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Galindo Izquierdo M, Borrás Blasco J, Pérez Ortega S, Salman-Monte TC, Vela-Casasempere P, Rodríguez Almaraz E, Calvo-Alen J, Álvaro-Gracia Álvaro JM, Barbado Ajo MJ, Rubio Renau R, Galvez-Fernandez M, Bahamontes-Rosa N, Sánchez-Covisa Hernández J, Solà Marsiñach C. Lack of awareness of systemic lupus erythematosus and its consequences in a cohort of moderate and severe patients in Spain: The LupusVoice study. Lupus 2024; 33:663-674. [PMID: 38577967 PMCID: PMC11193315 DOI: 10.1177/09612033241242886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/22/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND AND OBJECTIVES Systemic lupus erythematosus (SLE) is an autoimmune condition that can highly impact patients' quality of life (QoL). However, there is a lack of knowledge about SLE, affecting the general population and health care professionals (HCPs) alike. This lack of knowledge has negative implications for patients and the healthcare system, worsening prognosis, negatively impacting QoL, and increasing healthcare utilization. The aim of this paper is to draw attention, according to the perspective of the participants of this study, to the lack of awareness of SLE and its consequences in Spain, and to suggest improvements. PATIENTS AND METHODS This qualitative, descriptive, observational, multicenter, and cross-sectional study included 40 patients with moderate or severe SLE, recruited during their routine visits in six university hospitals in Spain. The study also included 11 caregivers and 9 HCPs. All participants were individually interviewed. Data from the interviews were coded and analyzed thematically by two anthropologists following a phenomenological perspective. RESULTS Our study identified a lack of disease awareness among primary care physicians, emergency medicine doctors, and other specialists treating SLE symptomatology. This led to diagnostic delays, which had a clinical and emotional impact on patients. Furthermore, symptom awareness was found to be context dependent. Differences in symptom awareness between HCPs and patients led to a mismatch between the severity evaluation made by doctors and patients. Some HCPs did not consider the limitations of the current severity evaluation of SLE, and therefore attributed symptoms potentially caused by SLE to the unfavorable socioeconomic conditions patients lived in. Finally, a lack of social awareness among friends, family members, and romantic partners led to lower social support, increased isolation, and negative physical and emotional impact for patients. Gender differences in the provision of support were identified. CONCLUSION This study highlights the need to increase SLE awareness among patients, HCPs, and the broader public in order to improve patient QoL. Being aware of the clinical and emotional impact of such lack of awareness, as well as the role played by context on the patient experience of SLE, is a crucial step towards achieving this goal.
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Affiliation(s)
| | | | | | | | - Paloma Vela-Casasempere
- Rheumatology Department, Hospital General Universitario Dr Balmis Alicante/ISABIAL/Universidad Miguel Hernandez, Alicante, Spain
| | | | - Jaime Calvo-Alen
- Rheumatology Department, Hospital Universitario Araba, Instituto de Investigación BIORABA, Universidad del País Vasco, Vitoria-Gasteiz, Spain
| | | | - Mͣ Julia Barbado Ajo
- Internal Medicine Department, Hospital Universitario Rio Hortega, Valladolid, Spain
| | - Raül Rubio Renau
- Evidence Generation Department, A Piece of Pie, Barcelona, Spain
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Cardwell FS, Elliott SJ, Barber MRW, Cheema K, George S, Boucher A, Clarke AE. Canadian patient experiences of lupus nephritis: a qualitative analysis. Lupus Sci Med 2023; 10:e000982. [PMID: 38087643 PMCID: PMC10729228 DOI: 10.1136/lupus-2023-000982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVE Lupus nephritis (LN) is one of the most severe manifestations of SLE; however, we know little about the lived experience of LN. This research investigates patient experiences and perspectives of (1) LN diagnosis; (2) living with LN; and (3) LN healthcare and treatment. METHODS Patients aged ≥18 years with biopsy-proven pure or mixed International Society of Nephrology/Renal Pathology Society class III, IV or V LN were purposefully recruited from a Canadian lupus cohort to participate in semistructured in-depth interviews. RESULTS Thirty patients with LN completed the interviews. The mean (SD) age was 42.1 (16.4) years, and 86.7% were female. Participants described challenges seeking, receiving and adjusting to a LN diagnosis, and some reported that their diagnosis process took weeks to years. While 16 participants were provided resources by healthcare providers to help them through the process of diagnosis, the need for accessible LN-specific information at diagnosis was highlighted (n=18). Participants also described the unpredictability of living with LN, particularly related to impacts on physical and mental health, relationships, leisure activities, employment and education, and family planning. While most (n=26) participants reported a positive impression of their care, the side effects of LN medications and the need to increase patient and societal awareness/understanding of LN were highlighted in the context of healthcare and treatment. CONCLUSIONS The unpredictability of living with LN, the heavy treatment burden and a lack of patient/societal awareness substantially affect the lived experience of LN. These findings will inform the development of LN-specific patient resources to increase understanding of LN and improve well-being for patients.
