Functional Disability among Systemic Sclerosis Patients: Relation to Disease Characteristics and Quality of Life Parameters

Abstract

Background: Disability in patients with scleroderma (SSc) has been associated with poor health-related quality of life (HRQoL) in all dimensions, including physical, psychological, and social dimensions. Objective: This study was conducted to examine different factors that may be associated with functional disability and poor HRQoL, with the aim of targeting these factors in the future to improve physical activity, functional outcomes, and HRQoL. Methods: A single-center cross-sectional study was conducted on 38 patients with SSc to compare characteristics between patients with and without disability using the Health Assessment Questionnaire Disability Index (HAQ-DI). Quality of life was assessed using the Short Form–36 (SF-36). Linear regressions were performed to examine variables contributing to functional disability. Results: Almost 65.78% (n = 25) of patients in the study group reported functional disability. The presence of functional disability was associated with reduced HRQoL, as reflected by physical function (P = 0.0001), physical role (P = 0.016), bodily pain (P = 0.001), general health (P = 0.002), social functional (P = 0.002), emotional role (P = 0.042), and mental health (P = 0.025) domains of the SF-36 score. Multiple linear regression indicated that the main predictive factors associated with HAQ-DI were the modified Hand Mobility in Scleroderma; modified Rodnan skin score; DIstance walked in 6 minutes, BOrg dyspnea index, and SAturation of oxygen at 6 minutes (DIBOSA); and Fatigue Severity Scale among patients with SSc. Conclusion: In patients with SSc, recognizing the relationships between clinical findings and functional disability will allow the development of further management strategies to minimize disease severity and enhance HRQoL.

AB0680 Psychological impact of autologous stem cell transplantation in systemic sclerosis patients and influence of support and coping strategies.

“…In severe cases of systemic sclerosis (SSc), autologous hematopoietic stem cell transplantation (aHSCT) is superior compared to cyclophosphamide with respect to effect on skin and lung manifestations, survival and quality of life. Nevertheless, major physical and psychological impacts have been found in a first qualitative study by Spierings et al ( 2020) 1 . Objectives: Assessment of subjectively experienced physical and psychological impacts of aHSCT and exploration of potential interrelations of those impacts.…”

“…In the first step, 6 questionnaires were used: Global physical and mental health (SF-36 and Scleroderma Health Assessment Questionnaire = SHAQ), body image (Adapted Satisfaction with Appearance Scale = ASWAP), coping strategies (Freiburger Fragebogen zur Krankheitsverarbeitung = FKV-15), resilience (Resilienzskala = RS-11), and control beliefs (Fragebogen zur Erfassung von Kontrollüberzeugung zu Krankheit und Gesundheit = KKG). In the second step, semi-structured interviews based on Spierings et al ( 2020) 1 were conducted and analysed via mixed methods qualitative content analysis following Mayring (2014). Results: 19 patients (12 female, 7 male, mean age 53.47 years (SD = 9.50)) completed all questionnaires and interviews in a mean time of 6.56 years after aHSCT (SD = 3.90, range 1-12 years).…”

Prevalence of depression in Systemic sclerosis: A systematic review and meta-analysis

“…Depressive symptoms in SSc patients contribute to the worsening of any aspect of the disease [5]. In addition, previous study has reported that depressive symptoms in patients with SSc often have profound impacts on patients' health and wellbeing including increased pain [6][7][8], gastrointestinal involvement [9,10], physical disability [11], impairment of sexual functioning [12], and decreased quality of life [13]. Therefore, depression may be useful targets for interventions aimed at improving subjective health and quality of life in individuals with SSc.…”

Fatigue and Quality of Life in Systemic Scleroderma Patients: A Comparative Study

“…Цю розбіжність можна пояснити чіткими видимими фізичними змінами, пов'язаними з ССД. Ці зміни мають тенденцію погіршуватися з часом, тим самим сприяючи посиленню психологічного дистресу, що проявляється у вигляді посилення симптомів депресії та тривоги [5]. Крім того, часте використання медичних послуг у поєднанні з відповідними зростаючими витратами ще більше ускладнює проблему.…”

“…У той час як лікарі можуть надавати пріоритет об'єктивним показникам статусу хвороби, пацієнти часто сприймають інші аспекти свого захворювання як більш тривожні. Ці аспекти охоплюють обмеження рухливості та спритності рук, біль, втома, порушення сну, депресію, сексуальну дисфункцію та емоційні страждання, спричинені дефігуруючими змінами зовнішнього вигляду, такими як пігментними змінами шкірних покривів, контрактури рук і телеангіоектазії обличчя [5]. Всі ці фактори прямо впливають на якість та задоволеність життям.…”