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Borgia RE, Ugarte-Gil MF, Vilá LM, Reveille JD, McGwin G, Alarcón GS. Health-Related Quality of Life in Adults With Adolescent- and Adult-Onset Systemic Lupus Erythematosus: A Longitudinal Study of a Multiethnic US Cohort. Arthritis Care Res (Hoboken) 2022. [PMID: 36039942 DOI: 10.1002/acr.25006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/27/2022] [Accepted: 08/25/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The long-term impact of childhood-onset systemic lupus erythematosus (SLE) on health-related quality of life (HRQoL) in adult SLE patients in comparison to those with adult-onset SLE is unknown. We aim to examine and compare HRQoL trajectories in adults with adolescent- and adult-onset SLE. METHODS Patients enrolled in the LUpus in MInorities: NAture versus Nurture cohort were included. Adolescent-onset SLE were those diagnosed before 24 years of age, and adult-onset SLE were those diagnosed otherwise. Sociodemographic, clinical, medications, behavioral/psychological, and functioning data were obtained. Longitudinal trajectories of the physical component summary (PCS) and the mental component summary (MCS) Short Form 36 health survey scores were compared between the groups using a linear mixed model accounting for time-dependent and independent covariates. RESULTS A total of 470 SLE patients were included (95 with adolescent-onset SLE and 375 with adult-onset SLE). The mean ± SD age at diagnosis was 19.7 ± 2.8 years in the adolescent group and 39.3 ± 11.0 years in the adult group. The baseline PCS scores were higher (better physical functioning) in adolescent-onset SLE than in adult-onset SLE (38.9 versus 34.3, respectively; P < 0.001); however, the baseline MCS scores were comparable between the groups (41.4 versus 40.5, respectively; P = 0.53). The HRQoL improved equally in both groups with no statistically significant difference within and between the groups (last mean PCS and MCS scores 43.9 and 45.3 in adolescent-onset SLE; 38.1 and 43 in adult-onset SLE). CONCLUSIONS Adults with adolescent-onset SLE exhibited better physical functioning than those in the adult SLE group, despite more severe disease; noteworthy, HRQoL was below the general US population, despite clinically meaningful improvement in HRQoL over time in both groups.
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Affiliation(s)
- R Ezequiel Borgia
- University Hospitals, Rainbow Babies & Children's Hospital, Cleveland, Ohio
| | - Manuel F Ugarte-Gil
- Hospital General Guillermo Almenara Irigoyen, EsSalud and Universidad Científica del Sur, Lima, Perú
| | - Luis M Vilá
- University of Puerto Rico, San Juan, Puerto Rico
| | | | | | - Graciela S Alarcón
- University of Alabama at Birmingham, Birmingham, and Universidad Peruana Cayetano Heredia, Lima, Perú
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2
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Cornet A, Mazzoni D, Edwards A, Monzani D, Pravettoni G, Andersen J, Mosca M. Coping with systemic lupus erythematosus in patients' words. Lupus Sci Med 2022; 9:9/1/e000656. [PMID: 35568437 PMCID: PMC9109093 DOI: 10.1136/lupus-2022-000656] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/07/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Previous research on coping strategies of patients with SLE showed that there are no absolute adaptive or maladaptive strategies and that the range of potential coping strategies is large and heterogeneous. In this paper, we aimed to identify, in a large sample of patients with SLE (N=3222), the most frequent words used by patients to describe their coping strategies, to group them into significant themes and to test their possible association with specific patient characteristics. METHODS Our analyses were based on the data set of the European survey 'Living with Lupus in 2020' (N=3222). Through the T-LAB software, we analysed the answers that adult participants gave to an open-ended question about how they cope with the disease. We identified the most frequent words, and with hierarchical cluster analysis we grouped them into semantic clusters (ie, themes) that were characterised by specific patterns of words. Finally, we tested the possible association between clusters and illustrative variables (sociodemographics, disease characteristics, quality of life). RESULTS Five coping strategies were identified, each of them constituting an important percentage of the total word occurrences: positive attitude (22.58%), social support (25.46%), medical treatments (10.77%), healthy habits (20.74%) and avoid stress (20.45%). Each strategy was statistically associated with specific patient characteristics, such as age and organ involvement. CONCLUSIONS Learning to adapt to a lifetime of having SLE may require replacing old coping strategies with more effective ones. Investigating patients' coping strategies in relation to different patient characteristics represents a useful starting point for developing more targeted and efficacious interventions.
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Affiliation(s)
| | - Davide Mazzoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| | | | - Dario Monzani
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Marta Mosca
- Rheumatology Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy
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Wang XA, Duculan R, Mancuso CA. Coping Mechanisms Mitigate Psychological Stress in Patients With Rheumatologic Diseases During the COVID-19 Pandemic. J Clin Rheumatol 2022; 28:e449-e455. [PMID: 34054073 DOI: 10.1097/rhu.0000000000001757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Coping with stress is part of self-managing systemic rheumatic diseases. Our objective was to assess stress and coping during the coronavirus disease 2019 (COVID-19) pandemic. METHODS During the pandemic in New York City, patients taking disease-modifying antirheumatic drugs answered open-ended questions about the pandemic's effects on daily life and their rheumatic condition. Themes of stress and coping were discerned from volunteered responses. Patients also completed the standard Generalized Anxiety Disorder (GAD-7) scale/PROMIS Anxiety surveys. Anxiety scores were independent variables in multivariable analyses with stress and coping themes as combined dependent variables. RESULTS Of the 112 patients interviewed (86% women; mean age, 50 years), 72 volunteered COVID-19-related stress on their rheumatic condition, home, work, and finances. Patients volunteering stress were younger, had disease longer, were taking more than 1 medication, had worse GAD-7 scores and a positive anxiety screen, and had worse PROMIS scores that were significantly worse than population norms (all comparisons, p ≤ 0.01; all variables remained associated in multivariable analyses). Fourty-one patients volunteered coping mechanisms including support from others, engaging in activities, and resilience already establish in dealing with rheumatic diseases. Of these, 18 volunteered both coping and stress and 23 volunteered coping and no stress. Patients in the latter (coping-only) group were more likely to be older, taking only 1 medication, and had better GAD-7 and PROMIS scores (all comparisons, p ≤ 0.02). In multivariable analysis, older age (p = 0.02) and lower GAD-7 (p = 0.03) or PROMIS scores (p = 0.03) remained associated. CONCLUSIONS Patients reported stress and coping due to the COVID-19 pandemic. Analyses with standard anxiety measures demonstrated lower anxiety in patients who volunteered coping mechanisms.
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Affiliation(s)
- Xin A Wang
- From the Department of Medicine, Weill Cornell Medical College
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4
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Allen KD, Beauchamp T, Rini C, Keefe FJ, Bennell KL, Cleveland RJ, Grimm K, Huffman K, Hu DG, Santana A, Saxena Beem S, Walker J, Sheikh SZ. Pilot study of an internet-based pain coping skills training program for patients with systemic Lupus Erythematosus. BMC Rheumatol 2021; 5:20. [PMID: 34134788 PMCID: PMC8210367 DOI: 10.1186/s41927-021-00191-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/23/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Patients with Systemic Lupus Erythematosus (SLE) often experience pain and other symptoms that negatively impact quality of life. Interventions that enhance the use of behavioral and cognitive coping strategies may lead to improved outcomes among patients with SLE. Pain coping skills training (PCST) programs have been shown to improve outcomes among patients with other rheumatic conditions, but there have been no trials of PCST among patients with SLE. This study was a preliminary assessment of the feasibility and efficacy of painTRAINER, an automated, internet-based PCST program, among patients with SLE. METHODS Participants (n = 60) with SLE from one health care system were randomly assigned with equal allocation to painTRAINER or a wait list control group. PainTRAINER involves 8 modules; participants were instructed to complete one module weekly, along with practice activities for each cognitive or behavioral coping skill. Outcome measures were assessed at baseline and 9-week follow-up, including the Pain Catastrophizing Scale, PROMIS Subscales (Pain Interference, Physical Function, Sleep Disturbance, Anxiety, Depression, Fatigue and Participation), and the LupusPRO questionnaire. Mean changes in outcomes from baseline to follow up and Cohen's d effect sizes were computed. RESULTS Effect sizes for the painTRAINER group (relative to the wait list group) were small, with changes being greatest for the PROMIS Depression score (d = - 0.32). Among those randomized to the painTRAINER group, 50% accessed the program ("painTRAINER users"). Most of those who did not access the program stated that they did not receive instructions via email. Effect sizes for "painTRAINER users" (relative to wait list) were larger than for the whole painTRAINER group: Pain Catastrophizing d = - 0.60, PROMIS Pain Interference d = - 0.3., PROMIS Depression d = - 0.44, LupusPRO Health-Related Quality of Life d = 0.30. CONCLUSIONS PainTRAINER users reported meaningful improvements in multiple physical and psychological outcomes, supporting the potential of PCST programs to benefit individuals with SLE. However, strategies are needed to improve engagement with the program and tailor content to comprehensively address key SLE symptoms and challenges. TRIAL REGISTRATION NCT03933839 , May 1, 2019.