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Affiliation(s)
- Francesca S Cardwell
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, Canada
| | - Susan J Elliott
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, Canada
| | - Megan R W Barber
- Division of Rheumatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kim Cheema
- Division of Nephrology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sydney George
- Health Outcomes and Economics, GSK, Mississauga, Ontario, Canada
| | - Adrian Boucher
- Health Outcomes and Economics, GSK, Mississauga, Ontario, Canada
| | - Ann Elaine Clarke
- Division of Rheumatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Hashemi S, Farahbakhsh S, Aghakhani Z, MomayezanMarnani A, Hemati N, Hashemi S. Health-related quality of life and its related factors in patients with systemic lupus erythematosus in southwest Iran: a cross-sectional study. BMC Psychol 2023; 11:259. [PMID: 37658385 PMCID: PMC10472603 DOI: 10.1186/s40359-023-01300-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 08/23/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Quality of life (QoL) is an important measure in health assessment. It is impacted by unclear factors in Systemic Lupus Erythematosus (SLE) patients. The study aimed to investigate the factors related to QoL in SLE patients. METHODS This cross-sectional study was performed on 140 (136 women and four men) Iranian SLE patients of Hafiz Hospital from June 2019 to August 2020. The Lupus Erythematosus Quality of Life Questionnaire (LEQoL) was used to evaluate the quality of life. The patients were evaluated with this questionnaire for four weeks in eight dimensions health, emotional health, body image, pain, planning, intimate relationships, and the burden of others. Related factors of LEQoL were evaluated using multivariable linear regression. RESULTS The mean age was 34.09(8.96) years. The total mean QoL Score was 65.5 ± 22.4. The multivariable analysis showed that duration of disease (β:-1.12, 95% CI:-1.44 to -0.79, P:0.001), physical activity(β:-12.99, 95% CI:-19.2 to -6.13, P:0.001), kidney involvement (β:-9.2, 95% CI:-16.61 to -2.79, P:0.03) and skin involvement(β:-8.7, 95% CI:-17.2 to -0.2, P:0.031) were significantly related to the total mean QOL score of SLE patients. CONCLUSION The QoL of Iranian patients with SLE was low. Age and gender can be related to the decrease in the QoL of patients with SLE. Increasing the disease duration, physical activity, kidney involvement, and skin involvement can be related to the decrease in the QOL of Iranian patients with SLE.
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Affiliation(s)
- Sakineh Hashemi
- Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sahar Farahbakhsh
- Occupational Therapy, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | | | - Nazi Hemati
- Clinical Exercise Physiology, Shiraz University, Shiraz, Iran
| | - Somayeh Hashemi
- Clinical Exercise Physiology, Shiraz University, Shiraz, Iran
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Colmenares-Roa T, Gastelum-Strozzi A, Crosley E, Fuentes-Silva Y, Reategui-Sokolova C, Elera-Fitzcarrald C, Ibañez S, Cairoli E, Pons-Estel BA, Drenkard C, Peláez-Ballestas I. Digital Narratives of Living With Lupus: Lived Experiences and Meanings for Latin American and Latino Patients and Their Families. Arthritis Care Res (Hoboken) 2023; 75:540-549. [PMID: 35188345 DOI: 10.1002/acr.24870] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/20/2022] [Accepted: 02/17/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Systemic lupus erythematosus (SLE) disproportionately affects Latin American and Latino populations, with worse outcomes compared to nonminority populations. Understanding patients' views is critical to provide culturally competent care. The objective of this research is to analyze lived experiences with SLE from comments made by Latin American and Latino patients, and their relatives and friends, on the public Facebook group "Hablemos de Lupus" (in English: "Let's Talk about Lupus"). METHODS Deidentified narratives posted as a reaction to the most popular resources shared by the page were extracted using the Facepager application. We conducted a thematic analysis under an interpretative medical anthropology framework. RESULTS Five core themes were demonstrated by social media comments: lived experiences with lupus, religious/spiritual thoughts, metaphors, heredity, and experiences of family and friends. Being diagnosed with lupus is perceived as a life-changing event. The fluctuating course of the disease causes uncertainty, and the perception of invisibility within the patient's social circle generates feelings of being misunderstood. Faith and spiritual thoughts are coping strategies. Patients use metaphors about the disease's meaning and their lived experiences (the purple butterfly, not belonging, bellicose metaphors) to communicate with others. Relatives and friends are impacted by their loved one's distress. CONCLUSION Patients perceive lupus as an unpredictable illness and use metaphors to foster empathy and communicate their experiences to others. Religion is as important as medical treatment to cope with the disease, and the experience of having lupus extends to family and friends. Findings can be used to improve physician-patient communication and lupus education campaigns in the Latin American and Latino population.
