Explaining the long-term impact of chronic Q fever and Q fever fatigue syndrome on psychosocial functioning, 2019, Hautvast et al

Andy

Andy

Retired committee member
'Psych researchers in "chronic illness doesn't make for happier patients" shock'!

Highlights
QFS and chronic Q fever patients experience long term psychosocial impairment.

Fatigue is the most important factor mediating the psychosocial impact.

QFS and chronic Q fever report more negative illness beliefs than diabetes patients.

Illness beliefs do not mediate the psychosocial impact as highly as fatigue.

Abstract
Objective
After Q fever infection, 1–5% of patients develop chronic Q fever, while about 20% develops Q fever fatigue syndrome (QFS). This study examines whether these two conditions have a long-term impact on psychosocial functioning compared to the general population and patients with type 2 diabetes (DM) and investigate which mediating factors influence outcomes.

Methods
Cross-sectional study was performed, measuring psychosocial functioning including quality of life (depression and satisfaction with life), anxiety, social functioning and relationship satisfaction in patients with proven or probable chronic Q fever or QFS, 5–9 years after acute Q fever infection. Multivariate linear regression was used to analyse differences between groups, correct for confounders and identify relevant mediators (fatigue, physical or cognitive functioning, illness perception).

Results
Quality of life and social functioning of chronic Q-fever and QFS patients was significantly lower and anxiety significantly higher compared to DM patients and the general population. The impact was completely mediated by fatigue in both Q fever groups. Physical and cognitive functioning and illness perception partially mediated the impact.

Conclusions
Health care workers need to be aware of the long-term impact of chronic Q fever and QFS on psychosocial functioning of patients in order to provide proper guidance.
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Paywall, https://www.sciencedirect.com/science/article/pii/S0022399918304331
Sci Hub, https://sci-hub.se/10.1016/j.jpsychores.2019.03.185
 
'Degree of pyschosocial intervention for chronically ill patients correlates strongly with levels of irritation in those patients at the psychosocial interventions, says new study.'

'"Clearly more psychosocial intervention is required", say leading psychosocial intervention experts, to thunderous applause from the adoring media.'
 
Merged thread

https://www.sciencedirect.com/science/article/abs/pii/S0022399918304331

J Psychosom Res. 2019 Jun;121:37-45. doi: 10.1016/j.jpsychores.2019.03.185. Epub 2019 Apr 1.
Explaining the long-term impact of chronic Q fever and Q fever fatigue syndrome on psychosocial functioning: A comparison with diabetes and the general population.
Reukers DFM1, van Jaarsveld CHM2, Knoop H3, Bleeker-Rovers CP4, Akkermans R5, de Grauw W2, van der Velden K2, van Loenhout JAF6, Hautvast JLA2.
1 Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands. Electronic address: Daphne.Reukers@radboudumc.nl.
2
Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.
3
Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
4
Radboud Expertise Center for Q Fever, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
5
Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands; IQ Healthcare, Radboud University Medical Center, Radboud Institue for Health Sciences, Nijmegen, the Netherlands.
6
Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands; Center for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium.
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Abstract
OBJECTIVE:
After Q fever infection, 1-5% of patients develop chronic Q fever, while about 20% develops Q fever fatigue syndrome (QFS). This study examines whether these two conditions have a long-term impact on psychosocial functioning compared to the general population and patients with type 2 diabetes (DM) and investigate which mediating factors influence outcomes.

METHODS:
Cross-sectional study was performed, measuring psychosocial functioning including quality of life (depression and satisfaction with life), anxiety, social functioning and relationship satisfaction in patients with proven or probable chronic Q fever or QFS, 5-9 years after acute Q fever infection. Multivariate linear regression was used to analyse differences between groups, correct for confounders and identify relevant mediators (fatigue, physical or cognitive functioning, illness perception).

RESULTS:
Quality of life and social functioning of chronic Q-fever and QFS patients was significantly lower and anxiety significantly higher compared to DM patients and the general population. The impact was completely mediated by fatigue in both Q fever groups. Physical and cognitive functioning and illness perception partially mediated the impact.

CONCLUSIONS:
Health care workers need to be aware of the long-term impact of chronic Q fever and QFS on psychosocial functioning of patients in order to provide proper guidance.

Copyright © 2019. Published by Elsevier Inc.

KEYWORDS:
Chronic Q fever; Long term impact; Psychosocial functioning; Q fever fatigue syndrome; QFS; Quality of life

PMID:

31006533

DOI:

10.1016/j.jpsychores.2019.03.185
[Indexed for MEDLINE]
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Last edited by a moderator:
Comparing a discriminated illness for which no help whatsoever is available with a high profile disease that has management, treatments, widespread awareness in medical personnel, drugs and genuine expertise like diabetes makes no sense. Or basically it's comparing the difference that medical care does to illness, which would actually be useful BPS research for once but that isn't even the intent. Because otherwise obviously unmanaged discriminated illness will fare worse in functioning than the exact opposite. This is like remarking that MS patients today fare much better than they did 50 years ago, an accurate observation, and concluding that the patients' anxiety and "illness perception", whatever that is, back then were to blame for the difference it made in their ability to function.

But especially, the answer is right there:
Health care workers need to be aware of the long-term impact of chronic Q fever and QFS on psychosocial functioning of patients in order to provide proper guidance.
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It's precisely the bad (or denied) medical care provided to those patients that causes the observed reduced functioning. And psychosocial ideology is precisely what is making any positive change impossible, because they only look at the smoke and don't care about the fire. So this here is basically the problem offering a solution that cannot be implemented because the problem has no intention of going away any time soon, which is the actual solution to the problem.

And this is just bizarre:
The impact was completely mediated by fatigue in both Q fever groups. Physical and cognitive functioning and illness perception partially mediated the impact.
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Shows they have no idea what they're talking about when they use the word fatigue and just choose the meaning they want. It separates fatigue from physical and cognitive functioning. That makes no sense, other of course than in the usual psychosocial misrepresentation of fatigue as whatever it is they mean by that in the present context. It shows their evaluation of those concepts has no validity to the real world. It's just angels dancing on hairpins. Always. Spinning and twirling.
 
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