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Affiliation(s)
- Kelli D Allen
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Center of Innovation to Accelerate Discovery and Practice Transformation, Department of Veterans Affairs Health Care Center, Durham, NC, USA.
| | | | - Christine Rini
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
| | - Francis J Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Kim L Bennell
- Centre for Health, Exercise, and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia
| | - Rebecca J Cleveland
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kimberlea Grimm
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katie Huffman
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David G Hu
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Andres Santana
- Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shruti Saxena Beem
- Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julie Walker
- Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Saira Z Sheikh
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Romeo JLR, Mokhles MM, van de Woestijne P, de Jong P, van den Bosch A, van Beynum IM, Takkenberg JJM, Bogers AJJC. Long-term clinical outcome and echocardiographic function of homografts in the right ventricular outflow tract†. Eur J Cardiothorac Surg 2020; 55:518-526. [PMID: 30084965 DOI: 10.1093/ejcts/ezy265] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/25/2018] [Accepted: 06/25/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Although homografts are often the preferred valve conduits for right ventricular outflow tract (RVOT) reconstruction, data on long-term homograft-related outcomes, durability and impact on quality of life (QoL) are scarce. The aim of this study was therefore to describe the long-term homograft function, clinical outcomes and QoL after RVOT reconstruction. METHODS We performed a single-centre retrospective analysis of all consecutive patients who underwent RVOT reconstruction with a homograft. Multiple subsequent allografts in the same patients were regarded as separate subjects. Valve-related events were analysed by Kaplan-Meier and Life Table methods. Serial echocardiographic measurements were analysed with mixed effects models. In addition, QoL was repeatedly assessed and compared with a matched general population. RESULTS In total, 701 consecutive homografts were implanted in 604 patients [59.6% males, mean age at operation 19.5 ± 15.2 (standard deviation)]. Hospital mortality was 3.3%. After 25 years follow-up, survival and freedom from valve replacement were 84 ± 4% and 56 ± 6%, respectively. Freedom from valve replacement after 15 years for patients under 1 year of age was 28 ± 14% years, for those between 1 and 18 years, 59 ± 8%, and for those older than 18 years, 82 ± 5%. The peak gradient increased predominantly in the first postoperative decade in infants and paediatric patients from 19 to 54 mmHg. In adults, the average gradient increased from 9 to 31 mmHg after 14 years. Compared to a gender- and age-matched Dutch population, patients reported lower vitality and general health but less bodily pain. Patients, in whom QoL was repeatedly assessed, reported lower scores on physical functioning and vitality after a 5-year follow-up period. However, we found no differences in any of the subscales in patients who underwent valve replacement during the 5-year interval. CONCLUSIONS Homografts are a durable valve alternative for RVOT reconstruction; in particular, adults show extensive freedom from valve replacement and report QoL comparable with healthy subjects. An online interactive application form created by our institution can be used to assess patient outcome after RVOT reconstruction with a homograft for different patient profiles.
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Affiliation(s)
- Jamie L R Romeo
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - M Mostafa Mokhles
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Pieter van de Woestijne
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Peter de Jong
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Ingrid M van Beynum
- Department of Pediatric Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Johanna J M Takkenberg
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Ad J J C Bogers
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
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6
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Corneloup M, Maurier F, Wahl D, Muller G, Aumaitre O, Seve P, Blaison G, Pennaforte JL, Martin T, Magy-Bertrand N, Berthier S, Arnaud L, Bourredjem A, Amoura Z, Devilliers H. Disease-specific quality of life following a flare in systemic lupus erythematosus: an item response theory analysis of the French EQUAL cohort. Rheumatology (Oxford) 2020; 59:1398-1406. [PMID: 31620787 DOI: 10.1093/rheumatology/kez451] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 07/30/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To explore, at an item-level, the effect of disease activity (DA) on specific health-related quality of life (HRQoL) in SLE patients using an item response theory longitudinal model. METHODS This prospective longitudinal multicentre French cohort EQUAL followed SLE patients over 2 years. Specific HRQoL according to LupusQoL and SLEQOL was collected every 3 months. DA according to SELENA-SLEDAI flare index (SFI) and revised SELENA-SLEDAI flare index (SFI-R) was evaluated every 6 months. Regarding DA according to SFI and each SFI-R type of flare, specific HRQoL of remitting patients was compared with non-flaring patients fitting a linear logistic model with relaxed assumptions for each domain of the questionnaires. RESULTS Between December 2011 and July 2015, 336 patients were included (89.9% female). LupusQoL and SLEQOL items related to physical HRQoL (physical health, physical functioning, pain) were most affected by musculoskeletal and cutaneous flares. Cutaneous flares had significant influence on self-image. Neurological or psychiatric flares had a more severe impact on specific HRQoL. Patient HRQoL was impacted up to 18 months after a flare. CONCLUSION Item response theory analysis is able to pinpoint items that are influenced by a given patient group in terms of a latent trait change. Item-level analysis provides a new way of interpreting HRQoL variation in SLE patients, permitting a better understanding of DA impact on HRQoL. This kind of analysis could be easily implemented for the comparison of groups in a clinical trial. TRIAL REGISTRATION ClinicalTrials.gov, http://clinicaltrials.gov, NCT01904812.