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Affiliation(s)
| | | | | | | | | | | | | | - Ernesto Cairoli
- Centro Asistencial del Sindicato Médico del Uruguay and Hospital Evangélico and Institut Pasteur de Montevideo, Montevideo, Uruguay
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5
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Ugarte-Gil MF, Gamboa-Cardenas RV, Reátegui-Sokolova C, Pimentel-Quiroz VR, Medina M, Elera-Fitzcarrald C, Rodriguez-Bellido Z, Pastor-Asurza CA, Perich-Campos RA, Alarcón GS. A better self-efficacy is predictive of better health-related quality of life (HRQoL) in patients with systemic lupus erythematosus: data from the Almenara Lupus Cohort. Lupus Sci Med 2023; 10:10/1/e000874. [PMID: 36787922 PMCID: PMC9930544 DOI: 10.1136/lupus-2022-000874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 01/27/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVE To determine the possible predictive value of self-efficacy on health-related quality of life (HRQoL) in patients with SLE. METHODS Patients with SLE from the Almenara Lupus Cohort were included. Self-efficacy was ascertained with the six domains from the Patient-Reported Outcomes Measurement Information System (PROMIS) self-efficacy for managing chronic conditions. For PROMIS domains, a score of 50 is the average for a clinical population (people with a chronic condition), a higher score indicates that the respondent has greater self-efficacy. HRQoL was ascertained with the physical and mental component summary (PCS and MCS) measures of the Short-Form 36 (SF-36). Generalised estimating equations were performed, using as outcome the PCS or MCS in the subsequent visit, and the self-efficacy domain in the previous visit; multivariable models were adjusted for possible confounders. The confounders were measured in the same visit as the self-efficacy domain. RESULTS Two-hundred and nine patients for a total of 564 visits were included; 194 (92.8%) patients were women and mean age at diagnosis was 36.4 (14.0) years. In the multivariable models, a better PCS was predicted by a better self-efficacy for managing symptoms, managing medications and treatments and managing social interactions and general self-efficacy; a better MCS was predicted by a better self-efficacy for managing daily activities, managing symptoms, managing medications and treatments and managing social interactions. CONCLUSION A better self-efficacy is predictive of subsequent better HRQoL, even after adjustment for possible confounders. These results should encourage clinicians to develop strategies to improve self-efficacy in patients with SLE.
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Affiliation(s)
- Manuel Francisco Ugarte-Gil
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru .,Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémicas, Universidad Científica del Sur, Lima, Peru
| | - Rocio Violeta Gamboa-Cardenas
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru,Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémicas, Universidad Científica del Sur, Lima, Peru
| | - Cristina Reátegui-Sokolova
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru,Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Victor Román Pimentel-Quiroz
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru,Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémicas, Universidad Científica del Sur, Lima, Peru
| | - Mariela Medina
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru
| | - Claudia Elera-Fitzcarrald
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru,Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Ica, Peru
| | - Zoila Rodriguez-Bellido
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru,Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Cesar Augusto Pastor-Asurza
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru,Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Risto Alfredo Perich-Campos
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru,Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Graciela S Alarcón
- Max E. Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA,School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
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Warchoł-Biedermann K, Mojs E, Sikorska D, Kotyla P, Teusz G, Samborski W. Psychological Implications to the Therapy of Systemic Lupus Erythematosus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16021. [PMID: 36498095 PMCID: PMC9737561 DOI: 10.3390/ijerph192316021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/20/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
Systemic lupus erythematosus (SLE) is a chronic and multi-systemic autoimmune disease, which has a deleterious impact on patients' psychological well-being. This paper aims to review the existing literature on empirical research on psychological outcomes of SLE and psychological interventions to improve well-being in SLE patients. A search of significant English language articles was conducted in PubMed, Medline, ScienceDirect, Scopus, and ResearchGate databases. Titles and abstracts were screened for the relevant terms, including "systemic lupus erythematosus", "childhood-onset systemic lupus erythematosus", "juvenile systemic lupus erythematosus", "lupus nephritis", and their respective synonyms along with "depression", "anxiety", "fatigue", "medical adherence", "health-related quality of life", "self-management" or "intervention". The articles were evaluated by independent reviewers and the lists of eligible publications were compared whilst disagreements were settled by discussion. Of the 59 publications sought for retrieval, 35 papers were shortlisted based on predefined inclusion/exclusion criteria. They were classified according to their content and the methodology applied. Research topics including "anxiety and depression in SLE" and "self-management interventions for SLE patients" were identified and are presented in this review. As the prognosis and life expectancy of SLE patients are improving, further research on the psychological outcomes of SLE and the evidence-based psychological interventions to improve patients' well-being are justified.
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Affiliation(s)
| | - Ewa Mojs
- Department of Clinical Psychology, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Dorota Sikorska
- Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 61-545 Poznan, Poland
| | - Przemysław Kotyla
- Department of Internal Medicine, Rheumatology and Clinical Immunology, Medical University of Silesia Katowice, 40-635 Katowice, Poland
| | - Grażyna Teusz
- Faculty of Educational Studies, Adam Mickiewicz University, 61-712 Poznan, Poland
| | - Włodzimierz Samborski
- Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 61-545 Poznan, Poland
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Rua-Figueroa Fernández de Larrinoa Í, Lozano MJC, Fernández-Cid CM, Cobo T, Salman Monte TC, Freire González M, Hidalgo Bermejo FJ, Román Gutiérrez CS, Cortés-Hernández J. Preventing organ damage in systemic lupus erythematosus: the impact of early biological treatment. Expert Opin Biol Ther 2022; 22:821-829. [PMID: 35815355 DOI: 10.1080/14712598.2022.2096406] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION One of the most important aims in the management of systemic lupus erythematosus (SLE) is to avoid or delay the accumulation of organ damage. The first five years after diagnosis are crucial for prognosis. AREAS COVERED This manuscript reviews available data on organ damage accrual in SLE and early therapeutic intervention as a possible strategy to prevent its long-term accrual. EXPERT OPINION Organ damage can be minimized by controlling disease activity and risk of flares, reducing the dose of glucocorticoids, and ensuring a proper therapeutic intervention with an early introduction of the right therapies. The current standard treatment cannot provide clinical remission in all patients with SLE. Therefore, there is a clinical need for introducing new therapeutic strategies able to achieve the main therapeutic objectives. The addition of biologic and other therapeutic agents to the standard of care is effective for controlling disease activity and for preventing severe flares, enabling a reduced use of glucocorticoids, and presumably reducing organ damage progression. Considering its efficacy and safety, early inclusion of biologic agents in the first lines of the treatment algorithm, at least in certain patients, could be considered as an innovative treatment approach to decrease disease burden in SLE patients.
