Logistic regression models for predicting physical and mental health-related quality of life in rheumatoid arthritis patients

Abstract

The aim of this work was to develop two logistic regression models capable of predicting physical and mental health related quality of life (HRQOL) among rheumatoid arthritis (RA) patients. In this cross-sectional study which was conducted during 2006 in the outpatient rheumatology clinic of our university hospital, Short Form 36 (SF-36) was used for HRQOL measurements in 411 RA patients. A cutoff point to define poor versus good HRQOL was calculated using the first quartiles of SF-36 physical and mental component scores (33.4 and 36.8, respectively). Two distinct logistic regression models were used to derive predictive variables including demographic, clinical, and psychological factors. The sensitivity, specificity, and accuracy of each model were calculated. Poor physical HRQOL was positively associated with pain score, disease duration, monthly family income below 300 US$, comorbidity, patient global assessment of disease activity or PGA, and depression (odds ratios: 1.1; 1.004; 15.5; 1.1; 1.02; 2.08, respectively). The variables that entered into the poor mental HRQOL prediction model were monthly family income below 300 US$, comorbidity, PGA, and bodily pain (odds ratios: 6.7; 1.1; 1.01; 1.01, respectively). Optimal sensitivity and specificity were achieved at a cutoff point of 0.39 for the estimated probability of poor physical HRQOL and 0.18 for mental HRQOL. Sensitivity, specificity, and accuracy of the physical and mental models were 73.8, 87, 83.7% and 90.38, 70.36, 75.43%, respectively. The results show that the suggested models can be used to predict poor physical and mental HRQOL separately among RA patients using simple variables with acceptable accuracy. These models can be of use in the clinical decision-making of RA patients and to recognize patients with poor physical or mental HRQOL in advance, for better management.

Effect of Stress Management on Quality of Life in Females with Rheumatoid Arthritis

“…Chronic diseases (such as RA) exacerbate and make the patients more prone to complications and lead to withdrawal from the society and greater stress. Breaking this cycle can be as effective as medication, regarding similar results (12)(13)(14)(15)(16)(17).…”

“…On the other hand, using self-evaluating stress management could increase mood, stability, and shortening of disease course. For example, in the author's previous studies (13)(14)(15)(16), stress management programs had a lowering effect on anxiety, depression, and RA symptoms. Other studies have demonstrated the same results (10-13).…”

“…Patients can identify stresses by stress management educational programs with cognitive-behavioral methods and work towards eliminating them. In other words, lowering stress in chronically ill patients could improve their illness and QOL together (12)(13)(14)(15)(16).…”

Relationship between Sleep Disorders, Pain and Quality of Life in Patients with Rheumatoid Arthritis

“…Furthermore, Alishiri et al, in Tehran showed an inappropriate general health in RA patients, also they found a significant relationship between general health with sleep and pain severity. 26 In the current study, 59.5% of the participants had low awareness about nature and complications of illness. In regard to significant relationship between duration of disease and QOL in participants, Masayo kojima et al, indicated a significant relation between duration of disease and number of surgeries related to illness and the QOL.…”

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

“…Fears about the consequences of the RA were independently correlated to physical HRQOL, i.e., patients who believe in worse consequences of RA had worse scores in the physical component of quality of life measures; patient global assessment of disease activity was also a significant predictor of poor mental and physical HRQOL [6,[33][34][35][36].…”