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Affiliation(s)
- Marie Corneloup
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon
| | - François Maurier
- Department of Internal Medicine and Clinical Immunology, Site Belle Isle, Metz
| | - Denis Wahl
- Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, CHRU de Nancy.,Inserm UMR_S 1116 at Lorraine University, Nancy
| | - Geraldine Muller
- Internal Medicine and Systemic Diseases Unit, University Hospital Centre Dijon, Dijon
| | - Olivier Aumaitre
- Department of Internal Medicine, Centre Hospitalier Universitaire, Hôpital Gabriel Montpied, Clermont-Ferrand
| | - Pascal Seve
- Department of Internal Medicine, University Hospital, Hôpital Croix Rousse, Lyon
| | - Gilles Blaison
- Department of Internal Medicine, Hopital Louis Pasteur, Colmar, Alsace
| | | | - Thierry Martin
- Internal Medicine and Clinical Immunology Department, Strasbourg University Hospital, Strasbourg
| | | | - Sabine Berthier
- Internal Medicine and Clinical Immunology Unit, University Hospital Dijon-Burgundy, Dijon
| | - Laurent Arnaud
- Department of Rheumatology, Hôpitaux Universitaires de Strasbourg.,INSERM UMR-S 1109, Strasbourg
| | - Abderrahmane Bourredjem
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon
| | - Zahir Amoura
- Department of Internal Medicine, National Referral Center for Systemic Lupus Erythematosus and Anti-Phospholipid Syndrome, Pitie-Salpetriere University Hospital, Paris, France
| | - Hervé Devilliers
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon
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Bottesi G, Spoto A, Trevisson E, Zuccarello D, Vidotto G, Cassina M, Clementi M. Dysfunctional coping is related to impaired skin-related quality of life and psychological distress in patients with neurofibromatosis type 1 with major skin involvement. Br J Dermatol 2019; 182:1449-1457. [PMID: 31329288 DOI: 10.1111/bjd.18363] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Low skin-related quality of life (QoL) is usually associated with low levels of self-confidence and self-esteem and with high levels of anxiety and depression symptoms. The way patients cope with a physical disease impacts significantly on their psychosocial adjustment to the disorder and on their emotional functioning. OBJECTIVES To explore how coping strategies, skin-related QoL, psychological distress and self-esteem interact in a sample of individuals with neurofibromatosis type 1 (NF1). METHODS Seventy-two adult patients with NF1 completed the following questionnaires: Coping Orientation to Problem Experiences (COPE), Skindex-29, Padua Skin-Related QoL questionnaire (PSRQ), State-Trait Anxiety Inventory-X2 form (STAI-X2), Depression Questionnaire (DQ) and Rosenberg Self-Esteem Scale (RSES). The k-modes algorithm was used to identify clusters of patients based on four variables: sex, NF1 severity, number and distribution of cutaneous neurofibromas. Individuals in different clusters were compared with regard to their scores; correlations between scores were analysed within each cluster. RESULTS Two main clusters were identified: individuals in Cluster 1 had a larger number and more widespread distribution of neurofibromas compared with Cluster 2. Patients in Cluster 1 scored higher only on several PSRQ and Skindex-29 scales. Among patients in Cluster 1, the COPE 'avoidance strategies' scale was significantly correlated with the PSRQ 'physical distress and impairments' scale, the Skindex-29 'physical symptoms' and 'functioning' scales, the STAI-X2, the DQ and the RSES. CONCLUSIONS Patients with major skin involvement have reduced skin-related QoL. Among them, current findings tentatively suggest that the higher the use of dysfunctional coping, the more impaired are QoL, psychological distress and self-esteem. What's already known about this topic? Neurofibromatosis type 1 (NF1) can affect the quality of life (QoL) in adolescent and adult patients. Low skin-related QoL is usually associated with low levels of self-confidence and self-esteem and with high levels of anxiety and depression symptoms. Questionnaires evaluating skin-related QoL, anxiety, depression, self-esteem and coping are available. What does this study add? Patients with a large number and a widespread distribution of cutaneous neurofibromas have reduced skin-related QoL compared with patients with minor skin involvement. The newly developed Padua Skin-Related QoL questionnaire allows the simultaneous evaluation of discomfort and comfort skin-related QoL dimensions in patients with NF1. Among patients with major skin involvement, the higher the use of dysfunctional coping, the more impaired are skin-related QoL, psychological distress and self-esteem. Our data suggest that patients with NF1 with major skin involvement who endorse dysfunctional beliefs about their own coping abilities might benefit from psychological counselling and coping skills treatments aiming to both improve perceived self-efficacy and learn more adaptive coping strategies.
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Affiliation(s)
- G Bottesi
- Department of General Psychology, University of Padova, Via Giustiniani 3, 35128, Italy
| | - A Spoto
- Department of General Psychology, University of Padova, Via Giustiniani 3, 35128, Italy
| | - E Trevisson
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Via Giustiniani 3, 35128, Padova, Italy
| | - D Zuccarello
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Via Giustiniani 3, 35128, Padova, Italy
| | - G Vidotto
- Department of General Psychology, University of Padova, Via Giustiniani 3, 35128, Italy
| | - M Cassina
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Via Giustiniani 3, 35128, Padova, Italy
| | - M Clementi
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Via Giustiniani 3, 35128, Padova, Italy
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Schlüter DK, Holland DP, Mills RJ, McDermott CJ, Williams TL, Young CA. Use of coping strategies in MND/ALS: Association with demographic and disease-related characteristics. Acta Neurol Scand 2019; 140:131-139. [PMID: 31058309 DOI: 10.1111/ane.13113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 04/05/2019] [Accepted: 04/21/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Understanding the use of coping strategies and which factors are associated with strategy utilization might help clinical staff anticipate which coping strategies individuals are more likely to utilize. In this study, we assess coping strategy use in the motor neuron disease (MND, also known as amyotrophic lateral sclerosis [ALS]) population and examine associations of demographic and disease variables with individual coping strategies. PARTICIPANTS AND METHODS A total of 233 participants with MND/ALS were recruited into the ongoing Trajectories of Outcomes in Neurological Conditions study from MND clinics across the United Kingdom. Participants completed a questionnaire pack collecting data on demographics and a range of patient-reported measures including the Coping Orientations to Problems Experienced scale. Associations between demographic and clinical characteristics and coping strategies were examined by simple and multiple ordinal logistic regression. RESULTS The most commonly used strategy was Acceptance, followed by Active Coping, Planning and Positive Re-interpretation and Growth. The least used strategies were Substance Use, Turning to Religion and Denial. Ten out of the fifteen strategies showed statistically significant associations with demographic and clinical characteristics. Most markedly, females were found to utilize many strategies more than males, namely Restraint, Seeking Instrumental Social Support, Seeking Emotional Social Support, Focus on and Venting of Emotions, Behavioural Disengagement and Mental Disengagement. CONCLUSION Clinical staff should be aware that coping strategy use is associated with several demographic and disease characteristics. Targeted advice on coping may improve coping capacity and facilitate psychosocial adjustment.
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Affiliation(s)
| | | | - Roger J Mills
- University of Liverpool, Liverpool, UK
- Walton Centre NHS Trust, Liverpool, UK
| | | | | | - Carolyn A Young
- University of Liverpool, Liverpool, UK
- Walton Centre NHS Trust, Liverpool, UK
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9
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Gu M, Cheng Q, Wang X, Yuan F, Sam NB, Pan H, Li B, Ye D. The impact of SLE on health-related quality of life assessed with SF-36: a systemic review and meta-analysis. Lupus 2019; 28:371-382. [PMID: 30813871 DOI: 10.1177/0961203319828519] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate the impact of systemic lupus erythematosus (SLE) on health-related quality of life (HRQoL) assessed with SF-36 and explore factors associated with HRQoL in SLE patients. METHODS A random-effect meta-analysis was performed to calculate extracted data. Sensitivity and subgroup analyses were performed to distinguish sources of heterogeneity. RESULTS A total of 36 articles were finally included in this meta-analysis, including 6510 patients. The pooled mean scores of SF-36 physical component summary and mental component summary were 46.10 (95% confidence interval (CI): 43.09-49.10) and 50.37 (95% CI: 47.78-52.87), respectively. Spearman's correlation analysis found that mean age, proportion of female participants, and publication decades were negatively associated with some of the SF-36 domains. Sample size and SLEDAI were positively associated with some of the SF-36 domains. Patients with SLE have lower HRQoL in comparison to the general population. CONCLUSIONS SLE has a significant impact on HRQoL, which proves that the necessity of improving HRQoL in SLE patients cannot be ignored. Measuring HRQoL should be considered as an indispensable part of the overall evaluation of health conditions of SLE patients.