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Affiliation(s)
| | | | | | - Tatiana Cobo
- Rheumatology Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Tarek C Salman Monte
- Rheumatology Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Spain
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8
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Tomai M, Lauriola M. Separate but Related: Dimensions of Healthcare Provider Social Support in Day-Treatment Oncology Units. Front Psychol 2022; 13:773447. [PMID: 35529557 PMCID: PMC9072867 DOI: 10.3389/fpsyg.2022.773447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
Social support by healthcare providers has been increasingly investigated during the past decade, but studies have made different choices concerning its measurement. To evaluate how social support from a healthcare provider impacts the perceived quality of care and patient outcomes, reliable and valid instruments capable of measuring specific aspects of the construct are needed. In study 1, we tested the factor structure and the psychometric properties of a new Healthcare Provider Social Support measure (HPSS) for oncology settings. One-hundred-sixty-two patients (89 females; M age = 58.97, SD age = 13.28) from religious and government-operated hospitals completed the HPSS during day treatment. We modeled the HPSS factor structure to represent four related aspects: Emotional, Informational, Appraisal, and Instrumental social support. Study 2 preliminarily assessed the concurrent validity of the HPSS with patient perceptions of the patient-doctor relationship. Sixty-nine patients (40 females; M age = 53.67, SD age = 13.74) completed the HPPS with scales assessing perceived doctor-patient communication and patient trust in the healthcare provider. Study 1, using Exploratory Structural Equation Modeling, showed that a bifactor model had an excellent fit. The analysis supported the use of subscale scores, which were more tenable than a single total score in terms of bifactor model indices. This conclusion was also supported by greater scalability of the subscales in a Mokken Scale Analysis. Oncology patients treated in the religious hospital perceived greater Emotional, Informational, and Instrumental social support from their healthcare provider than those treated in government-operated. Study 2 showed that patient ratings of healthcare provider social support, except Instrumental, were positively correlated with better doctor communication skills and greater trust in the physician. Multiple regression analyses showed that Informational and Emotional support provided a unique contribution to building trust in the physician, controlling for the doctor's communication skills. The study results showed that the four social support ratings were reliable and valid, sharpening the distinction between functional components in the formal healthcare system.
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Affiliation(s)
- Manuela Tomai
- Department of Dynamic and Clinical Psychology, and Health, Sapienza University of Rome, Rome, Italy
| | - Marco Lauriola
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
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Radin M, El Hasbani G, Barinotti A, Roccatello D, Uthman I, Taher A, Sciascia S. Quality of life measures in Systemic Lupus Erythematosus: A systematic review. Reumatismo 2022; 73. [DOI: 10.4081/reumatismo.2021.1447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 01/12/2022] [Indexed: 11/23/2022] Open
Abstract
In this study we systematically investigated the health-related quality of life (HRQoL) tools, which have been most often used over the last five years to evaluate the QoL in patients with systemic lupus erythematosus (SLE), focusing on their items and applications. A detailed literature search was conducted: the inclusion criteria were as follows: 1) studies including at least 50 patients; 2) studies including at least 25 patients with SLE; 3) quality of life testing with validated measures. The systematic review was based on 119 studies for a total of 32,449 SLE patients and 3092 controls. A total of 35 different patients-reported quality of life measures, applied in cohorts of patients with SLE, were retrieved with the 36-item Medical Outcome Short Form (SF-36) (63 studies of 119 =52.95%), Lupus Quality of Life (LupusQoL) (17 studies =14.3%) and Lupus Patient-Reported Outcome (LupusPRO) (12 studies =10%) being the most commonly used tools. Overall, this systematic review of the literature indicated that quality of life in patients with SLE appears to be poor and generally lower compared to both the general population and patients with other chronic conditions, as was shown by a few studies that used SF-36 and LupusPRO. The use of HRQoL scoring in SLE is gaining increasing interest and is used both in randomized controlled trials and in real-life. Future efforts are needed to improve the understanding of the impact of the disease burden on quality of life from the patient’s perspective.
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Souza RRD, Marcon SS, Teston EF, Barreto MDS, Reis PD, Cecilio HPM, Marquete VF, Ferreira PC. From diagnosis to complications: experiences of those who live with systemic lupus erythematosus. Rev Bras Enferm 2022; 75:e20200847. [DOI: 10.1590/0034-7167-2020-0847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 07/19/2021] [Indexed: 08/22/2023] Open
Abstract
ABSTRACT Objective: To understand how people with lupus experience the diagnosis and how they deal with complications arising from the disease. Method: Qualitative study, whose data were collected between February and July 2019, through semi-structured interviews with 26 individuals and submitted to content analysis. Results: Three categories emerged that show illness from lupus as a difficult experience, permeated by sadness, fear and suffering, which, in addition to being linked to society’s lack of knowledge about the disease, negatively impacts the lives of those who experience it. Furthermore, they show that the time of living with the disease favors the development of self-care strategies and greater therapeutic adherence and, consequently, longer periods of disease remission. Considerations: More disclosure about the disease and its implications in the daily lives of those affected is essential, culminating in greater understanding of family, friends and colleagues and improvements in health care and quality of life for these people.
