Quality of life in systemic lupus erythematosus patients during more and less active disease states: Differential contributors to mental and physical health

Dobkin, Patricia L.; Costa, Deborah Da; Dritsa, Maria; Fortin, Paul R.; Senécal, Jean‐Luc; Goulet, Jean; Choquette, D.; Rich, Éric; Beaulieu, André; Cividino, Alfred; Edworthy, Steven M.; Barr, Susan G.; Ensworth, Stephanie; Esdaile, John M.; Gladman, Dafna D.; Smith, Doug; Zummer, Michael; Clarke, Ann E.

doi:10.1002/1529-0131(199912)12:6<401::aid-art8>3.0.co;2-f

Cited by 66 publications

(77 citation statements)

References 24 publications

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“…Global physical function was improved by 7 points on the SF-36; although this change was not statistically significant, it is greater than the minimum clinically significant change suggested for interpreting change scores in rheumatoid arthritis trials (59). The clinical trial results confirm cross-sectional findings from research done by our group and other investigators, and support the importance of psychosocial factors in outcome in SLE (8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Discussionsupporting

confidence: 69%

“…Self-efficacy has been correlated with SLE outcome in several studies (8)(9)(10)(11)(12)(13)(14)(15) and has been found to consistently predict health-related outcomes in prospective studies (60). In this trial, we demonstrated that self-efficacy could be enhanced by our intervention and that it was a key predictor of mental health status and fatigue outcomes.…”

Section: Discussionmentioning

confidence: 53%

“…What was more significant, perhaps, was that both self-efficacy and social support could likely be improved with targeted interventions, thus making these factors the first examples of modifiable, nonmedical risk factors associated with SLE outcomes. Since that time, other studies have confirmed the importance of psychosocial factors and outcome in SLE (9)(10)(11)(12)(13)(14)(15).…”

mentioning

confidence: 82%

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A randomized clinical trial of a psychoeducational intervention to improve outcomes in systemic lupus erythematosus

Karlson¹,

Liang²,

Eaton³

et al. 2004

Arthritis & Rheumatism

162

157

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Objective. In a cross-sectional study, we previously identified 2 potentially modifiable risk factors for adverse outcomes in systemic lupus erythematosus (SLE): self-efficacy and social support. The goal of this study was to evaluate in a randomized controlled trial a theory-based intervention to improve patient selfefficacy and partner support to manage SLE.Methods. Patients with SLE ages 18 years and older who met the American College of Rheumatology criteria and were able to identify a partner (spouse or family member) were recruited from 2 academic medical centers and randomized into an experimental group or a control group. Patients in the experimental group and their partners received an intervention designed to enhance self-efficacy, couples communication about lupus, social support, and problem solving, in the form of a 1-hour session with a nurse educator followed by monthly telephone counseling for 6 months. Patients in the control group and their partners received an attention placebo, including a 45-minute video presentation about lupus, and monthly telephone calls. Measures of physical and mental health status, disease activity, and psychosocial factors were collected at baseline, 6 months, and 12 months. The effect of the intervention on physical and mental health and disease activity at 6 and at 12 months was modeled with linear regression and adjusted for baseline health status, disease activity, sociodemographic factors, treatment change, and psychosocial factors.Results. One hundred twenty-two patients (plus their partners) were enrolled and randomized as follows: 64 to the experimental intervention and 58 to the attention control group. The participants were predominantly white, approximately half were college educated, and the groups were balanced for sociodemographic factors. At 6 months, significantly higher scores for couples communication (P ‫؍‬ 0.01) and problem-focused coping (P ‫؍‬ 0.03) were seen in the experimental group compared with the control group. At 12 months (6 months after the intervention ended), social support was higher (4.4 versus 4.1; P ‫؍‬ 0.03), self-efficacy was higher (7.2 versus 6.2; P ‫؍‬ 0.02), couples communication was higher (3.5 versus 3.1; P ‫؍‬ 0.03), and fatigue was lower (5.1 versus 6.3; P ‫؍‬ 0.02) in the experimental group compared with the control group. Global mental health status at 12 months, as measured by the Short Form 36 survey, was 69 points in the experimental group compared with 58 points in the control group (P ‫؍‬ 0.04). In multivariate models, adjusting for baseline covariates, scores for couple communication (P ‫؍‬ 0.01) were significantly higher at 6 months, and scores for self-efficacy (P ‫؍‬ 0.004) and global mental health status (P ‫؍‬ 0.03) were significantly higher at 12 months in the experimental group compared with the control group, and the mean score for global physical function was higher by 7 points, which was a clinically meaningful

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 53%

mentioning

confidence: 82%

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A randomized clinical trial of a psychoeducational intervention to improve outcomes in systemic lupus erythematosus

Karlson¹,

Liang²,

Eaton³

et al. 2004

Arthritis & Rheumatism

162

157

View full text Add to dashboard Cite

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“…De acuerdo con la actividad lúpica, muchos estudios son concluyentes en que es un factor determinante para la percepción favorable o no de la CVRS, incluso independientemente de la edad, el género, la educación y el estatus socio-económico (Da Costa, et al, 2000;Dobkin, et al, 1999;Freire, et al, 2007;Mok, et al, 2009;Wang, et al, 2001;Ruperto, et al, 2004;Zheng, et al, 2009). Mas sin embargo en nuestro estudio se observa que la interacción de la variable sociodemográfica ocupación con la actividad lúpica afecta de manera significativa sobre la dimensión salud mental, mientras que la ansiedad asociada a la actividad lúpica afecta el rol físico de la CVRS.…”