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Affiliation(s)
- M Gu
- 1 Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, China.,2 Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Q Cheng
- 1 Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, China.,2 Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - X Wang
- 1 Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, China.,2 Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - F Yuan
- 1 Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, China.,2 Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - N B Sam
- 1 Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, China.,2 Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - H Pan
- 1 Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, China.,2 Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - B Li
- 1 Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, China.,2 Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - D Ye
- 1 Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, China.,2 Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
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Groot N, Shaikhani D, Teng YKO, de Leeuw K, Bijl M, Dolhain RJEM, Zirkzee E, Fritsch‐Stork R, Bultink IEM, Kamphuis S. Long-Term Clinical Outcomes in a Cohort of Adults With Childhood-Onset Systemic Lupus Erythematosus. Arthritis Rheumatol 2019; 71:290-301. [PMID: 30152151 PMCID: PMC6590133 DOI: 10.1002/art.40697] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 08/21/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Childhood-onset systemic lupus erythematosus (SLE) is a severe, lifelong, multisystem autoimmune disease. Long-term outcome data are limited. This study was undertaken to identify clinical characteristics and health-related quality of life (HRQoL) of adults with childhood-onset SLE. METHODS Patients participated in a single study visit comprising a structured history and physical examination. Disease activity (scored using the SLE Disease Activity Index 2000 [SLEDAI-2K]), damage (scored using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI]), and HRQoL (scored using the Short Form 36 Health Survey) were assessed. Medical records were reviewed. RESULTS In total, 111 childhood-onset SLE patients were included; the median disease duration was 20 years, 91% of patients were female, and 72% were white. Disease activity was low (median SLEDAI-2K score 4), and 71% of patients received prednisone, hydroxychloroquine (HCQ), and/or other disease-modifying antirheumatic drugs. The vast majority of new childhood-onset SLE-related manifestations developed within 2 years of diagnosis. Damage such as myocardial infarctions began occurring after 5 years. Most patients (62%) experienced damage, predominantly in the musculoskeletal, neuropsychiatric, and renal systems. Cerebrovascular accidents, renal transplants, replacement arthroplasties, and myocardial infarctions typically occurred at a young age (median age 20 years, 24 years, 34 years, and 39 years, respectively). Multivariate logistic regression analysis showed that damage accrual was associated with disease duration (odds ratio [OR] 1.15, P < 0.001), antiphospholipid antibody positivity (OR 3.56, P = 0.026), and hypertension (OR 3.21, P = 0.043). Current HCQ monotherapy was associated with an SDI score of 0 (OR 0.16, P = 0.009). In this cohort, HRQoL was impaired compared to the overall Dutch population. The presence of damage reduced HRQoL scores in 1 domain. High disease activity (SLEDAI-2K score ≥8) and changes in physical appearance strongly reduced HRQoL scores (in 4 of 8 domains and 7 of 8 domains, respectively). CONCLUSION The majority of adults with childhood-onset SLE in this large cohort developed significant damage at a young age and had impaired HRQoL without achieving drug-free remission, illustrating the substantial impact of childhood-onset SLE on future life.
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Affiliation(s)
- N. Groot
- Sophia Children’s HospitalErasmus University Medical Center, Rotterdam, The Netherlands, and Wilhelmina Children’s HospitalUniversity Medical CenterUtrechtThe Netherlands
| | - D. Shaikhani
- Sophia Children’s HospitalErasmus University Medical CenterRotterdamThe Netherlands
| | - Y. K. O. Teng
- Leiden University Medical CenterLeidenThe Netherlands
| | - K. de Leeuw
- University Medical CenterGroningenThe Netherlands
| | - M. Bijl
- Martini HospitalGroningenThe Netherlands
| | | | - E. Zirkzee
- Maasstad HospitalRotterdamThe Netherlands
| | - R. Fritsch‐Stork
- University Medical Center, Utrecht, The Netherlands, Hanusch Hospital of WGKK and AUVA Trauma Center, Vienna, Austria, and Sigmund Freud UniversityViennaAustria
| | - I. E. M. Bultink
- Amsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - S. Kamphuis
- Sophia Children’s HospitalErasmus University Medical CenterRotterdamThe Netherlands
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Conceição CTM, Meinão IM, Bombana JA, Sato EI. Psychoanalytic psychotherapy improves quality of life, depression, anxiety and coping in patients with systemic lupus erythematosus: a controlled randomized clinical trial. Adv Rheumatol 2019; 59:4. [PMID: 30670099 DOI: 10.1186/s42358-019-0047-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 01/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systemic Lupus Erythematosus (SLE) is an autoimmune disease which impairs the quality of life. The objective of study was to evaluate the effectiveness of Brief Group Psychoanalytic Psychotherapy to improve quality of life, depression, anxiety and coping strategies in SLE patients. METHODS In a randomized clinical trial, 80 female SLE patients were allocated into two groups: therapy group (n = 37) and control group (n = 43). Therapy group (TG) attended weekly psychotherapy sessions for 20 weeks; control group (CG) remained on a waiting list. Both groups received standard medical care. Questionnaires and scales were applied by blinded evaluators at baseline (T1) and after 20 weeks (T2): Socioeconomic Status, SLE International Collaborating Clinic/American College of Rheumatology-Damage Index, SLE International Disease Activity, SLE Specific Symptom Checklist, SLE Quality of life, Hospital Anxiety Depression Scale, Coping Strategies Inventory. Intent to treat intra- and inter-group analysis was performed for all variables in T1 and T2 using Qui-square, t-Student, Mann-Whitney and Wilcoxon tests. Analysis of Variance was used to compare categorical variables over time. P < 0.05 was considered significant. RESULTS The mean age of patients was 42 years; 54% were white, with mean disease duration of years 12. At baseline, both groups were homogeneous in all variables, including medications. After 20 weeks of psychotherapy TG was significantly different from CG, with lower frequency of symptoms (p = 0.001), lower level of anxiety (p = 0.019) and depression (p = 0.022), better index in five of six domains of quality of life scale (p ≤ 0.005), including total SLEQOL (p < 0.001) and with higher positive planful problem solving strategy (p = 0.017). No change in disease activity score was observed in both groups. CONCLUSIONS Psychoanalytic psychotherapy was effective to improve many domains of quality of life and one positive coping skill and to reduce SLE symptoms, anxiety and depression levels. Brief group psychotherapy can be a useful tool to complement medical care in SLE patients. TRIAL REGISTRATION Number NCT01840709 .
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Affiliation(s)
- Céu Tristão Martins Conceição
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Botucatu 740 - Disciplina de Reumatologia CEP 04023900, São Paulo, SP, Brazil
| | - Ivone Minhoto Meinão
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Botucatu 740 - Disciplina de Reumatologia CEP 04023900, São Paulo, SP, Brazil
| | - José Atilio Bombana
- Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Emília Inoue Sato
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Botucatu 740 - Disciplina de Reumatologia CEP 04023900, São Paulo, SP, Brazil.
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Middleton KR, Haaz Moonaz S, Hasni SA, Magaña López M, Tataw-Ayuketah G, Farmer N, Wallen GR. Yoga for systemic lupus erythematosus (SLE): Clinician experiences and qualitative perspectives from students and yoga instructors living with SLE. Complement Ther Med 2018; 41:111-117. [PMID: 30477826 PMCID: PMC6279250 DOI: 10.1016/j.ctim.2018.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/23/2018] [Accepted: 09/03/2018] [Indexed: 10/28/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease associated with widespread inflammation and tissue damage. It is more common and severe among Blacks, Hispanics, and Asians; with higher incidence in women. While the goals of medical treatment are to prevent flares and reduce organ damage, up to 50% of patients perceive their health to be suboptimal with unaddressed needs including fatigue and pain. Recent SLE treatment guidelines focus on improving quality of life. Yoga has shown improvements in quality-of-life and fatigue in various diagnoses. While there is growing evidence that yoga therapy may help osteoarthritis and rheumatoid arthritis symptoms, there is only one reference in the literature related to SLE. METHODS/SETTING An adjunct study was undertaken to evaluate adapting the Yoga as Self Care for Arthritis in Minority Communities study for a bilingual population living with SLE in the Washington, DC area. Informants included 7 patients enrolled onto the study, and 3 yoga instructors living with SLE. Qualitative methods included journals and semi-structured interviews. RESULTS Enrolling patients clarified revisions for intake questionnaires, and symptoms that may impact class participation. Participants demonstrated increased balance, body awareness, and tolerated a faster-paced yoga class when compared to those in the parent study. Yoga instructors' recommendations included modifying yoga based on energy levels and frequent changes in physical ability. CONCLUSION This paper shares perspectives from various informants and affirms the feasibility of progressing to a larger study. It summarizes our findings and recommendations towards creating a randomized controlled trial, as there are currently none in the literature.
