Sociodemographic factors associated with functional disability in outpatients with rheumatoid arthritis in Southwest China

Abstract

With the rising number of patients with rheumatoid arthritis (RA), there is a limited understanding about sociodemographic factors that influence functional disability in Chinese patients. In order to provide more targeted interventions to improve health-related quality of life (HRQoL) for patients with RA, we conducted a cross-sectional study to investigate the level and influencing factors of functional disability. Convenient samples were collected in outpatients with RA from a rheumatological center in southwest China from September to December 2013. Data were collected by printed questionnaires, and functional disability was measured by the Health Assessment Questionnaire Disability Index (HAQ-DI). The results showed that 58.48 % of 607 outpatients had functional disability. Patients from rural residents, with lower household income and lower education level, were significantly associated with worse functional disability. Multivariate regression findings showed that pain, age, disease duration, total cost for treatment, and frequency of hospitalization were positively associated with functional disability. Meanwhile, subjective and available social support was the protective predictors for functional disability. The results suggested that systematic intervention and therapies should be provided as early as possible. Patients and health care providers should promote the awareness of the importance of accessible health education in early intervention of RA. Besides, pain management and social support are encouraged to postpone the process of disability of patients and improve the HRQoL. Lastly, but not least, prevention and intervention of RA should be incorporated into public health education.

Functional disability associated with disease and quality-of-life parameters in Chinese patients with rheumatoid arthritis

“…One possible explanation for the different results was the existence of cultural diversity and the different participants included in different studies with either Chinese or Western cohorts. Not surprisingly, disease duration was significantly associated with functional disability in Chinese patients with RA, which was in line with previous studies [11, 12]. When RA progresses, the joints were increasingly affected, which possibly increased the HAQ-DI score.…”

“…It could be explained by some cultural features which may influence disease management in China. Previous studies have reported that gender [10], age [11, 16], SES [12], comorbidities [13, 14], and pinch strength [17, 20] were associated with the HAQ-DI in RA patients. However, our study demonstrated there were no association between these variables and the HAQ-DI.…”

“…Developed in 1978, the health assessment questionnaire-disability index (HAQ-DI) remained the gold standard for measuring functional disability in RA [8, 9]. Current epidemiological evidence suggested gender [10], age [11], socioeconomic status (SES) [12], disease duration [11, 12], comorbidities [13, 14], pain [15, 16], disease activity [9, 13], laboratory indexes [17, 18], medication adherence [19], grip strength [17, 20], joints damage [9], anxiety/depression [21, 22], and quality of life [1, 4] were significantly associated with the HAQ-DI in RA patients. Only a study from Finland [20] in RA identified that joint mobility have greatest influence on the HAQ-DI.…”

Disease activity, resilience and health-related quality of life in Chinese patients with rheumatoid arthritis: a multi-center, cross-sectional study

“…One important reason for the discrepancy in the MCS comparisons may be that considerable developments in treatment in recent years have had a significant beneficial effect on RA patients’ HRQOL [39]. However, for the discrepancy in the PCS comparisons, the disease can become very severe and difficult to control by the time rheumatological care is accessed due to limited knowledge or self-management about RA in mainland China [40]. Other reasons may be some differences in the sources and cultural backgrounds of subjects, and the interpretation of the concept of HRQOL across studies.…”

Calidad de vida relacionada con la salud, percepción de enfermedad, felicidad y emociones negativas en pacientes con diagnóstico de artritis reumatoide

“…La AR afecta aproximadamente al 1% de la población mundial, y a medida que avanza la enfermedad, las consecuencias para la salud del paciente se identifican por la pérdida de la movilidad articular, deformidad, discapacidad, dolor crónico y la presencia de emociones negativas como la ansiedad, la depresión, el estrés y la desesperanza (Gibofsky, 2012;Santiago, Geenen, Jacobs & Da Silva, 2015;Zhao, Chen & Chen, 2015), además de presentar dependencia física y emocional, fatiga, rigidez matutina y trastornos del sueño, entre otros (Purabdollah, Lakdizaji, Rahmani, Hajaliu & Anzarin, 2015).…”