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Clear Associations Between Demographic and Psychosocial Factors and Health-related Quality of Life in Patients with Early Inflammatory Joint Complaints
GOEDELE A. GEUSKENS, ALEX BURDORF, ANDREA W.M. EVERS, and JOHANNA M.W. HAZES
ABSTRACT. Methods. In this cross-sectional study, patients had inflammatory joint complaints for less than 12 months. Data were collected on clinical characteristics, demographics, lifestyle, behavioral coping, perceived health control, and social support. HRQOL was assessed by 8 dimensions of the Medical Outcome Study Short Form-36 Health Survey. Multiple regression analysis was used to determine the associations between clinical, demographic, lifestyle, and psychosocial characteristics with HRQOL. Results. In total, 359 patients were included, of which 24% were classified as RA, 34% as mono- or oligo-poly arthritis, and 42% as inflammatory joint complaints without clinical synovitis. Among all patients, the health dimensions physical function, physical role functioning, and bodily pain were most affected. The diagnostic group, erythrocyte sedimentation rate, disease duration, and comorbidity explained 4%–9% of the variance in HRQOL dimensions, whereas the combined demographic and psychosocial characteristics explained an additional 21%–29% of HRQOL. HRQOL was negatively associated with younger age, lower education, non-Dutch origin, passive behavioral coping with pain, lower perceived health control, and low social support. Passive behavioral coping with pain had the strongest association with HRQOL. Conclusion. In patients with early inflammatory joint complaints, HRQOL was associated more strongly with personal characteristics than with clinical characteristics. From the time of onset of complaints onwards, physicians should take psychosocial factors and demographics into account to obtain an optimal disease outcome. (First Release Aug 1 2008; J Rheumatol 2008;35:1754-61) Key Indexing Terms:
QUALITY OF LIFE From the Departments of Rheumatology and Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam; and Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Supported by The Dutch Arthritis Association (NR 03-401). G.A. Geuskens, MSc, Departments of Rheumatology and Public Health; A. Burdorf, PhD, Department of Public Health, Erasmus MC, University Medical Center Rotterdam; A.W.M. Evers, PhD, Department of Medical Psychology, Radboud University Nijmegen Medical Centre; J.M.W. Hazes, MD, PhD, Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam. Address reprint requests to G.A. Geuskens, Erasmus MC, University Medical Center Rotterdam, Department of Rheumatology, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. E-mail: g.geuskens@erasmusmc.nl Accepted for publication April 29, 2008. |
