Impact of television depictions of illness on perceptions of illness
- Conditions
- GoutMusculoskeletal - Other muscular and skeletal disorders
- Registration Number
- ACTRN12622000518763
- Lead Sponsor
- niversity of Auckland
- Brief Summary
Research question This study aimed to assess the impact of viewing a fictional television episode depicting gout as an acute illness caused by poor diet and managed through lifestyle change on perceptions of the public about the disease. Background information Gout is a chronic disease caused by monosodium urate crystal deposition (1, 2). Biological factors such as chronic kidney disease and genetic variants play an important role in its development (3, 4). The key management strategy for patients with gout and recurrent flares (5-7) is through medication (urate-lowering therapy). For patients with established gout, dietary changes alone have not been shown to be sufficient to control the disease (8, 9). Despite the importance of biological factors in its development, there is a prevalent view in the community that gout is a disease caused by a poor diet and alcohol consumption which can be managed through dietary and lifestyle changes (10). A previous analysis of film and television found that the most common cause of gout depicted was overindulgence in food and alcohol (61%). Portrayals of biological causes were infrequent (12%) (11). The most common management strategies depicted were a change in diet (36%) and short-term pain relief (32%), with urate-lowering therapy mentioned only once (5%) (11). There were similar findings in an analysis of newspaper articles about gout, which found that overindulgence in food and alcohol was the most commonly reported cause of the disease (12). Television is a preferred source of medical information for many members of the public (20, 21), including some patients with gout (22). There is a substantial need to improve community knowledge about gout and its management. This study aimed to determine whether television depictions of gout contribute to community perceptions of gout and beliefs about its causes and management. Participant characteristics Between February 21, 2022 and July 31, 2022, 206 participants were screened for eligibility in the study. Six participants were unable to attend the study interview and were not enrolled in the study. There were 200 participants randomized into the study. Most participants were of New Zealand European ethnicity (113/200, 56.5%) and female (153/200, 76.5%), and the average age was 29 years (range 18-70 years). There were 15/200 (7.5%) participants of Maori ethnicity. No participants had a personal diagnosis of gout, and 36/200 (18%) had a family member or friend with a diagnosis of gout. Key results Participants who watched the gout episode believed they had a greater understanding of gout than those who watched the control episode. Those who watched the gout episode also believed that gout would last a shorter time, and that gout would have a greater effect on their life compared to the control group. When asked about the most important causes of gout, most participants who viewed the gout episode listed diet as the most important cause of gout (70/100, 70%) compared with the control group (38/100, 38%), which was a statistically significant finding. Those who had watched the control episode were more likely to list genetics as the most important cause of gout (26/100, 26% versus 10/100, 10%) which was also a statistically significant finding. Participants watching the gout episode were less likely to believe patients would require long-term medication than those watching the control episode. There was no difference between the two groups in motivation to take long-term medications or concern about long-term medications. Those who watched the gout episode were more likely to believe changing to a healthier diet would be an effective management strategy than the control group, and less likely to think that taking long-term medication would be effective. Limitations Limitations included short follow-up following a single viewing, and it is unknown how long the differences in illness beliefs persist after viewing a single episode, or the effects of repeated exposure to similar screen depictions. A television episode showing gout caused by biological factors could not be included as a comparison because no suitable shows were identified in the previous content analysis (11), as almost all depictions of gout focused on dietary causes. References 1. Jin Z, Wang D, Zhang H, Liang J, Feng X, Zhao J, et al. Incidence trend of five common musculoskeletal disorders from 1990 to 2017 at the global, regional and national level: results from the global burden of disease study 2017. Annals of the rheumatic diseases. 2020. 2. Loeb JN. The influence of temperature on the solubility of monosodium urate. Arthritis and rheumatism. 1972;15(2):189-92. 3. Tin A, Marten J, Halperin Kuhns VL, Li Y, Wuttke M, Kirsten H, et al. Target genes, variants, tissues and transcriptional pathways influencing human serum urate levels. Nature genetics. 2019;51(10):1459-74. 4. Chonchol M, Shlipak MG, Katz R, Sarnak MJ, Newman AB, Siscovick DS, et al. Relationship of uric acid with progression of kidney disease. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2007;50(2):239-47. 5. FitzGerald JD, Dalbeth N, Mikuls T, Brignardello-Petersen R, Guyatt G, Abeles AM, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis & rheumatology (Hoboken, NJ). 2020. 6. Richette P, Doherty M, Pascual E, Barskova V, Becce F, Castañeda-Sanabria J, et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Annals of the rheumatic diseases. 2017;76(1):29-42. 7. Doherty M, Jenkins W, Richardson H, Sarmanova A, Abhishek A, Ashton D, et al. Efficacy and cost-effectiveness of nurse-led care involving education and engagement of patients and a treat-to-target urate-lowering strategy versus usual care for gout: a randomised controlled trial. Lancet (London, England). 2018;392(10156):1403-12. 8. Juraschek SP, Gelber AC, Choi HK, Appel LJ, Miller ER, 3rd. Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet and Sodium Intake on Serum Uric Acid. Arthritis & rheumatology (Hoboken, NJ). 2016;68(12):3002-9. 9. Holland R, McGill NW. Comprehensive dietary education in treated gout patients does not further improve serum urate. Internal medicine journal. 2015;45(2):189-94. 10. Petrie KJ, MacKrill K, Derksen C, Dalbeth N. An illness by any other name: The effect of renaming gout on illness and treatment perceptions. Health psychology : official journal of the Division of Health Psychology, American Psychological Association. 2018;37(1):37-41. 11. Derksen C, Murdoch R, Petrie KJ, Dalbeth N. "An apple pie a day does not keep the doctor away": Fictional depictions of gout in contemporary film and television. BMC rheumatology. 2021;5(1):4. 12. Duyck SD, Petrie KJ, Dalbeth N. "You Don't Have to Be a Drinker to Get Gout, But It Helps": A Content Analysis of the Depiction of Gout in Popular Newspapers. Arthritis care & research. 2016;68(11):1721-5. 13. Kleinstäuber M, Wolf L, Jones ASK, Dalbeth N, Petrie KJ. Internalized and Anticipated Stigmatization in Patients With Gout. ACR open rheumatology. 2020;2(1):11-7. 14. Te Karu L, Bryant L, Elley CR. Maori experiences and perceptions of gout and its treatment: a kaupapa Maori qualitative study. Journal of primary health care. 2013;5(3):214-22.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- All
- Target Recruitment
- 200
Aged 18 years or older and able to complete a questionnaire in English.
Cognitive impairment which would preclude completion of the questionnaire.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method