An evaluation of a biopsychosocial framework for health-related quality of life and disability in rheumatoid arthritis

Abstract

Objective To examine the relationships between physical, psychological, and social factors and health-related quality of life (HRQOL) and disability in rheumatoid arthritis (RA). Methods A sample of 106 patients with rheumatoid arthritis (RA) completed measures of self-reported disease activity and psychosocial functioning, including coping, personal mastery, social network, perceived stress, illness beliefs, the SF-36 and Health Assessment Questionnaire Disability Index (HAQ-DI). In addition, physician-based assessment of disease activity using the Disease Activity Scale (DAS 28) was obtained. Hierarchical multiple regression analyses were used to evaluate the relationships between psychosocial factors and scores on the SF-36 and HAQ-DI. Results Lower self-reported disease activity and higher active coping were significantly related to SF-36 physical functioning scores, whereas lower self-reported disease activity, higher personal mastery, and lower perceived stress contributed to higher SF-36 mental health functioning. Higher self-reported disease activity and lower helplessness were associated with greater disability as indexed by the HAQ-DI. The DAS 28 was unrelated to these outcomes. Conclusions The findings highlight the importance of targeting psychological factors to enhance HRQOL in the clinical management of RA patients.

Work Productivity Loss in Early Arthritis During the First 3 Years of Disease: A Study From a French National Multicenter Cohort

“…We used a self-reported questionnaire to collect baseline data on demographic characteristics (age, sex, ever smoker, education status, occupational category), time to see a rheumatologist (delay between the first symptom and the first visit to a rheumatologist), disease characteristics (Disease Activity Score in 28 (31,32).…”

Individual and Contextual Determinants of Quality of Life in Adolescents With Congenital Heart Disease

“…In the present study, as based on conceptual grounds [5], quality of life is defined as the degree of overall life satisfaction that is positively or negatively influenced by individuals' perception of certain important aspects of life, both related and unrelated to health [6]. In line with a biopsychosocial framework [7], the present longitudinal study aimed at identifying contextual and individual determinants of quality of life in adolescent patients with CHD by focusing on parental support, peer support, and sense of coherence (SOC), all being core psychosocial constructs in adolescence.…”

Fears and beliefs of people living with rheumatoid arthritis: a systematic literature review

“…Since beliefs in more severe consequences of rheumatic disease and feelings of helplessness were associated with worse outcome measures of functioning it is convenient to consider beliefs when facing to patients with poor function not otherwise explained by disease activity [26,30,32,33].…”

“…Among RA patients, helplessness (patients' Fear of too many changes in therapy Kumar 2011 [43] beliefs that they were not able to control pain and the course of disease) has a lower but statistically significant correlation with disability [30]. People who attributed more symptoms to RA, believe in a long illness duration, and held stronger beliefs that it would have negative consequences also presented greater disability on disease-specific measures of functioning; on the other side, stronger beliefs of personal control were associated with lower levels of disability, as were stronger beliefs in the ability of treatment to control RA [6,26,[31][32][33].…”