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Affiliation(s)
- Kimberly R Middleton
- National Institutes of Health (NIH), Clinical Center, Nursing Research and Translational Science, 10 Center Drive, Room 2B-01, Bethesda, MD 20892, United States.
| | | | - Sarfaraz A Hasni
- National Institute of Arthritis and Musculoskeletal and Skin, Disease (NIAMS), Bethesda, MD 20892, United States.
| | | | | | - Nicole Farmer
- National Institutes of Health (NIH), Clinical Center, Nursing Research and Translational Science, 10 Center Drive, Room 2B-01, Bethesda, MD 20892, United States.
| | - Gwenyth R Wallen
- National Institutes of Health (NIH), Clinical Center, Nursing Research and Translational Science, 10 Center Drive, Room 2B-01, Bethesda, MD 20892, United States.
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Developing an item bank to measure the coping strategies of people with hereditary retinal diseases. Graefes Arch Clin Exp Ophthalmol 2018; 256:1291-1298. [PMID: 29730797 DOI: 10.1007/s00417-018-3998-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 04/10/2018] [Accepted: 04/20/2018] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Our understanding of the coping strategies used by people with visual impairment to manage stress related to visual loss is limited. This study aims to develop a sophisticated coping instrument in the form of an item bank implemented via Computerised adaptive testing (CAT) for hereditary retinal diseases. METHODS Items on coping were extracted from qualitative interviews with patients which were supplemented by items from a literature review. A systematic multi-stage process of item refinement was carried out followed by expert panel discussion and cognitive interviews. The final coping item bank had 30 items. Rasch analysis was used to assess the psychometric properties. A CAT simulation was carried out to estimate an average number of items required to gain precise measurement of hereditary retinal disease-related coping. RESULTS One hundred eighty-nine participants answered the coping item bank (median age = 58 years). The coping scale demonstrated good precision and targeting. The standardised residual loadings for items revealed six items grouped together. Removal of the six items reduced the precision of the main coping scale and worsened the variance explained by the measure. Therefore, the six items were retained within the main scale. Our CAT simulation indicated that, on average, less than 10 items are required to gain a precise measurement of coping. CONCLUSIONS This is the first study to develop a psychometrically robust coping instrument for hereditary retinal diseases. CAT simulation indicated that on an average, only four and nine items were required to gain measurement at moderate and high precision, respectively.
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Applyrs DL, Williams EM, Faith TD, Kamen DL, Vazques E, Jurkowski JM. Cultural and quality-of-life considerations when administering corticosteroids as a therapeutic strategy for African American women living with systemic lupus erythematosus. Patient Prefer Adherence 2018; 12:1007-1014. [PMID: 29928116 PMCID: PMC6003291 DOI: 10.2147/ppa.s156457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study investigated the association among corticosteroids, emotional health, physical health, and work/regular activities of daily living in an ethnically diverse sample of women with systemic lupus erythematosus. METHODS A secondary analysis of data from the Medical University of South Carolina Lupus Database was conducted between confirmed cases of lupus (n = 224) and controls (n = 60). The sample comprised 57 Caucasian Americans, 141 Gullah African Americans (a subpopulation of African Americans from the Sea Islands of South Carolina and Georgia), and 86 non-Gullah African Americans. RESULTS Emotional health outcomes were better for women with systemic lupus erythematosus compared with controls. High emotional health scores may be influenced by cultural factors such as masking emotion, disease-coping mechanisms, religion, and strong familial and social support. Although a significant association was not detected between emotional health and work/regular activities of daily living, relationships were significant after adjusting for corticosteroid use. CONCLUSION These findings suggest corticosteroid use does influence the strength of the association between emotional health and work/regular activities of daily living.
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Affiliation(s)
| | - Edith M Williams
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
- Correspondence: Edith M Williams, Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite CS303D, Charleston, SC 29425, USA, Tel +1 843 876 1519, Email
| | - Trevor D Faith
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Diane L Kamen
- Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - Elizabeth Vazques
- Department of Epidemiology and Biostatistics, State University of New York at Albany, One University Place, Rensselaer, NY, USA
| | - Janine M Jurkowski
- Department of Health Policy, Management, and Behavior, State University of New York at Albany, One University Place, Rensselaer, NY, USA
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15
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Prem Senthil M, Khadka J, Gilhotra JS, Simon S, Pesudovs K. Exploring the quality of life issues in people with retinal diseases: a qualitative study. J Patient Rep Outcomes 2017; 1:15. [PMID: 29757297 PMCID: PMC5934910 DOI: 10.1186/s41687-017-0023-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 09/21/2017] [Indexed: 11/30/2022] Open
Abstract
Background The lack of an appropriate retina-specific patient-reported outcome instrument restricts the understanding of the full impact of hereditary retinal diseases and other less common but potentially blinding acquired retinal diseases such as, vascular occlusions, epiretinal membrane, macular hole, central serous retinopathy and other vitreoretinopathies on quality of life. This study aims to explore the quality of life issues in people with hereditary retinal diseases and acquired retinal diseases to develop disease-specific patient-reported outcome instruments. Methods A qualitative research methodology to understand the lived experiences of people with retinal diseases was carried out. Data were collected through semistructured interviews. The coding, aggregation and theme development was carried out using the NVivo −10 software. Results Seventy-nine interviews were conducted with participants with hereditary retinal diseases (n = 32; median age = 57 years) and acquired retinal diseases (n = 47; median age = 73 years). We identified nine quality of life themes (domains) relevant to people with retinal diseases. Difficulty in performing important day-to-day activities (activity limitation) was the most prominent quality of life issue in the hereditary retinal diseases group whereas concerns about health, disease outcome and personal safety (health concerns) was the most prominent quality of life issue in the acquired retinal diseases group. Participants with hereditary retinal diseases had more issues with social interaction (social well-being), problems with mobility and orientation (mobility), and effect on work and finance (economic) than participants with acquired retinal diseases. On the contrary, participants with acquired retinal diseases reported more inconveniences (conveniences) than participants with hereditary retinal diseases, which were mostly attributed to treatment. Participants with hereditary retinal diseases were coping better compared to participants with acquired retinal diseases. Conclusions Our study found that participants with both hereditary and acquired retinal diseases are living with myriad of disease-specific quality of life issues. Many of these issues are completely different and unique to each disease group. Hence, these group of diseases would need separate patient-reported outcome instruments to capture the disease-specific quality of life impacts. Electronic supplementary material The online version of this article (10.1186/s41687-017-0023-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mallika Prem Senthil
- 1NHMRC Centre for Clinical Eye Research, Flinders University of South Australia, Adelaide, South Australia 5001 Australia
| | - Jyoti Khadka
- 1NHMRC Centre for Clinical Eye Research, Flinders University of South Australia, Adelaide, South Australia 5001 Australia
| | | | - Sumu Simon
- 2University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Konrad Pesudovs
- 1NHMRC Centre for Clinical Eye Research, Flinders University of South Australia, Adelaide, South Australia 5001 Australia
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16
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Plantinga L, Lim SS, Bowling CB, Drenkard C. Perceived stress and reported cognitive symptoms among Georgia patients with systemic lupus erythematosus. Lupus 2017; 26:1064-1071. [PMID: 28420055 PMCID: PMC5494014 DOI: 10.1177/0961203317693095] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To examine associations of perceived stress with cognitive symptoms among adults with systemic lupus erythematosus (SLE). Methods Among 777 adult (≥18 years) SLE patients, the association of Perceived Stress Scale (PSS) scores with two self-reported cognitive symptoms was examined: forgetfulness (severe/moderate vs. mild/none; from the Systemic Lupus Activity Questionnaire) and difficulty concentrating (all/most vs. some/little/none of the time; from the Lupus Impact Tracker). The study used multivariable logistic regression to estimate the odds ratios (ORs) per minimal important difference (MID = 0.5*SD) of PSS score and cognitive symptoms. Results Forgetfulness and difficulty concentrating were reported by 41.7% and 29.5%, respectively. Women and those with less education and high disease activity had higher PSS scores and were more likely to report cognitive symptoms than their counterparts. With adjustment for age, race, sex, education, and disease activity, each MID increase in PSS score was associated with higher prevalence of forgetfulness (OR = 1.43, 95% CI 1.29-1.47) and difficulty concentrating (OR = 2.19, 95% CI 1.90-2.52). No substantial differences in this association by age, race, sex, or disease activity were noted. Conclusions SLE patients, particularly those with high disease activity, report a high burden of cognitive symptoms, for which stress may be a modifiable risk factor.
