RESEARCH - Psychosocial factors, disease status, and quality of life in patients with RA

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J Psychosom Res. 2009 Nov;67(5):425-31. Epub 2009 Mar 5.

Psychosocial factors, disease status, and quality of life in patients

with rheumatoid arthritis.

Kojima M, Kojima T, Ishiguro N, Oguchi T, Oba M, Tsuchiya H, Sugiura

F, Furukawa TA, Suzuki S, Tokudome S.

Department of Public Health, Nagoya City University Graduate School of

Medical Sciences, Nagoya 467-8601, Japan.

OBJECTIVE: To explore the interrelationships between the psychosocial

and illness factors that determine the disease status of patients with

rheumatoid arthritis (RA) and to identify how each factor is

associated with quality of life (QOL).

METHODS: The study group comprised 120 RA outpatients who completed a

series of health examinations and questionnaires. Disease severity,

functional disability, counts of swollen and/or tender joints,

duration of RA, frequency of arthritis surgery, and C-reactive protein

level were assessed by rheumatologists. Self-report inventories

completed by the patients were used to assess perceived degree of

pain, fatigue (visual analogue scales), depression (Beck Depression

Inventory-II), anxiety (Hospital Anxiety and Depression Scale), and

social support (Social Support Questionnaire). Mental and physical

components of health-related QOL were evaluated using the Short-Form

36 Health Survey.

RESULTS: After z-transformation of the data, a principal axis factor

analysis was conducted. A four-factor structure was identified in

which the components reflected psychosocial factors, disease activity,

current symptoms, and physical functional status, respectively. There

was no significant association between psychosocial factors and

disease activity, while the other components were moderately

correlated with each other. Multiple regression analysis revealed that

physical QOL was determined by current symptoms and physical

functions. Mental QOL was determined by psychosocial factors, current

symptoms, and physical functions.

CONCLUSION: Disease activity was independent from psychosocial factors

and failed to reflect the perceived physical and mental QOL of RA

patients. Clinicians should therefore evaluate psychosocial factors,

as well as subjective disease status, to improve the QOL of patients

with RA.

PMID: 19837205

http://preview.ncbi.nlm.nih.gov/pubmed/19837205

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