Understanding the psychosocial determinants of effective disease management in rheumatoid arthritis to prevent persistently active disease: a qualitative study

Stoll, Nkasi; Dey, Mrinalini; Norton, Sam; Adas, Maryam; Bosworth, Ailsa; Buch, Maya H; Cope, Andrew; Lempp, Heidi; Galloway, James; Nikiphorou, Elena

doi:10.1136/rmdopen-2024-004104

Cited by 3 publications

(1 citation statement)

References 50 publications

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“…In the early stages, most domestic and international scholars investigated the influencing factors of HL primarily from demographic characteristics. As cross-sectional studies have progressed, social and psychological factors have become hot topics of discussion ( Stoll et al, 2024 ). However, correlation research remains comparatively scarce, and comprehensive, large-scale cross-sectional studies encompassing multiple factors are still pending.…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional study of predictive factors of health literacy among rheumatoid arthritis patients in China

Liu,

Meng,

Wang

et al. 2024

Front. Psychol.

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ObjectiveTo investigate the factors that influence health literacy (HL) among Chinese patients with rheumatoid arthritis (RA) and furnish theoretical underpinnings for the development of intervention strategies aimed at enhancing patients’ quality of life.MethodsFrom May 2022 to December 2022, a comprehensive survey was conducted among both outpatients and inpatients diagnosed with (RA) in a tertiary hospital in China. The survey utilized various instruments, including a general information questionnaire, a chronic disease patient health literacy scale, the Health Assessment Questionnaire-Disability Index (HAQ-DI), the Chinese-translated Rheumatoid Arthritis Self-Efficacy Scale, the Chinese-translated Rheumatoid Arthritis Stigma Scale, and the Chinese-translated Compliance Questionnaire for Rheumatology Treatments.ResultsThe average scores of HL, self-efficacy, medication adherence, and disability index were 83.54 ± 17.43, 84.91 ± 14.37, 70.16 ± 11.24, and 0.26 ± 0.44, respectively. HL in Chinese RA patients was negatively correlated with age, erythrocyte sedimentation rate (ESR), number of tender joints, number of swollen joints, and disease activity, while positively correlated with self-efficacy and medication adherence. Age, disease activity, disability index, self-efficacy, and medication adherence are predictive factors of HL, and a predictive model has been initially constructed.ConclusionIn the management of RA, healthcare professionals should develop and implement effective intervention measures by focusing on improving medication adherence, enhancing patients’ self-efficacy, improving patients’ physical function, and reducing disease activity. This will help enhance the health literacy and promote clinical outcomes in RA patients.

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Section: Introductionmentioning

confidence: 99%

A cross-sectional study of predictive factors of health literacy among rheumatoid arthritis patients in China

Liu,

Meng,

Wang

et al. 2024

Front. Psychol.

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Significant others in inflammatory arthritis: roles, influences, and challenges—a scoping review

Hansen,

Nørgaard,

de Thurah

et al. 2024

Rheumatol Int

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Improving self-management in individuals with inflammatory arthritis (IA) is crucial for effective disease management. However, current recommendations primarily focus on interventions for the diagnosed individuals, overlooking the potential impact of their significant others on their self-management abilities. This review aims to fill this gap by identifying and mapping relevant research employing both qualitative and quantitative design to provide a broader understanding of the potential of significant others in relation to IA management. We examined studies published from 2007 to 2024 that explore our research questions using electronic databases and grey literature searches. Two independent reviewers meticulously screened and categorized the studies based on a developed framework employing basic content analysis. Out of 20.925 studies, 43 were included: 22 quantitative studies (including 1 educational trial), 20 qualitative studies, and 1 mixed-methods study. Our analysis of the included studies revealed that significant others predominantly provided practical and emotional support and could positively or negatively influence the person with IAs self-management abilities. Additionally, significant others reported their own feelings of emotional distress and expressed the need for knowledge, skills and social support enabling them to provide better support while taking care of them self. Greater focus on the significant others of those diagnosed with IA in their provision of support to this patient group may both improve the people with IA self-management skills and address significant others’ reported needs. Future studies should explore the impact of such initiatives through randomized controlled trials.

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Health-related quality of life (HRQoL) loss associated with self-perceived anxiety/depression in seropositive rheumatoid arthritis

Rojas-Gualdrón,

Franco-Salazar,

Gómez-Henck

et al. 2024

Clin Rheumatol

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Objective To analyze the HRQoL loss associated with self-perceived anxiety/depression in patients with seropositive rheumatoid arthritis (RA). Method This secondary data analysis is based on a registry-based retrospective follow-up study of patients with seropositive RA treated between August 2014 and January 2023 in ARTMEDICA, Colombia. HRQoL loss and self-perceived anxiety/depression were defined as outcomes. Disease activity (DAS-28) and other patient data were also gathered. Statistical analyses were performed using the ordinal logistic and generalized linear regression models. Results A total of 3579 patients with a mean follow-up of 2.9 (SD 2.4) years, 85.6% women with a median age at diagnosis of 48.1 (IQR 37.8–57.5) years, and a median of 6.5 (IQR 1.9–14.7) years living with RA were included. At program admission, the median DAS-28 score was 2.8 (IQR 2.1–4.2), and 6.6% of patients reported extreme anxiety/depression. The average HRQoL loss was 3.4 months per year lived with seropositive AR. Among patients with no pain or discomfort, moderate and extreme anxiety/depression were associated with mean HRQoL losses of 2.2 (95% CI − 2.3 to − 2.2) and 4.1 (95% CI − 4.3 to − 3.8) months. In patients with extreme pain/discomfort, these estimations were 0.8 (95% CI − 0.9 to − 0.7) and 1.9 (95% CI − 2.1 to − 1.7) months, respectively. Conclusion Our study adds to the available body of evidence by clarifying the differential impact of anxiety/depression on HRQoL, depending on the severity of pain. These findings highlight the importance of strengthening mental health care and psychological well-being interventions for patients with RA, regardless of pain or disease activity. Key Points• The average HRQoL loss was 3.4 months per year lived with seropositive AR.• Pain/discomfort rather than disease activity explained the severity of anxiety/depression as well as its associated HRQoL loss.• For patients with extreme pain/discomfort and anxiety/depression, the average HRQoL loss was 8.1 months per year lived with the disease compared to 0.4 months for patients without those impacts.

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Understanding the psychosocial determinants of effective disease management in rheumatoid arthritis to prevent persistently active disease: a qualitative study

Cited by 3 publications

References 50 publications

A cross-sectional study of predictive factors of health literacy among rheumatoid arthritis patients in China

A cross-sectional study of predictive factors of health literacy among rheumatoid arthritis patients in China

Significant others in inflammatory arthritis: roles, influences, and challenges—a scoping review

Health-related quality of life (HRQoL) loss associated with self-perceived anxiety/depression in seropositive rheumatoid arthritis

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