Relation Among Anxiety, Depression, Sleep Quality and Health-Related Quality of Life Among Patients with Systemic Lupus Erythematosus: Path Analysis

The validity, reliability, and responsiveness of a new biopscyhosocial questionnaire for patients with systemic lupus erythematosus

OBJECTIVE

In recent years, the importance of holistic care in individuals with systemic lupus erythematosus (SLE) has been emphasized, and therefore a measurement tool that evaluates biopsychosocial impact is needed. This study was conducted to determine the validity, reliability, and responsiveness of the Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire (BETY-BQ) in individuals with SLE.

METHODS

Lupus Quality of Life (LupusQoL), Short Form-36 (SF-36), Health Assessment Questionnaire (HAQ), and Hospital Anxiety and Depression Scale (HADS) were used for the validity. For reliability, evaluations were repeated at 1 -week intervals and for responsiveness, the same scales were re-administered at 3-month intervals to 30 patients.

RESULTS

BETY-BQ showed moderate to high correlations with LupusQoL subparameters (rho = -0.522 to -0.718, p < 0.001), moderate to very high correlations with SF-36 subparameters (r = -0.826 to rho = 0.594, p < 0.001), high correlations with HAQ and HADS-D (rho = 0.735, p < 0.001; rho = 0.622, p < 0.001, respectively) and a moderate correlation with HADS-A (rho = 0.571, p < 0.001). In the test-retest method the correlation between the responses was very high (r = 0.989, p < 0.001). The intraclass correlation coefficient (r = 0.944, p < 0.001) and Cronbach's alpha value were found to be excellent (0.952). BETY-BQ showed moderate correlations with LupusQoL subparameters (the body image r = -0.443, p = 0.014; planning rho = -0.529, p = 0.003; fatigue r = -0.484, p = 0.007; intimate relationships rho = -0.421, p = 0.02), SF-36 social function subparameter (rho = -0.427, p = 0.019) and anxiety and depression subparameter of HADS (rho = 0.418, p = 0.021; r = 0.507, p = 0.004, respectively).

CONCLUSION

BETY-BQ which was found as a valid, reliable, and responsive scale in individuals with SLE, was presented to healthcare professionals for use in clinical and research studies as a scale that can be preferred in the evaluation of biopsychosocial status of individuals with SLE.

Positive psychological capital, post-traumatic growth, social support, and quality of life in patients with systemic lupus erythematosus: A cross-sectional study

OBJECTIVE

This study aimed to investigate the correlation between positive psychological capital, post-traumatic growth, social support, and quality of life (QOL) in patients with systemic lupus erythematosus (SLE).

METHODS

A cross-sectional study was conducted at the First Affiliated Hospital of Xinjiang Medical University from October 2022 to May 2023. A sample of 330 hospitalized SLE patients was selected for this study. The collected data included demographic information, the SLE disease activity index, the Positive Mental Capital Questionnaire, the Chinese version of the Post-Traumatic Growth Scale, the Social Support Rating Scale, and the Chinese version of the Lupus Quality of Life Scale.

RESULTS

The QOL score among the 330 SLE patients was measured as M(P25, P75) of 105 (83.00,124.00). Positive psychological capital, post-traumatic growth, and social support demonstrated significant positive correlations with the QOL in SLE patients (p < 0.05). Multiple linear regression analysis revealed that literacy, disease level, disease duration, occupation, marital status, psychological capital, social support, and post-traumatic growth were influential factors associated with the QOL in SLE patients.

CONCLUSION

Medical professionals should be attentive to the psychological well-being of SLE patients and should consider implementing early psychological interventions. These interventions are crucial for enhancing the QOL for individuals diagnosed with SLE.

Development of a nomogram prediction model for depression in patients with systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease with depression as one of its most common symptoms. The aim of this study is to establish a nomogram prediction model to assess the occurrence of depression in patients with SLE. Based on the Hospital Anxiety and Depression Scale cutoff of 8, 341 patients with SLE, recruited between June 2017 and December 2019, were divided into depressive and non-depressive groups. Data on socio-demographic characteristics, medical history, sociopsychological factors, and other risk factors were collected. Between-group differences in clinical characteristics were assessed with depression as the dependent variable and the variables selected by logistic multiple regression as predictors. The model was established using R language. Marital status, education, social support, coping, and anxiety predicted depression (p < 0.05). The nomogram prediction model showed that the risk rate was from 0.01 to 0.80, and the receiver operating characteristic curve analysis showed that the area under the curve was 0.891 (p < 0.001). The calibration curve can intuitively show that the probability of depression predicted by the nomogram model is consistent with the actual comparison. The designed nomogram provides a highly predictive assessment of depression in patients with SLE, facilitating more comprehensive depression evaluation in usual clinical care.