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11
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Sebri V, Mazzoni D, Triberti S, Pravettoni G. The Impact of Unsupportive Social Support on the Injured Self in Breast Cancer Patients. Front Psychol 2021; 12:722211. [PMID: 34616337 PMCID: PMC8488137 DOI: 10.3389/fpsyg.2021.722211] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/24/2021] [Indexed: 12/24/2022] Open
Affiliation(s)
- Valeria Sebri
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Davide Mazzoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Stefano Triberti
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, 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, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
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12
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Souza RRD, Barreto MDS, Teston EF, Reis PD, Cecilio HPM, Marcon SS. DUALITY OF LIVING WITH SYSTEMIC LUPUS ERYTHEMATOSUS: FLUCTUATING BETWEEN “GOOD DAYS” AND “BAD DAYS”. TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2020-0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to learn the perception of individuals with Systemic Lupus Erythematosus about living with the disease. Method: an exploratory and descriptive research study, of a qualitative nature, carried out with 26 individuals undergoing treatment at the rheumatology outpatient clinic of a university hospital in southern Brazil. The data were collected in the period from February to July 2019, by means of semi-structured interviews that were audio-recorded and subjected to the thematic modality of content analysis. Results: a category entitled: “Fluctuating between good and bad days in living with Systemic Lupus Erythematosus”, composed of two subcategories that portray that living with Lupus is something unstable/fickle, emerged from the results. This is because, as a result of the periods of remission and exacerbation of the signs and symptoms of the disease, the patients experience a paradox of constant oscillation between ups and downs. Conclusion: it was learned that individuals with Lupus perceive that living with the disease is marked by an oscillation between good days and bad days, which are related to periods of remission and exacerbation of the manifestations of the disease, respectively.
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Affiliation(s)
- Rebeca Rosa de Souza
- Universidade Estadual de Maringá, Brasil; Universidade Estadual do Paraná, Brasil
| | | | | | - Pamela dos Reis
- Universidade Estadual de Maringá, Brasil; Instituto Adventista do Paraná, Brasil
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Hoge C, Bowling CB, Lim SS, Drenkard C, Plantinga LC. Association of Poverty Income Ratio with Physical Functioning in a Cohort of Patients with Systemic Lupus Erythematosus. J Rheumatol 2020; 47:983-990. [PMID: 32115428 DOI: 10.3899/jrheum.190991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2020] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To examine the association of income relative to the poverty threshold [poverty income ratio (PIR)] with self-reported physical functioning (PF) in a cohort of patients with systemic lupus erythematosus. METHODS We used cross-sectional data on 744 participants from Georgians Organized Against Lupus (GOAL), and secondary analyses used data on 56 participants from a nested pilot study. Primary analyses used multivariable linear regression to estimate the association between PIR (categorized as < 1.00, 1.00-1.99, 2.00-3.99, and ≥ 4.00; lower PIR indicate higher poverty) and PF (scaled subscore from the Medical Outcomes Study Short Form-12 survey; range 0-100, higher scores indicate better functioning). Secondary analyses summarized complementary measures of PF as means or percentages by PIR (categorized as < 1.00, 1.00-1.99, and ≥ 2.00). RESULTS The mean age of participants was 48.0 years; 6.7% were male; 80.9% were black; and 37.5%, 21.0%, 29.6%, and 12.0% had PIR of < 1.00, 1.00-1.99, 2.00-3.99, and ≥ 4.00, respectively. The overall mean PF score was 45.8 (36.2, 40.7, 55.5, and 61.2 for PIR of < 1.00, 1.00-1.99, 2.00-3.99, and ≥ 4.00). With adjustment, higher PIR remained associated with higher PF scores [2.00-3.99 vs 1.00-1.99: β = 10.9 (95% CI 3.3-18.6); ≥ 4.00 vs 1.00-1.99: β = 16.2 (95% CI 6.4-26.0)]. In secondary analyses, higher PIR was also associated with higher scores for objective physical performance. CONCLUSION Our results show that higher income relative to the poverty threshold is associated with better PF across multiple domains, warranting further research into multicomponent functional assessments to develop individual treatment plans and potentially improve socioeconomic disparities in outcomes.
