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Yamazaki S, Izawa K, Matsushita M, Moriichi A, Kishida D, Yoshifuji H, Yamaji K, Nishikomori R, Mori M, Miyamae T. Promoting awareness of terminology related to unmet medical needs in context of rheumatic diseases in Japan: a systematic review for evaluating unmet medical needs. Rheumatol Int 2023; 43:2021-2030. [PMID: 37597057 DOI: 10.1007/s00296-023-05425-z] [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: 07/19/2023] [Accepted: 08/06/2023] [Indexed: 08/21/2023]
Abstract
To optimize patient prognosis, patient needs, including unmet needs, should be adequately assessed. However, such needs are more challenging to report and, consequently, more likely to go unmet compared with the needs reported by physicians. We aimed to determine the appropriate direction of future research on unmet medical needs in rheumatic diseases in Japan by conducting a literature review. We searched PubMed and Web of Science using 23 terms linked to unmet medical needs for major rheumatic diseases in Japan. Further, we collected articles on health-related quality of life and investigated the scales used for assessment, as well as whether the terms "unmet needs" or "unmet medical needs" were used. We identified 949 papers on 10 diseases, including systemic lupus erythematosus, systemic sclerosis, dermatomyositis, juvenile idiopathic arthritis, adult-onset Still's disease, antiphospholipid syndrome, mixed connective tissue disease, Takayasu arteritis, Sjögren's syndrome, and Behçet's disease; 25 of the 949 papers were selected for full-text review. Fifteen articles on five diseases were related to health-related quality of life. The term "unmet needs" was used in only one article. Six out of 15 studies used the 36-item short form survey, whereas the scales used in other studies differed. The optimal treatment plan determined by a physician may not necessarily align with the best interests of the patient. In clinical research, cross sectional and standardized indicators of health-related quality of life should be employed along with highly discretionary questionnaires to assess and optimize resource allocation in healthcare and simultaneously achieve patient-desired outcomes.
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Affiliation(s)
- Susumu Yamazaki
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Kazushi Izawa
- Department of Pediatrics, Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - Masakazu Matsushita
- Department of Internal Medicine and Rheumatology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Akinori Moriichi
- Division of Specific Pediatric Chronic Diseases, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | - Dai Kishida
- Department of Medicine (Neurology & Rheumatology), Shinshu University School of Medicine, Nagano, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ken Yamaji
- Department of Internal Medicine and Rheumatology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Ryuta Nishikomori
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Masaaki Mori
- Department of Lifetime Clinical Immunology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takako Miyamae
- Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University School of Medicine, Nagano, Japan
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Carrión-Nessi FS, Marcano-Rojas MV, Romero Arocha SR, Mendoza Millán DL, Forero-Peña DA, Antuarez-Magallanes AW, Al Snih S, Rodríguez MA, Fuentes-Silva YJ. Impact of demographic, clinical, and treatment compliance characteristics on quality of life of Venezuelan patients with systemic lupus erythematosus. BMC Rheumatol 2022; 6:2. [PMID: 34983688 PMCID: PMC8725562 DOI: 10.1186/s41927-021-00232-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/09/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND We have here assessed the impact of demographic, clinical, and treatment compliance characteristics on health-related quality of life (HRQoL) of Venezuelan patients with systemic lupus erythematosus (SLE). We have used a disease-specific questionnaire, the Lupus Quality of Life (LupusQoL), validated in our patient population, to measure HRQoL. METHODS A cross-sectional study was conducted among 100 patients with SLE from outpatient clinics. Patients completed a form with demographic, clinical, and treatment compliance data, and the LupusQoL questionnaire. HRQoL was classified as better or worse according to previously established cut-off points for this patient population. Spearman's r test was used to determine the correlations between age, years of education, disease duration, SLEDAI, and SLICC-DI with the eight domains of the LupusQoL. Mann-Whitney U test was used to compare the HRQoL between the two groups of patients according to treatment compliance. Binomial logistic regression using the backward stepwise selection method was performed to identify the risk factors associated with each of the eight domains of the LupusQoL among patients with inactive (SLEDAI < 4) and active (SLEDAI ≥ 4) SLE. RESULTS HRQoL of our patients was classified as better in all domains of the LupusQoL. Age correlated negatively with all domains of the LupusQoL, except with "burden to others", and disease activity correlated negatively with all domains of the LupusQoL, except with "intimate relationships" and "burden to others" (p < 0.05). Patients who fully complied with indicated treatment had higher scores in "physical health" domain compared to patients who did not comply with at least one of the prescribed medications (p < 0.05). In patients with active SLE, a risk factor associated with worse "planning" and "intimate relationships" was advanced age, while having had SLE flare-ups in the previous six months was a risk factor associated with worse "physical health" (p < 0.05). CONCLUSION Age and disease activity were negatively correlated with almost all domains of the LupusQoL, and treatment compliance was associated with higher score in the "physical health" domain. Disease control and treatment compliance should be the main goals for a better HRQoL in our patients with SLE.
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Affiliation(s)
- Fhabián S Carrión-Nessi
- "Dr. Francisco Battistini Casalta" Health Sciences School, University of Oriente - Bolivar Nucleus, Ciudad Bolivar, Venezuela.
