Background Systemic Lupus Erythematosus (SLE) and Systemic Sclerosis (SSc) are complex chronic auto-immune diseases with a wide presentation of multi organ involvement, comorbidities and complications. This complexity implies that the management and treatment of SLE and SSc needs a multidisciplinary care team that exists of healthcare professionals from different professions, and physicians of different disciplines. Within this multidisciplinary approach, each physician might have certain ideas and beliefs about the disease of a particular patient with SLE and SSc. Differences in opinions and views can cause inconsistent advice, confusions and misinterpretations.
Objectives The aim of this study was to cluster physicians based on their illness perceptions of patients with SLE and SSc.
Methods A sample of 287 physicians from nine disciplines, working at three hospitals in Belgium was approached. The inclusion criteria were that physicians had to be certified in their specialism, and had experience with SLE or SSc patients. Participating physicians were asked to complete the Revised Illness Perception Questionnaire for Healthcare Professionals (IPQ-R HP) on the basis of four patient vignettes, i.e. 2 vignettes per disease (SLE-SSc). These vignettes were based on real-life patients followed at our outpatient clinic. The IPQ-R HP (38-items scored on a 5-point scale rated from 1 = strongly disagree to 5 = strongly agree) measures beliefs of the healthcare professional in relation to duration and cyclical nature of the patients' illness; perceived consequences; emotional impact; personal/treatment control; and understanding of the illness by the patient. Statistical analysis was performed using k-means cluster analysis for each disease separately.
Results Fifty physicians (62% men, mean age 43 y (SD=11), mean working experience 13 y (SD=12)) were included. For each disease, three clusters of physicians with different illness perceptions were identified. For SLE, cluster 1 (42%) reported less severe consequences, less emotional impact and a clear picture of SLE by the patient. Cluster 2 (36%) perceived severe consequences for the patient and a chronic and cyclical time course. Cluster 3 (22%) reported less personal control and understanding of SLE by the patient. Three of the 5 rheumatologists were detected in cluster 2. For SSc, cluster 1 (22%) perceived less consequences and less emotional representations by the patient. Cluster 2 (42%) reported the cyclicity of SSc, emotional impact and severe consequences due to SSc. Cluster 3 (36%) perceived a non-cyclical time course and less personal/treatment control by the patient. Three of the 5 rheumatologists were present in cluster 2.
Conclusions There is a lot of variability in illness perceptions between physicians of different disciplines and within physicians of the same discipline regarding SLE and SSc patients. Further studies should focus on the factors that determine these differences in perceptions and eventual consequences for patient care.
Disclosure of Interest None declared
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