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Affiliation(s)
- Courtney Hoge
- From the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Medical Center (VAMC), and Department of Medicine, Duke University, Durham, North Carolina; and Department of Medicine, Emory University, Atlanta, Georgia, USA.,C. Hoge, MSPH, Department of Epidemiology, Rollins School of Public Health, Emory University; C.B. Bowling, MD, MSPH, Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham VAMC; S.S. Lim, MD, MPH, Department of Medicine, Emory University; C. Drenkard, MD, PhD, Department of Medicine, Emory University; L.C. Plantinga, PhD, Department of Epidemiology, Rollins School of Public Health, Department of Medicine, Emory University
| | - C Barrett Bowling
- From the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Medical Center (VAMC), and Department of Medicine, Duke University, Durham, North Carolina; and Department of Medicine, Emory University, Atlanta, Georgia, USA.,C. Hoge, MSPH, Department of Epidemiology, Rollins School of Public Health, Emory University; C.B. Bowling, MD, MSPH, Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham VAMC; S.S. Lim, MD, MPH, Department of Medicine, Emory University; C. Drenkard, MD, PhD, Department of Medicine, Emory University; L.C. Plantinga, PhD, Department of Epidemiology, Rollins School of Public Health, Department of Medicine, Emory University
| | - S Sam Lim
- From the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Medical Center (VAMC), and Department of Medicine, Duke University, Durham, North Carolina; and Department of Medicine, Emory University, Atlanta, Georgia, USA.,C. Hoge, MSPH, Department of Epidemiology, Rollins School of Public Health, Emory University; C.B. Bowling, MD, MSPH, Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham VAMC; S.S. Lim, MD, MPH, Department of Medicine, Emory University; C. Drenkard, MD, PhD, Department of Medicine, Emory University; L.C. Plantinga, PhD, Department of Epidemiology, Rollins School of Public Health, Department of Medicine, Emory University
| | - Cristina Drenkard
- From the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Medical Center (VAMC), and Department of Medicine, Duke University, Durham, North Carolina; and Department of Medicine, Emory University, Atlanta, Georgia, USA.,C. Hoge, MSPH, Department of Epidemiology, Rollins School of Public Health, Emory University; C.B. Bowling, MD, MSPH, Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham VAMC; S.S. Lim, MD, MPH, Department of Medicine, Emory University; C. Drenkard, MD, PhD, Department of Medicine, Emory University; L.C. Plantinga, PhD, Department of Epidemiology, Rollins School of Public Health, Department of Medicine, Emory University
| | - Laura C Plantinga
- From the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Medical Center (VAMC), and Department of Medicine, Duke University, Durham, North Carolina; and Department of Medicine, Emory University, Atlanta, Georgia, USA. .,C. Hoge, MSPH, Department of Epidemiology, Rollins School of Public Health, Emory University; C.B. Bowling, MD, MSPH, Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham VAMC; S.S. Lim, MD, MPH, Department of Medicine, Emory University; C. Drenkard, MD, PhD, Department of Medicine, Emory University; L.C. Plantinga, PhD, Department of Epidemiology, Rollins School of Public Health, Department of Medicine, Emory University.
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Abstract
Lupus nephritis (LN) is a form of glomerulonephritis that constitutes one of the most severe organ manifestations of the autoimmune disease systemic lupus erythematosus (SLE). Most patients with SLE who develop LN do so within 5 years of an SLE diagnosis and, in many cases, LN is the presenting manifestation resulting in the diagnosis of SLE. Understanding of the genetic and pathogenetic basis of LN has improved substantially over the past few decades. Treatment of LN usually involves immunosuppressive therapy, typically with mycophenolate mofetil or cyclophosphamide and with glucocorticoids, although these treatments are not uniformly effective. Despite increased knowledge of disease pathogenesis and improved treatment options, LN remains a substantial cause of morbidity and death among patients with SLE. Within 10 years of an initial SLE diagnosis, 5-20% of patients with LN develop end-stage kidney disease, and the multiple comorbidities associated with immunosuppressive treatment, including infections, osteoporosis and cardiovascular and reproductive effects, remain a concern. Clearly, early and accurate diagnosis of LN and prompt initiation of therapy are of vital importance to improve outcomes in patients with SLE.
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Petrongolo JL, Zelikovsky N, Keegan RM, Furth SL, Knight A. Examining Uncertainty in Illness in Parents and Children With Chronic Kidney Disease and Systemic Lupus Erythematosus: A Mediational Model of Internalizing Symptoms and Health-Related Quality of Life. J Clin Psychol Med Settings 2019; 27:31-40. [PMID: 30989366 DOI: 10.1007/s10880-019-09617-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To examine if parent illness uncertainty is indirectly associated with child depression, anxiety, and HRQOL in the CKD/SLE population. Parent-child dyads (N = 31) from outpatient rheumatology and nephrology clinics included children (ages 9-18) diagnosed with CKD (Stage 1, 2, or nephrotic syndrome) or SLE. Parents completed demographic and uncertainty measures and children completed uncertainty, depression, anxiety, and HRQOL measures. This cross-sectional study examined mediational models using the percentile bootstrapping method. Parent uncertainty had an indirect effect on child depression, anxiety, and HRQOL through the mediator, child uncertainty. In other words, parents' illness uncertainty regarding their child's condition correlates to the child's illness uncertainty, which then is associated with the child's mental health and wellbeing. Reverse mediations illustrated that parent uncertainty did not mediate child uncertainty and outcome variables. Results extend previous research by examining parent and child illness uncertainty in understudied conditions (CKD/SLE) and the relationship to outcome variables commonly related to depression (e.g., anxiety and HRQOL). Findings allow health psychologists and medical personnel to understand the impact of uncertainty on the child's wellbeing and HRQOL. Clinical implications, including using specialized interventions to address illness uncertainty, are discussed.
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Affiliation(s)
- Jennifer L Petrongolo
- Department of Psychology, La Salle University, 1900 West Olney Avenue, Philadelphia, PA, 19141, USA.