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Affiliation(s)
- Laura Plantinga
- Division of Renal Medicine, Department of Medicine, Emory University
- Division of Geriatrics and General Medicine, Department of Medicine, Emory University
| | - S. Sam Lim
- Division of Rheumatology, Department of Medicine, Emory University
| | - C. Barrett Bowling
- Division of Geriatrics and General Medicine, Department of Medicine, Emory University
- Birmingham/Atlanta VA Geriatrics Research and Clinical Center, Atlanta, Georgia, United States
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17
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Williams EM, Egede L, Faith T, Oates J. Effective Self-Management Interventions for Patients With Lupus: Potential Impact of Peer Mentoring. Am J Med Sci 2017; 353:580-592. [PMID: 28641721 PMCID: PMC6249683 DOI: 10.1016/j.amjms.2017.01.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 12/28/2016] [Accepted: 01/20/2017] [Indexed: 01/22/2023]
Abstract
Systemic lupus erythematosus (SLE) is associated with significant mortality, morbidity and cost for the individual patient and society. In the United States, African Americans (AAs) have 3-4 times greater prevalence of lupus, risk of developing lupus at an earlier age and lupus-related disease activity, organ damage and mortality compared with whites. Evidence-based self-management interventions that incorporate both social support and health education have reduced pain, improved function and delayed disability among patients with lupus. However, AAs and women are still disproportionately affected by lupus. This article presents the argument that peer mentoring may be an especially effective intervention approach for AA women with SLE. SLE peers with a track record of success in lupus management and have a personal perspective that clinicians often lack. This commonality and credibility can establish trust, increase communication and, in turn, decrease disparities in healthcare outcomes.
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Affiliation(s)
- Edith M Williams
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina.
| | - Leonard Egede
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Trevor Faith
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - James Oates
- Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, South Carolina; Rheumatology Section, Ralph H. Johnson VA Medical Center, Charleston, South Carolina
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Chatrung C, Sorajjakool S, Amnatsatsue K. Wellness and Religious Coping Among Thai Individuals Living with Chronic Kidney Disease in Southern California. JOURNAL OF RELIGION AND HEALTH 2015; 54:2198-2211. [PMID: 25300413 DOI: 10.1007/s10943-014-9958-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This qualitative research is based on eight Thai participants living with chronic kidney disease living in Southern California. Four emerging themes are (a) wellness, (b) self-care, (c) impact of illness on life, and (d) religious coping. Family relations, social support, and religious coping affected self-care and how they managed their everyday activities. Knowledge about the disease and its mechanism were crucial to the decision-making process in relation to self-care. Good self-care and appropriate self-management led to wellness and improved quality of life. Religion provided a belief system focusing on the place of acceptance that was essential for coping with emotional stressors.
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Affiliation(s)
- Chutikarn Chatrung
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Bangkok, Thailand.
| | - Siroj Sorajjakool
- School of Religion, Loma Linda University, Loma Linda, CA, 92350, USA.
| | - Kwanjai Amnatsatsue
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Bangkok, Thailand.
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Rashid-Tavalai Z, Bakhshani NM, Amirifard H, Lashkaripour M. Effectiveness of Combined Copying Skills Training and Pharmacological Therapy for Patients with Migraine. Glob J Health Sci 2015; 8:179-86. [PMID: 26755464 PMCID: PMC4954873 DOI: 10.5539/gjhs.v8n6p179] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 09/09/2015] [Indexed: 11/12/2022] Open
Abstract
Headache is one of the most common complaints in neurological clinics. The current study carried out to determine the benefits of combined Coping Skills Training (CST) and Pharmacotherapy (Ph) for patients with migraine. Forty patients with migraine recruited from the outpatient clinics of Zahedan University of Medical Sciences( Iran) and randomly assigned to one of two treatment groups: the first group received combined coping skills training (CST) and pharmacotherapy(Ph); and the second group received the pharmacotherapy alone(Ph). Five patients due to lack of regular presence or filling out the questionnaires excluded from the study. Finally, the results of 35 subjects were analyzed. Data collection was done using the World Health Organization Quality of Life Questionnaire, General Self-Efficacy Scale-Sherer, Ways of Coping Questionnaire and Migraine Headache Index. The results of ANCOVA on post-test, after controlling the pre-test scores, suggested a significant difference in self-efficacy scores between CST+Ph and Ph groups. Moreover, results of ANCOVA did not show significant differences between the two groups in the scores of pain severity, quality of life, and the use of coping strategies. Findings of the present study indicated that coping-skills training, as a psychological intervention, improved self-efficacy. Further longitudinal studies are needed to confirm this conclusion.
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Peláez-Ballestas I, Boonen A, Vázquez-Mellado J, Reyes-Lagunes I, Hernández-Garduño A, Goycochea MV, Bernard-Medina AG, Rodríguez-Amado J, Casasola-Vargas J, Garza-Elizondo MA, Aceves FJ, Shumski C, Burgos-Vargas R. Coping strategies for health and daily-life stressors in patients with rheumatoid arthritis, ankylosing spondylitis, and gout: STROBE-compliant article. Medicine (Baltimore) 2015; 94:e600. [PMID: 25761177 PMCID: PMC4602460 DOI: 10.1097/md.0000000000000600] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 02/05/2015] [Accepted: 02/06/2015] [Indexed: 11/26/2022] Open
Abstract
This article aims to identify the strategies for coping with health and daily-life stressors of Mexican patients with chronic rheumatic disease. We analyzed the baseline data of a cohort of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and gout. Their strategies for coping were identified with a validated questionnaire. Comparisons between health and daily-life stressors and between the 3 clinical conditions were made. With regression analyses, we determined the contribution of individual, socioeconomic, educational, and health-related quality-of-life variables to health status and coping strategy. We identified several predominant coping strategies in response to daily-life and health stressors in 261 patients with RA, 226 with AS, and 206 with gout. Evasive and reappraisal strategies were predominant when patients cope with health stressors; emotional/negative and evasive strategies predominated when coping with daily-life stressors. There was a significant association between the evasive pattern and the low short-form health survey (SF-36) scores and health stressors across the 3 diseases. Besides some differences between diagnoses, the most important finding was the predominance of the evasive strategy and its association with low SF-36 score and high level of pain in patients with gout. Patients with rheumatic diseases cope in different ways when confronted with health and daily-life stressors. The strategy of coping differs across diagnoses; emotional/negative and evasive strategies are associated with poor health-related quality of life. The identification of the coping strategies could result in the design of psychosocial interventions to improve self-management.
