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

Abstract

BackgroundPositive psychological constructs that can moderate or mediate the negative impact of disease activity on health-related quality of life (HRQOL) in patients with rheumatoid arthritis (RA) have not been explored widely. This study aimed to assess the associations of disease activity, resilience with HRQOL and the moderating and mediating roles of resilience among Chinese RA patients.MethodsA multi-center, cross-sectional study was conducted in RA inpatients in northeast of China. A total 298 subjects completed the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and Ego-Resiliency Scale (ERS) to measure HRQOL and resilience. For the SF-36, physical function, physical role limitation, bodily pain and general health perception are gathered into physical component summary (PCS), while vitality, social functioning, emotional role limitation and mental health are gathered into mental component summary (MCS). Disease activity was evaluated by the Disease Activity Score 28-C-reactive protein (DAS28-CRP). Hierarchical regression analysis was applied to examine the associations of disease activity, resilience and the disease activity*resilience interaction with PCS and MCS, respectively. Asymptotic and resampling strategies were utilized to examine the mediating role of resilience.ResultsThe mean scores of PCS and MCS were 40.67 and 59.14, respectively. Disease activity was negatively associated with both PCS and MCS, and resilience was only positively associated with MCS. The disease activity*resilience interaction term were significantly associated with MCS (β = 0.144, P = 0.003). The associations between disease activity and MCS were gradually reduced in low (1 SD below the mean, β = −0.369, P < 0.001), mean (β = −0.218, P < 0.001) and high (1 SD above the mean, β = −0.068, P = 0.369) groups of resilience. Resilience acted as a partial mediator in the disease activity-MCS association (effect size was −0.085, BCa 95% CI: −0.159, −0.028).ConclusionsDisease activity was negatively associated with both physical and mental HRQOL, and resilience was only positively associated with mental HRQOL. Resilience could attenuate and mediate the association between disease activity and mental HRQOL. In addition to controlling disease activity, targeted intervention strategies designed for resilience should be strengthened to improve the HRQOL of this population.

Development of Resilience Among Rheumatoid Arthritis Patients: A Qualitative Study

“…The patient narratives in our study suggest that the development of resilience promotes psychological well-being as well as self-care behaviors, such as adherence to physical therapy/ exercise routines or managing one's medical information. This finding is consistent with previous literature suggesting that resilience benefits patients with rheumatic diseases through improved physical and psychological functioning (24,28), lower fatigue (40) and disease activity, and higher mental health-related quality of life (27).…”

“…Among RA patients, high resilient coping tempered the association of pain symptoms and stress with depressive symptoms (20). Resilience is negatively associated with fatigue (26) and is thought to protect against the negative effects of illness-related stressors on the severity of symptoms, physical functioning, and mental health-related quality of life in RA (27,28).…”

Effects of stigma, hope and social support on quality of life among Chinese patients diagnosed with oral cancer: A cross-sectional study

“…The findings of our study showed that patients with a college education or higher had a higher QoL score, which echoed the findings of Liu's study [32]. On the one hand, higher education levels were proven to be positively related to high resilience [33], and resilient patients are always considered to possess stronger abilities to rebound from frustration and tragedy [34].…”

Konservative Therapie rheumatischer Erkrankungen

“…Die aus der Erfahrungsmedizin erwachsenen konservativen Therapien hingegen finden nur selten den Weg ins Bewusstsein der Bevölkerung. Auch die Hilfe zur Selbsthilfe, wie die Diätberatung, Suchtberatung und die Beratung hinsichtlich sportlicher Belastungen sowie beruflicher und Freizeitaktivitäten stellt einen zentralen, wenn auch häufig vernachlässigten Punkt zur Verbesserung der Lebensqualität dar (3)(4)(5)(6)(7)(8).…”