| | - Nataliya Zelikovsky
- Department of Psychology, La Salle University, 1900 West Olney Avenue, Philadelphia, PA, 19141, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and the Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Rachel M Keegan
- Department of Psychology, La Salle University, 1900 West Olney Avenue, Philadelphia, PA, 19141, USA
| | - Susan L Furth
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and the Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Andrea Knight
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and the Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd, Philadelphia, PA, 19104, USA
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Sun Y, Gao L, Kan Y, Shi BX. The Perceived Stress Scale-10 (PSS-10) is reliable and has construct validity in Chinese patients with systemic lupus erythematosus. Lupus 2018; 28:149-155. [PMID: 30518288 DOI: 10.1177/0961203318815595] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Systemic lupus erythematosus is a chronic, progressive, autoimmune disease that causes significant stress on patients. There is no specific instrument for assessing stress in Chinese systemic lupus erythematosus patients. The objective of this study was to test the reliability and validity of the 10-item Perceived Stress Scale in Chinese systemic lupus erythematosus patients. Validity evaluation included structural and construct validity (convergent and discriminant validity). Structural validity was assessed by exploratory factor analysis. Convergent validity was assessed by correlating the total score of the 10-item Perceived Stress Scale with the Patient Health Questionnaire-9, Self-Efficacy for Managing Chronic Disease 6-Item Scale, the Simplified Coping Style Questionnaire, and the Systemic Lupus Erythematosus Disease Activity Index. Discriminant validity was determined by the statistically significant differences in perceived stress scores among patients with different education levels and disease activity. Reliability was assessed by internal consistency and test-retest reliability. The test-retest reliability was measured at 1-week intervals. Exploratory factor analysis extracted two dimensions that explained 66.45% of the variation. Moderate-to-strong correlations were also found between the 10-item Perceived Stress Scale and the Patient Health Questionnaire-9, Self-Efficacy for Managing Chronic Disease 6-Item Scale, the Simplified Coping Style Questionnaire, and Systemic Lupus Erythematosus Disease Activity Index. Excellent test-retest reliability (intraclass correlation coefficient = 0.954) and internal consistency (Cronbach's alpha = 0.810) were demonstrated. In conclusion, the 10-item Perceived Stress Scale can be used to measure stress among Chinese systemic lupus erythematosus patients and serve as a basis for further research.
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Affiliation(s)
- Y Sun
- School of Nursing, Tianjin Medical University, Tianjin City, People's Republic of China
| | - L Gao
- Department of Nursing, Huizhou First People's Hospital, Huizhou City, People's Republic of China
| | - Y Kan
- Department of Rheumatology and Immunology, Tianjin First Center Hospital, Tianjin City, People's Republic of China
| | - B-X Shi
- School of Nursing, Tianjin Medical University, Tianjin City, People's Republic of China
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Larsen JL, Hall EOC, Jacobsen S, Birkelund R. The existential experience of everyday life with systemic lupus erythematosus. J Adv Nurs 2018; 74:1170-1179. [PMID: 29350776 DOI: 10.1111/jan.13525] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 01/19/2023]
Abstract
AIM To explore from the perspective of women the nature of basic existential conditions while living with systemic lupus erythematosus. BACKGROUND Systemic lupus erythematosus has an unpredictable disease course and is documented to cause an existential rearrangement of life. The significance of changes in existential conditions and related experiences are unclear in the context of nursing and women with systemic lupus erythematosus. DESIGN A qualitative design guided by Van Manen's hermeneutic-phenomenological methodology. METHOD Individual in-depth interviews with 15 women diagnosed with systemic lupus erythematosus and of various ages, disease durations and severities were undertaken from September 2013 - October 2015. Data were analysed following van Manen's phenomenological approach and using drawing as an interpretive tool. FINDINGS The main existential experience was interpreted as a person "moving with the waves of systemic lupus erythematosus" constituted by the themes "oscillating between presence and absence of systemic lupus erythematosus," "recognizing space and bodily possibilities and limitations" and "being enriched through relationships and activities." When systemic lupus erythematosus was flaring, well-being was threatened and a laborious time to escape the feeling of a setback-in-life persisted long after the disease was medically under control. CONCLUSION Daily life with systemic lupus erythematosus is conditioned by a prominent need to be in existential motion, related to the absence and presence of systemic lupus erythematosus. The experience of a setback-in-life by illness might challenge well-being and indicates that periods of disease flares or disturbing symptoms are critical time points to provide support.
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Affiliation(s)
- Janni Lisander Larsen
- Nursing Section, Department of Public Health, Aarhus University, Aarhus, Denmark.,Copenhagen Lupus and Vasculitis Clinic, Rheumatology and Spine Diseases Centre, Rigshospitalet, Copenhagen, Denmark
| | - Elisabeth O C Hall
- Nursing Section, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Søren Jacobsen
- Copenhagen Lupus and Vasculitis Clinic, Rheumatology and Spine Diseases Centre, Rigshospitalet, Copenhagen, Denmark
| | - Regner Birkelund
- Denmark & Lillebaelt Hospital, Institute of Regional Health Research, University of Southern, Vejle, Denmark
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Elera-Fitzcarrald C, Alva M, Gamboa-Cardenas R, Mora-Trujillo CS, Zevallos F, García-Poma A, Medina M, Rodriguez-Bellido Z, Perich-Campos RA, Pastor-Asurza CA, Segami MI, Ugarte-Gil MF. Factors associated with health-related quality of life in Peruvian patients with systemic lupus erythematosus. Lupus 2018; 27:913-919. [DOI: 10.1177/0961203317751062] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Claudia Elera-Fitzcarrald
- Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud
- School of Medicine, Universidad Científica del Sur
| | - Magaly Alva
- Medical Specialties Department, Hospital Edgardo Rebagliati Martins-EsSalud
| | | | - Claudia S Mora-Trujillo
- Medical Specialties Department, Hospital Edgardo Rebagliati Martins-EsSalud