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Affiliation(s)
- Ingris Peláez-Ballestas
- From the Department of Rheumatology (IP-B, JV-M, JC-V, RB-V), Hospital General de México "Eduardo Liceaga," Mexico City, Mexico; Maastricht University Medical Center (AB), The Netherlands; Postgraduate Department of Psychology (I-RL), Universidad Nacional Autónoma de México, Mexico City; Department of Pediatrics (A-HG), Hospital Universitario "José Eleuterio Gonzalez", Monterrey, Nuevo Leon; Clinical Epidemiology Unit (MVG), Hospital Gabriel Mancera Regional 1, IMSS, Mexico City; Department of Rheumatology (AGB-M), Hospital Civil de Guadalajara, Guadalajara, Jalisco; Department of Rheumatology (JR-A, MAG-E), Hospital Universitario "José Eleuterio Gonzalez," Monterrey, Nuevo Leon; Hospital General de zona 46 (FJA), IMSS and Unidad de Investigación Crônico-Degenerativas, Guadalajara, Jalisco; and Department of Rheumatology (CS), Hospital Central, PEMEX, Mexico City, Mexico
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Effect of psychological intervention on health-related quality of life in people with systemic lupus erythematosus: A systematic review. Int J Nurs Sci 2014. [DOI: 10.1016/j.ijnss.2014.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Doria A, Gatto M, Zen M, Iaccarino L, Punzi L. Optimizing outcome in SLE: treating-to-target and definition of treatment goals. Autoimmun Rev 2014; 13:770-7. [DOI: 10.1016/j.autrev.2014.01.055] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 01/22/2014] [Indexed: 12/15/2022]
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Vargas-Hitos JA, Sabio JM, Martínez-Egea I, Jiménez-Jáimez E, Rodríguez-Guzmán M, Navarrete-Navarrete N, López-Lozano E, Romero-Alegría Á, de la Calle C, Jáimez-Gámiz L, Baños-Piñero P, Nebrera-Navarro F, Fidalgo A, Caminal L, de Ramón Garrido E, Ortego-Centeno N, Expósito M, Zamora-Pasadas M, Jiménez-Alonso J. Influence of psychological stress on headache in patients with systemic lupus erythematosus. J Rheumatol 2014; 41:453-7. [PMID: 24488423 DOI: 10.3899/jrheum.130535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare the prevalence and disability of headache in patients with systemic lupus erythematosus (SLE) with the general population and to assess the role of chronic psychological stress (CPS) in headache development. METHODS One hundred seventy patients with SLE and 102 control subjects matched for age, sex, and level of education were included in this multicenter, cross-sectional study. CPS, headache-related disability, and chronic analgesic intake (CAI) were evaluated in all participants. RESULTS No statistical differences in the prevalence of headache between both groups were observed but headache disability was significantly higher in patients with SLE. In addition, a higher average score in the Cohen Perceived Stress Scale (CPSS) and a higher prevalence of patients with CAI were observed in patients with SLE. In multivariate analysis, CPSS score was positively (OR 1.09; 95% CI: 1.03-1.14; p = 0.001) and CAI negatively (OR 0.43; 95% CI: 0.19-0.99; p = 0.049) associated with headache in patients with SLE. CONCLUSION Despite the prevalence of headache in patients with SLE and the general population being similar, headache-related disability may be higher in patients with SLE. Moreover, CPS might play a role in the pathogenesis of SLE headache, whereas CAI might have a protective effect against it.
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Affiliation(s)
- José Antonio Vargas-Hitos
- From the Systemic Autoimmune Diseases Unit, Internal Medicine Department, the Clinical Analysis Department, and the Department of Statistics, Virgen de las Nieves University Hospital; Occupational Medicine, MAZ Department, Granada; Internal Medicine Department, Asturias Central Hospital, Oviedo; Internal Medicine Department, Carlos Haya University Hospital, Málaga; Internal Medicine Department, San Cecilio University Hospital, Granada, Spain
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Basu N, McClean A, Harper L, Amft EN, Dhaun N, Luqmani RA, Little MA, Jayne DRW, Flossmann O, McLaren J, Kumar V, Erwig LP, Reid DM, Jones GT, Macfarlane GJ. The characterisation and determinants of quality of life in ANCA associated vasculitis. Ann Rheum Dis 2013; 73:207-11. [DOI: 10.1136/annrheumdis-2012-202750] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Koenig HG. Religion, spirituality, and health: the research and clinical implications. ISRN PSYCHIATRY 2012; 2012:278730. [PMID: 23762764 PMCID: PMC3671693 DOI: 10.5402/2012/278730] [Citation(s) in RCA: 632] [Impact Index Per Article: 52.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 10/15/2012] [Indexed: 12/31/2022]
Abstract
This paper provides a concise but comprehensive review of research on religion/spirituality (R/S) and both mental health and physical health. It is based on a systematic review of original data-based quantitative research published in peer-reviewed journals between 1872 and 2010, including a few seminal articles published since 2010. First, I provide a brief historical background to set the stage. Then I review research on R/S and mental health, examining relationships with both positive and negative mental health outcomes, where positive outcomes include well-being, happiness, hope, optimism, and gratefulness, and negative outcomes involve depression, suicide, anxiety, psychosis, substance abuse, delinquency/crime, marital instability, and personality traits (positive and negative). I then explain how and why R/S might influence mental health. Next, I review research on R/S and health behaviors such as physical activity, cigarette smoking, diet, and sexual practices, followed by a review of relationships between R/S and heart disease, hypertension, cerebrovascular disease, Alzheimer's disease and dementia, immune functions, endocrine functions, cancer, overall mortality, physical disability, pain, and somatic symptoms. I then present a theoretical model explaining how R/S might influence physical health. Finally, I discuss what health professionals should do in light of these research findings and make recommendations in this regard.
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Affiliation(s)
- Harold G. Koenig
- Departments of Medicine and Psychiatry, Duke University Medical Center, P.O. Box 3400, Durham, NC 27705, USA
- Department of Medicine, King Abdulaziz University, Jeddah 21413, Saudi Arabia
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Somers TJ, Kurakula PC, Criscione-Schreiber L, Keefe FJ, Clowse MEB. Self-efficacy and pain catastrophizing in systemic lupus erythematosus: Relationship to pain, stiffness, fatigue, and psychological distress. Arthritis Care Res (Hoboken) 2012; 64:1334-40. [DOI: 10.1002/acr.21686] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Mattsson M, Möller B, Stamm T, Gard G, Boström C. Uncertainty and opportunities in patients with established systemic lupus erythematosus: a qualitative study. Musculoskeletal Care 2012; 10:1-12. [PMID: 22009870 DOI: 10.1002/msc.220] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED Systemic lupus erythematosus (SLE) is a chronic disease which can affect any organ, and the impact of the condition will affect each person differently. There are few qualitative studies including the experiences of both women and men with a diagnosis of SLE corresponding to the American College of Rheumatology (ACR) criteria where both negative and positive impacts of the disease have been presented. PURPOSE The aim was to describe how patients with established SLE experience their illness in everyday life, including both negative and positive aspects. METHOD Four focus group interviews were conducted with 16 women and three men with SLE according to ACR criteria, with varied disease activity and no or little organ damage. The interviews were tape recorded, transcribed verbatim and analysed using qualitative content analysis. RESULTS Two themes emerged: multifaceted uncertainty contained the categories 'an unreliable body', 'obtrusive pain and incomprehensible fatigue', 'mood changes and worries', 'reliance on medication and health care'; Focus on health and opportunities included 'learning process implying personal strength', 'limitations and possibilities in activities and work', 'a challenge to explain and receive support' and 'living an ordinary life incorporating meaningful occupations'. CONCLUSIONS While we expected to find a mainly negative impact, positive aspects were also described. Our findings were complex and showed that patients with established SLE can experience both uncertainty and opportunities. This highlights the importance for healthcare professionals of gaining a better understanding of patients' uncertainty, to enable them to support patients, allowing them to focus on health and opportunities. Measurement instruments that capture different aspects of uncertainty and opportunities needs to be developed.
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Affiliation(s)
- M Mattsson
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
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Beckerman NL, Sarracco M. Listening to lupus patients and families: fine tuning the assessment. SOCIAL WORK IN HEALTH CARE 2012; 51:597-612. [PMID: 22905976 DOI: 10.1080/00981389.2012.683679] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Given the chronicity and uncertainty of lupus, patients and their family members will face physical, financial, social, and emotional challenges that can be overwhelming. This article records the experiences of three different families affected by lupus. Although these patients and families are very different, their perspectives identify common emotional challenges. Understanding these experiences from their perspectives can help facilitate an assessment that is highly attuned to the potential psychosocial impact of lupus on the patient and the family.
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Affiliation(s)
- N L Beckerman
- Wurzweiler School of Social Work, Yeshiva University, New York, New York 10033, USA.
