Coping with health-stressors and defence styles associated with health-related quality of life in patients with systemic lupus erythematosus

Abstract

This study aimed to assess the association of coping with health-stressors and defence styles with health-related quality of life (HRQOL) in systemic lupus erythematosus (SLE). In 56 SLE patients we assessed disease activity (SLEDAI), functional limitations (HAQ), psychological distress (SCL-90-R), defence styles (Defence Style Questionnaire), hostility (HDHQ), coping with health-stressors (Sense of Coherence scale) and HRQOL (WHOQOL-BREF). Two hundred and eight rheumatologic patients (168 with rheumatoid arthritis [RA] and 40 with primary Sjögren's syndrome [SS]) served as disease controls. SLE patients' HRQOL was similar to that of patients with RA and primary SS after adjusting for demographic and disease variables. Psychological distress was significantly associated with most aspects of HRQOL, but sense of coherence mediated the relationship of psychological distress with Physical HRQOL; this mediation effect was unique to SLE, as mediation analyses showed. Maladaptive action defence style was also significantly associated with Environment HRQOL independently of psychological distress (p < 0.024). These findings indicate that, apart from the early assessment and treatment of psychological distress, clinicians and consultation-liaison psychiatrists should bear in mind the SLE patients' psychological resources and coping capacities to deal with the stress of the disease, since such traits, although usually underestimated, are strongly independently associated with HRQOL.

Coping and Quality of Life in Patients with Systemic Lupus Erythematosus: A Review

“…Two studies found that the sense of coherence (soc) is a strong correlate of hrqol in patients with sle (Abu-Shakra et al, 2006;Hyphantis, Palieraki, Voulgari, Tsifetaki & Drosos, 2011). This construct theory hypothesizes that an individual with a strong soc maintains and improves health through effective coping with stressors and flexibility, for the purpose of facilitating the adoption of preventive behaviors related to health and eliminating unhealthy ones, while low levels of soc correspond to individuals with low perceived competence to overcome the health stressors (Hyphantis, et al, 2011). Thus, a person with a strong soc would be able to cope with stressors related to illness, and therefore enjoy a better qol (AbuShakra et al, 2006).…”

“…Dobkin et al, 1999;Rinaldi et al, 2006;Da Costa et al, 2000;Friedman et al, 1999;Abu-Shakra et al, 2006;Bennett, Fuertes, Keitel & Phillips, 2011;Dobkin et al, 2002;Haupt et al, 2005;Dobkin et al, 2001) who qol-Brief scales 2 (Hyphantis et al, 2011;Abu-Shakra et al, 2006) Focus groups 1 (Robbins, Allegrante, & Paget, 1993;Beckerman, 2011) Coping: The Coping Style Inventory (csi) 1 (Kozora, et al, 2005) Freiburg questionnaire on coping with illness (fkv) 1 (Haupt et al, 2005) The Coping Orientation to Problems Experienced (cope) 1 (Rinaldi et al, 2006) Lupus erythematosus needs questionnaire (slenq) 1 (Auerbach, Beckerman & Blanco, 2013) Lupuspro 1 (Jolly et al, 2014) General Health Questionnaire-30 (ghq-30) 1 (Ng & Chan, 2007) Coping skills 10 items questionnaire designed by Arthritis Foundation. 1 (Sohng, 2003) Focus groups 3 (Beckerman, 2011;Beckerman & Sarracco, 2012;Robbins, Allegrante & Paget, 1993) in different significant domains of life experience, such as social relationships, personal development and intimacy.…”

Self‐efficacy and pain catastrophizing in systemic lupus erythematosus: Relationship to pain, stiffness, fatigue, and psychological distress

“…No study to date has examined how coping cognitions specific to pain may influence important outcomes, such as pain, stiffness, fatigue, and mood, in SLE patients. Past studies in patients with SLE have demonstrated that patients' general coping strategies and perceptions of control (i.e., not specifically related to SLE pain) are related to SLE disease activity (2,6 -8), physical functioning (9), psychological functioning (2,10), and other measures of quality of life (11). Two pain coping cognitions that may be particularly important to consider in patients with SLE are self-efficacy for pain control and pain catastrophizing.…”

Integral Treatment of Systemic Lupus Erythematosus

“…The use of SOC scale detect those patients who are coping poorly with the illness because they have poor psychological resources, in order to promote psychotherapeutic interventions that improve patients' QOL. (Abu-Shakra et al, 2006;Hyphantis et al, 2011) …”