- School of Medicine, Universidad Nacional Mayor de San Marcos
- School of Medicine, Universidad Ricardo Palma
| | | | | | - Mariela Medina
- Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud
| | - Zoila Rodriguez-Bellido
- Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud
- School of Medicine, Universidad Nacional Mayor de San Marcos
| | - Risto A Perich-Campos
- Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud
- School of Medicine, Universidad Nacional Mayor de San Marcos
| | | | - María I Segami
- Medical Specialties Department, Hospital Edgardo Rebagliati Martins-EsSalud
- School of Medicine, Universidad Nacional Mayor de San Marcos
| | - Manuel F Ugarte-Gil
- Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud
- School of Medicine, Universidad Científica del Sur
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Clinical predictors of response and discontinuation of belimumab in patients with systemic lupus erythematosus in real life setting. Results of a large, multicentric, nationwide study. J Autoimmun 2018; 86:1-8. [DOI: 10.1016/j.jaut.2017.09.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/06/2017] [Accepted: 09/11/2017] [Indexed: 12/21/2022]
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Sancassiani F, Cocco A, Cossu G, Lorrai S, Trincas G, Floris F, Mellino G, Machado S, Nardi AE, Fabrici EP, Preti A, Carta MG. "VelaMente?!" - Sailin in a Crew to Improve Self-Efficacy in People with Psychosocial Disabilities: A Randomized Controlled Trial. Clin Pract Epidemiol Ment Health 2017; 13:200-212. [PMID: 29238396 PMCID: PMC5712647 DOI: 10.2174/1745017901713010200] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 10/11/2017] [Accepted: 10/15/2017] [Indexed: 12/12/2022]
Abstract
INTRODUCTION It has been proposed that sailing can improve quality of life, personal and social skills of people with severe psychosocial disabilities. This study aimed to assess the efficacy of a psychosocial rehabilitative intervention focused on sailing on quality of life, self-efficacy and sense of coherence in people with severe psychosocial disabilities. METHODS The study was a randomized, with parallel groups, waiting-list controlled trial. Participants were 51 people with severe psychosocial disabilities. The intervention was a structured course to learn sailing in a crew lasting three months. A randomized group began the sailing course immediately after a pre-treatment assessment; the waitlist group began the sailing course after a three months period of treatments as usual. Participants were assessed before and after the sailing course, or the waiting list period, on the General Self-Efficacy scale (GSES), Sense Of Coherence scale (SOC) and Health Survey-short form (SF-12). RESULTS Self-efficacy significantly increased after the sailing course and decreased after treatment as usual (p=0.015). Sense of coherence and the levels of quality of life tended to improve after the sailing course, albeit below levels of statistical significance. CONCLUSION When compared to more traditional psychosocial rehabilitative activities, an intervention focused on sailing in a crew positively impacts the sense of coherence and the levels of quality of life and significantly improves self-efficacy of people with severe psychosocial disabilities. Further longitudinal research is required.
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Affiliation(s)
- Federica Sancassiani
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Alessio Cocco
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Giulia Cossu
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Stefano Lorrai
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Giuseppina Trincas
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Francesca Floris
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Gisa Mellino
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Sergio Machado
- Laboratory of Panic and Respiration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, (RJ), Brazil
- Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program - Salgado de Oliveira University, Niterói, Brazil
| | - Antonio Egidio Nardi
- Laboratory of Panic and Respiration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, (RJ), Brazil
| | | | - Antonello Preti
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
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Monahan RC, Beaart-van de Voorde LJJ, Steup-Beekman GM, Magro-Checa C, Huizinga TWJ, Hoekman J, Kaptein AA. Neuropsychiatric symptoms in systemic lupus erythematosus: impact on quality of life. Lupus 2017; 26:1252-1259. [PMID: 28420059 PMCID: PMC5593126 DOI: 10.1177/0961203317694262] [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] [Indexed: 11/17/2022]
Abstract
Objective Assess quality of life in patients with systemic lupus erythematosus (SLE) presenting with neuropsychiatric symptoms (neuropsychiatric SLE, NPSLE). Methods Quality of life was assessed using the Short-Form 36 item Health Survey (SF-36) in patients visiting the Leiden NPSLE clinic at baseline and at follow-up. SF-36 subscales and summary scores were calculated and compared with quality of life of the general Dutch population and patients with other chronic diseases. Results At baseline, quality of life was assessed in 248 SLE patients, of whom 98 had NPSLE (39.7%). Follow-up data were available for 104 patients (42%), of whom 64 had NPSLE (61.5%). SLE patients presenting neuropsychiatric symptoms showed a significantly reduced quality of life in all subscales of the SF-36. Quality of life at follow-up showed a significant improvement in physical functioning role (p = 0.001), social functioning (p = 0.007), vitality (p = 0.023), mental health (p = 0.014) and mental component score (p = 0.042) in patients with neuropsychiatric symptoms not attributed to SLE, but no significant improvement was seen in patients with NPSLE. Conclusion Quality of life is significantly reduced in patients with SLE presenting neuropsychiatric symptoms compared with the general population and patients with other chronic diseases. Quality of life remains considerably impaired at follow-up. Our results illustrate the need for biopsychosocial care in patients with SLE and neuropsychiatric symptoms.
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Affiliation(s)
- R C Monahan
- 1 Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - G M Steup-Beekman
- 1 Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - C Magro-Checa
- 1 Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - T W J Huizinga
- 1 Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - J Hoekman
- 2 Faculty of Health Care, University of Applied Sciences, Leiden, The Netherlands
| | - A A Kaptein
- 3 Section Medical Psychology, Leiden University Medical Centre, Leiden, The Netherlands
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