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Kaltsouda A, Skapinakis P, Damigos D, Ikonomou M, Kalaitzidis R, Mavreas V, Siamopoulos KC. Defensive coping and health-related quality of life in chronic kidney disease: a cross-sectional study. BMC Nephrol 2011; 12:28. [PMID: 21689443 PMCID: PMC3141643 DOI: 10.1186/1471-2369-12-28] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2010] [Accepted: 06/20/2011] [Indexed: 11/28/2022] Open
Abstract
Background Coping with the stresses of chronic disease is considered as a key factor in the perceived impairment of health related quality of life (HRQL). Little is known though about these associations in chronic kidney disease (CKD). The present study aimed to investigate the relationship of defensive coping and HRQL among patients in different CKD stages, after adjusting for psychological distress, sociodemographic and disease-related variables. Methods The sample consisted of 98 CKD patients, attending a university nephrology department. Seventy-nine (79) pre-dialysis patients of disease stages 3 to 4 and 19 dialysis patients were included. HRQL was assessed by the 36-item Short-Form health survey (SF-36), defensive coping by the Rationality/Emotional Defensiveness (R/ED) scale of the Lifestyle Defense Mechanism Inventory (LDMI) and psychological distress by the depression and anxiety scales of the revised Hopkins Symptom CheckList (SCL-90-R). Regression analyses were carried out to examine the association between SF-36 dimensions and defensive coping style. Results Patients on dialysis had worse scores on SF-36 scales measuring physical aspects of HRQL. In the fully adjusted analysis, a higher defensive coping score was significantly associated with a lower score on the mental component summary (MCS) scale of the SF-36 (worse mental health). In contrast, a higher defensive score showed a small positive association with the physical component summary (PCS) scale of the SF-36 (better health), but this was marginally significant. Conclusions The results provided evidence that emotional defensiveness as a coping style tends to differentially affect the mental and the physical component of HRQL in CKD. Clinicians should be aware of the effects of long-term denial and could examine the possibility of screening for defensive coping and depression in recently diagnosed CKD patients with the aim to improve both physical and mental health.
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Affiliation(s)
- Anna Kaltsouda
- Department of Psychiatry, School of Medicine, University of Ioannina, Ioannina 45110, Greece.
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Abstract
Over recent decades short- and medium-term survival has greatly improved in patients affected with systemic lupus erythematosus, but long-term prognosis still remains poor mainly due to complications of the disease and/or its treatment. To improve long-term prognosis in systemic lupus erythematosus, we should try to adopt, early in the disease course, strategies that can contribute to reducing long-term complications, including screening for and prophylaxis against infections, control of risk factors for atherosclerosis, and cancer surveillance. However, in patients with systemic lupus erythematosus all these preventive strategies are often not sufficient. Indeed, two important systemic lupus erythematosus-related factors play a relevant role in all these complications: severe disease manifestations, such as glomerulonephritis and central nervous system involvement, and corticosteroid and cyclophosphamide use. Therefore, to prevent long-term complications, we should try to control disease activity and severity using the lowest effective dosage of these drugs. Moreover, strategies directed at preventing clinical manifestations in asymptomatic antinuclear antibody-positive individuals or in antiphospholipid antibody-positive systemic lupus erythematosus patients, as well as at preventing severe manifestations in patients with mild systemic lupus erythematosus at the time of the diagnosis should be considered.
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Affiliation(s)
- A Doria
- Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy.
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Doria A, Arienti S, Rampudda M, Canova M, Tonon M, Sarzi-Puttini P. Preventive strategies in systemic lupus erythematosus. Autoimmun Rev 2008; 7:192-7. [DOI: 10.1016/j.autrev.2007.11.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Stamm TA, Bauernfeind B, Coenen M, Feierl E, Mathis M, Stucki G, Smolen JS, Machold KP, Aringer M. Concepts important to persons with systemic lupus erythematosus and their coverage by standard measures of disease activity and health status. ACTA ACUST UNITED AC 2007; 57:1287-95. [PMID: 17907225 DOI: 10.1002/art.23013] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To explore the array of concepts important to patients with chronic systemic lupus erythematosus (SLE) and to compare these with instruments assessing disease activity, damage, and health status. METHODS We conducted a qualitative focus-group study of patients with SLE concerning their problems in daily functioning. The group sessions were tape recorded, transcribed, and divided into meaning units. The concepts contained in these meaning units were extracted and linked to the International Classification of Functioning, Disability and Health (ICF). We then compared the concepts from the focus groups with those concepts covered by SLE activity scores, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), and the Short Form 36 Health Survey (SF-36). RESULTS A total of 92 concepts emerged from 5 focus groups; of these, 28 related to body functions and structures, 24 to activities and participation, and 25 to environmental factors. Two concepts were linked to the health condition itself and 6 to personal factors. Seven were not covered by the ICF. Of the 28 concepts regarding body functions and structures, 24 (86%) were covered by the combination of activity scores and the SDI. The SF-36 also addressed 3 of these concepts and contained 9 (38%) of 24 concepts in activities and participation. CONCLUSION Although the combination of SLE activity scores, SDI, and SF-36, as suggested for SLE studies, well covers body functions and structures and includes a significant portion of problems regarding activities and participation, neither environmental nor personal factors are covered at all.
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Ito H, Matsuno T, Hirayama T, Tanino H, Minami A. Health-related quality of life in patients with systemic lupus erythematosus after medium to long-term follow-up of hip arthroplasty. Lupus 2007; 16:318-23. [PMID: 17576732 DOI: 10.1177/0961203307077989] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Health-related quality of life (HRQOL) of systemic lupus erythematosus (SLE) patients with hip arthroplasty after medium to long-term follow-up has not been reported. We conducted a retrospective study for SLE patients with osteonecrosis of the femoral head (ONF). Forty-seven consecutive arthroplasties were performed in 36 patients. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Medical Outcome Survey Short Form 36 (SF-36) and Harris hip score were evaluated. Two patients died before the four-year follow-up and two patients were lost to follow-up. The remaining 43 hips in 32 patients with an average age at surgery of 35 years and an average follow-up of 12.0 years (range 4.0-25.0) were assessed. Bipolar hemiarthroplasty was performed for 18 hips in 12 patients, and total hip arthroplasty (THA) was performed for 25 hips in 20 patients. The mean WOMAC scores for pain and function at the recent followup were 90.8 +/- 8.5points and 79.0 +/- 18.3 points. Patients with THA had significantly high scores in SF-36 physical functioning (P < 0.05) and bodily pain (P < 0.03) compared to those with bipolar hemiarthroplasty. Although improvement could not reach the level of general population, the hip arthroplasty contributed to support HRQOL of SLE patients.
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Affiliation(s)
- H Ito
- Department of Orthopaedic Surgery, Asahikawa Medical College, Higashi, Asahikawa, Japan.
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Bricou O, Taïeb O, Baubet T, Gal B, Guillevin L, Moro MR. Stress and coping strategies in systemic lupus erythematosus: a review. Neuroimmunomodulation 2006; 13:283-93. [PMID: 17709950 DOI: 10.1159/000104856] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Systemic lupus erythematosus (SLE), a chronic and unpredictable disease accompanied by functional disability and a possible involvement of the central nervous system, leads to considerable psychological distress. A review of studies on stress and/or coping strategies in SLE since 1990 is presented. Many studies have investigated the place of major and minor stress and coping strategies in SLE morbidity (disease activity, organ damage, and physical and mental components of quality of life). Stress as a causal factor is not proved, but it seems to act as an exacerbating factor in disease activity and to have an impact on the quality of life. Coping strategies are more consistently associated with quality of life than with disease activity. Organ damage appears to be less associated with psychosocial factors than disease activity or quality of life. Despite the limitations of these studies, therapeutic interventions should be proposed to reduce psychological distress, to improve the quality of life and possibly to moderate the evolution of the disease.
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Affiliation(s)
- Olivier Bricou
- Department of Psychiatry, Hôpital Avicenne (AP-HP), Paris 13 University, Bobigny, France
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