger. In S. Rachman (Ed.), Contributions to medical psychology (Vol. 2, pp. 7–30). Oxford: Pergamon Press.

    Google Scholar 

  • Linn, B., Linn, M., & Gurel, L. (1968). Cumulative illness rating scale. Journal of the American Geriatriatrics Society, 16, 622–626.

    Article  CAS  Google Scholar 

  • Loh, A., Kremer, N., Giersdorf, N., Jahn, H., Hänselmann, S., Bermejo, I., & Härter, M. (2004). Information and participation interests of patients with depression in clinical decision making in primary care. Zeitschrift für Ärztliche Fortbildung und Qualität im Gesundheitswesen, 98, 101–107.

    PubMed  Google Scholar 

  • Loh, A., Leonhart, R., Wills, C. E., Simon, D., & Härter, M. (2007). The impact of patient participation on adherence and clinical outcome in primary care of depression. Patient Education and Counseling, 65, 69–78.

    Article  PubMed  Google Scholar 

  • Lynch, J., Moore, M., Moss-Morris, R., & Kendrick, T. (2011). Are patient beliefs important in determining adherence to treatment and outcome for depression? Development of the beliefs about depression questionnaire. Journal of Affective Disorders, 133, 29–41.

    Article  PubMed  Google Scholar 

  • Mahler, C., Hermann, K., Horne, R., Jank, S., Haefeli, W. W., & Szecsenyi, J. (2012). Patients´ beliefs about medicines in a primary care setting in Germany. Journal of Evaluation in Clinical Practice, 18, 409–413.

    Article  PubMed  Google Scholar 

  • Mahler, C., Jank, S., Herrmann, K., Horne, R., Ludt, S., Haefeli, W. E., & Szecsenyi, J. (2009). Psychometric properties of the German version of the ‘satisfaction with information about medicines scale’ (SIMS-D). Value in Health, 12, 1176–1179.

    Article  PubMed  Google Scholar 

  • Moss-Morris, R., Weinman, J. A., Petrie, K. J., Horne, R., Cameron, L., & Buick, D. L. (2002). The revised illness perception questionnaire (IPQ-R). Psychology & Health, 17, 1–16.

    Article  Google Scholar 

  • Petrie, K. J., Cameron, L., Ellis, C. J., Buick, D. L., & Weinman, J. A. (2002). Changing illness perceptions after myocardial infarction: An early intervention randomized controlled trial. Psychosomatic Medicine, 64, 580–586.

    Article  PubMed  Google Scholar 

  • Petrie, K. J., Jago, J. A., & Devcich, D. A. (2007). The role of illness perceptions in patients with medical conditions. Current Opinion in Psychiatry, 20, 163–167.

    Article  PubMed  Google Scholar 

  • Petrie, K. J., & Weinman, J. (2006). Why illness perceptions matter. Clinical Medicine, 6, 536–539.

    Article  PubMed  Google Scholar 

  • Prins, M., Verhaak, P., Bensing, J., & van der Meer, K. (2008). Health beliefs and perceived need for mental health care of anxiety and depression: The patients’ perspective explored. Clinical Psychological Review, 28, 1038–1058.

    Article  Google Scholar 

  • Quiles, Y., & Terol, C. (2011). Using common sense model in eating disorders. Journal of Health Psychology, 16, 208–216.

    Article  PubMed  Google Scholar 

  • Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.

    Article  Google Scholar 

  • Roca, M., Armengol, S., Salvador-Carulla, L., Monzon, S., Salvà, J., & Gili, M. (2011). Adherence to medication in depressive patients. Journal of Clinical Psychopharmacology, 31, 541–543.

    Article  PubMed  Google Scholar 

  • Simon, D., Loh, A., Wills, C. E., & Härter, M. (2006). Depressed patients’ perceptions of depression treatment decision-making. Health Expectations, 10, 62–74.

    Article  PubMed Central  Google Scholar 

  • Stafford, L., Berk, M., & Jackson, H. (2009). Are illness perceptions about coronary artery disease predictive of depression and quality of life outcomes? Journal of Psychosomatic Research, 66, 211–220.

    Article  PubMed  Google Scholar 

  • PASW Statistics—SPSS 18. (2010). Chicago: SPSS Inc.

  • Steffanowski, A., Löschmann, C., Schmidt, J., Wittmann, W. W., & Nübling, R. (2007). Meta-analysis of the effects of psychosomatic rehabilitation (mesta-study). Bern: Verlag Hans Huber.

    Google Scholar 

  • Ten Doesschate, M. C., Bockting, C. L., & Schene, A. H. (2009). Adherence to continuation and maintenance antidepressant use in recurrent depression. Journal of Affective Disorders, 115, 167–170.

    Article  PubMed  Google Scholar 

  • Theunissen, N. C., de Ridder, D. T., Bensing, J. M., & Rutten, G. E. (2003). Manipulation of patient-provider interaction: Discussing illness representations or action plans concerning adherence. Patient Education and Counseling, 51, 247–258.

    Article  PubMed  Google Scholar 

  • Vaughan, R., Morrison, L., & Miller, E. (2003). The illness representations of multiple sclerosis and their relations to outcome. British Journal of Health Psychology, 8, 287–301.

    Article  PubMed  Google Scholar 

  • Wearden, A., & Peters, S. (2008). Therapeutic techniques for interventions based on Leventhal’s common sense model. British Journal of Health Psychology, 13, 189–193.

    Article  PubMed  Google Scholar 

  • World Health Organization. (2008). The global burden of disease: 2004 update. Retrieved from http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf.

Download references

Acknowledgements

The project “Bedarfsgerechte Patienteninformation auf der Basis subjektiver Konzepte” (Needs-based Patient Information Based on Subjective Concepts) was funded by the German Pension Insurance (Grant No. 0421-FSCP-0544) in the funding priority “Versorgungsnahe Forschung” (Patient-oriented Research). We would like to thank the funders, the cooperating centres Rehabilitationsklinik Frankenhausen DRV-Bund, Bad Frankenhausen; Rehabilitationsklinik “Garder See”, Lohmen; Klinik am Homberg, Bad Wildungen; DE´IGNIS Fachklinik GmbH, Egenhausen; Psychosomatische Fachklinik Schömberg, Schömberg, and the participating patients.

Author information

Authors and Affiliations

  1. Section of Health Care Research and Rehabilitation Research, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany

    Manuela Glattacker & Katja Heyduck

  2. Department of Palliative Care, University Medical Center Freiburg, Freiburg, Germany

    Cornelia Meffert

  3. Rehabilitation Center Glotterbad, Glottertal, Germany

    Teresa Jakob

Authors
  1. Manuela Glattacker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katja Heyduck
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cornelia Meffert
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Teresa Jakob
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Manuela Glattacker.

Ethics declarations

Conflict of interest

Manuela Glattacker, Katja Heyduck, Cornelia Meffert, and Teresa Jakob declare that they have no conflict of interests.

Human and Animal Rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation of the Ethics Committee of the University Medical Centre Freiburg and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Glattacker, M., Heyduck, K., Meffert, C. et al. Illness Beliefs, Treatment Beliefs and Information Needs as Starting Points for Patient Information: The Evaluation of an Intervention for Patients with Depression. J Clin Psychol Med Settings 25, 316–333 (2018). https://doi.org/10.1007/s10880-018-9551-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10880-018-9551-1

Keywords

Search

Navigation