Section: Discussionunclassified

“…En conclusión, se planteó que la severidad de la fatiga y la comorbilidad con fibromialgia tiene una alta relación con un estado de salud desfavorable en los pacientes con LES. Dobkin, et al, (1999) en Canadá desarrollaron un estudio con el objetivo de identificar los índices de salud mental y física de la CVRS a una muestra de 129 pacientes con diagnóstico de LES a quienes se les evaluó el distrés psicológico, el apoyo social, el afrontamiento al estrés, la CVRS a través del cuestionario de Salud MOS SF-36, el índice de actividad lúpica mediante el SLAM-R y el índice de daño orgánico con el SLICC-ACR. Los pacientes fueron divididos en dos grupos, los de mayor actividad lúpica (n=38) y menor estado de actividad lúpica (n=91).…”

Section: Estudios Empíricos De Calidad De Vida En Pacientes Con Lupusunclassified

Calidad de vida relacionada con la salud, factores psicológicos y fisiopatológicos en pacientes con diagnóstico de Lupus Eritematoso Sistémico - LES

et al. 2010

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ResumenEl objetivo de este estudio fue analizar, por un lado, los niveles de ansiedad, depresión, apoyo social, índice de actividad lúpica, fibromialgia, daño orgánico y renal, tiempo de diagnóstico de la enfermedad y factores sociodemográficos en 78 pacientes con diagnóstico de Lupus Eritematoso Sistémico; y analizar el efecto de estas variables sobre la calidad de vida relacionada con la salud. Se emplearon como instrumentos: el cuestionario de Salud MOS SF-36, la Escala Hospitalaria de Ansiedad y Depresión HAD, el cuestionario de Apoyo Social Funcional DUKE-UNK, el Índice de Actividad Lúpica SLEDAI y el Índice de Daño Orgánico SLICC-ACR; y se consideró además el diagnóstico médico de Fibromialgia y de Nefropatía. Los resultados señalaron que factores fisiopatológicos (actividad lúpica y daño orgánico), psicológicos (ansiedad-depresión) y sociodemográficos (ocupación y estado civil) y la interacción entre estos afectan la calidad de vida a nivel mental más que físico en los pacientes con lupus.Palabras clave: Lupus Eritematoso Sistémico, calidad de vida relacionada con la salud, ansiedad, depresión, Fibromialgia. AbstractThe aim of this research was to evaluate the impact of anxiety, depression, social support, Systemic Lupus Erythematosus (SLE) disease activity index, fibromyalgia, organic and kidney damage, and time of diagnosis of disease on Health-related Quality of Life in 78 patients with SLE diagnosis. Participants completed the Health Survey Questionnaire (SF-36), the Hospital Anxiety and Depression (HAD) scale, the Duke-UNK Functional Social Support questionnaire, the SLEDAI (SLE Disease Activity Index), and the SLICC/ACR damage index for SLE. As a complementary measure, Fibromyalgia and Nephropathy diagnosis was considered. The results shown that in patients with lupus, pathophysiological (SLE disease activity index and organic damage), psychological (anxiety-depression) and sociodemographic factors (occupation and civil status) affect the quality of life in the mental domain rather than in the physical level.

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Neurocognitive impairment in childhood‐onset systemic lupus erythematosus: Measurement issues in diagnosis

Williams¹,

Aranow²,

Ross³

et al. 2011

Arthritis Care & Research

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Objectives To assess the prevalence of neurocognitive impairment (NCI) in childhood-onset systemic lupus erythematosus (cSLE) comparing published classification criteria, and to examine associations between NCI, disease characteristics, psychosocial-well being and intelligence. Methods cSLE patients and ethnicity- and age-matched healthy controls completed a neuropsychological research battery, and results were categorized by three different NCI classification criteria with different cutoff scores (e.g., >2, 1.5, or 1 SD below mean) and number of required abnormal tests or domains. Results Forty-one cSLE subjects and 22 controls were included. Subjects were predominantly female (70%) and Hispanic (70%). Executive functioning, psychomotor and fine-motor speed were most commonly affected. Method 1 classified 34.1% of cSLE subjects with NCI, compared to Method 2 (14.6% with decline and 7.3 % with NCI) and Method 3 (63.4% with NCI). Prevalence of NCI was not significantly different between controls and patients using any of the categorization methods. NCI was not associated with SLE disease activity or characteristics, or with depression. Using Method 3, patients in the cognitive impairment group reported significantly lower quality of life estimates (69.7 vs 79.3, p=0.03). Below average intellectual functioning (IQ < 90) differentiated the number of test scores >1 and >1.5 SD, but not >2 SD below the mean. Conclusions NCI was prevalent in cSLE, but varied according to chosen categorization method. A similar proportion of cSLE patients and controls had NCI, reinforcing the importance of studying an appropriate control group. Categorical classification (i.e. impaired/nonimpaired) may oversimplify the commonly observed deficits in cSLE.

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Quality of life in systemic lupus erythematosus patients during more and less active disease states: Differential contributors to mental and physical health

Cited by 66 publications

References 24 publications

A randomized clinical trial of a psychoeducational intervention to improve outcomes in systemic lupus erythematosus

A randomized clinical trial of a psychoeducational intervention to improve outcomes in systemic lupus erythematosus

Calidad de vida relacionada con la salud, factores psicológicos y fisiopatológicos en pacientes con diagnóstico de Lupus Eritematoso Sistémico - LES

Neurocognitive impairment in childhood‐onset systemic lupus erythematosus: Measurement issues in diagnosis

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