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela.
| | - María V Marcano-Rojas
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Internal Medicine Department, "Tcnel. Dr. César Bello D'Escrivan" Medical Assistance Nucleus, Ciudad Bolivar, Venezuela
| | - Sinibaldo R Romero Arocha
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Medical Scientist Training Program (MD/PhD), University of Minnesota Medical School, Minneapolis, MN, USA
| | - Daniela L Mendoza Millán
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - David A Forero-Peña
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - Allen W Antuarez-Magallanes
- "Dr. Francisco Battistini Casalta" Health Sciences School, University of Oriente - Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Soham Al Snih
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA
- Sealy Center of Aging, University of Texas Medical Branch, Galveston, TX, USA
| | - Martín A Rodríguez
- Sealy Center of Aging, University of Texas Medical Branch, Galveston, TX, USA
| | - Yurilís J Fuentes-Silva
- "Dr. Francisco Battistini Casalta" Health Sciences School, University of Oriente - Bolivar Nucleus, Ciudad Bolivar, Venezuela
- Centro Clínico Universitario de Oriente, Ciudad Bolivar, Venezuela
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Tanaka Y, O'Neill S, Li M, Tsai IC, Yang YW. Systemic Lupus Erythematosus: Targeted literature review of the epidemiology, current treatment and disease burden in the Asia Pacific region. Arthritis Care Res (Hoboken) 2020; 74:187-198. [PMID: 32841537 DOI: 10.1002/acr.24431] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 07/09/2020] [Accepted: 08/18/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To understand the epidemiology, current treatment and disease burden of systemic lupus erythematosus (SLE) in the Asia Pacific region (APAC). METHODS A targeted literature review of published evidence on SLE in APAC was conducted, using the MEDLINE® database (2008-2018), conference proceedings and other supplementary sources. RESULTS The review identified 70 studies conducted in China (n=15), Japan (n=13), Taiwan (n=12), Korea (n=9), Australia (n=7), Hong Kong (n=6), Singapore (n=4), and multiple places within the APAC region (n=4). Incidence rates (per 100,000 per year) ranged from 0.9-8.4, while prevalence rates ranged from 3.7-127 (per 100,000); however, recent data was limited. Asian SLE patients were reported to have higher disease severity, activity (higher SLE disease activity index scores) and organ damage accrual; along with increased morbidity, mortality, and susceptibility to renal involvement compared with other ethnicities in APAC. The risk of developing SLE is higher in the Asian population. Routinely used SLE therapies included belimumab, hydroxychloroquine, cyclophosphamide, tacrolimus, azathioprine, mycophenolate mofetil, and corticosteroids; however, prescribing patterns varied across the region. Increased disease activity was associated with high economic burden and poor quality of life for SLE patients in APAC. CONCLUSION SLE remains a disease with a significant unmet medical need for an innovative therapy that is well-tolerated and effective for patients in APAC. Further evidence is required to better characterize the disease and fully capture the burden and impact of SLE in APAC. This review has highlighted where there is a paucity of data from patients across the APAC region.
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Affiliation(s)
- Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Sean O'Neill
- Department of Rheumatology, Royal North Shore Hospital, Northern Clinical School, University of Sydney, St Leonards, New South Wales, Australia
| | - Mengtao Li
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, National Clinical Research Center for Immunologic Diseases, Ministry of Science & Technology, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - I-Ching Tsai
- Janssen: Pharmaceutical Companies of Johnson & Johnson, 11F, No.2, Sec.3, Minsheng East Rd, Taipei City, Taiwan
| | - Ya-Wen Yang
- Janssen Global Services, LLC, Horsham, PA, USA
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Seguier J, Jouve E, Bobot M, Whalen E, Dussol B, Gentile S, Burtey S, Halfon P, Retornaz F, Chaussabel D, Chiche L, Jourde-Chiche N. Paradoxical association between blood modular interferon signatures and quality of life in patients with systemic lupus erythematosus. Rheumatology (Oxford) 2019; 59:1975-1983. [DOI: 10.1093/rheumatology/kez541] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/02/2019] [Indexed: 12/14/2022] Open
Abstract
Abstract
Objectives
Blood transcriptomic IFN signature is a hallmark of SLE. The impaired health-related quality of life (HRQOL) observed in SLE is poorly related to disease activity. The aim of this study was to test how IFN signatures were associated with HRQOL in SLE patients.
Methods
Among consecutive patients, blood transcriptomic profiles were analysed with a modular framework comprising 3 IFN modules: M1.2, M3.4 and M5.12. Disease activity was evaluated by the SLEDAI score, and HRQOL was assessed with the SF-36 questionnaire, which includes eight domains: physical function, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health (MH) and physical component summary and mental component summary scores.
Results
A total of 57 SLE patients were evaluated, among whom 27 (47%) were clinically quiescent, 30 (53%) were flaring, and 19 (33%) had active lupus nephritis. All SF-36 domains were altered in SLE patients compared with the general French population (P < 0.0001). In multivariate analysis, taking into account flares, age, ethnicity, smoking and renal severity, social functioning was independently associated with the IFN score (P = 0.027). Analyses restrained to quiescent patients (n = 27) yielded greater associations between social functioning and the three IFN modules, and between MH and M3.4. Considering all quiescent visits (n = 51), the IFN score was independently correlated with social functioning (P = 0.022) and MH (P = 0.038).
Conclusion
This unexpected paradoxical association between IFN signature and some specific HRQOL domains argues against a pivotal role of IFNs in the persistently altered HRQOL of SLE patients.
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Affiliation(s)
- Julie Seguier
- AP-HM, Service de Médecine Interne, Hôpital de la Timone, Marseille, France
| | - Elisabeth Jouve
- EA 3279 CEReSS, AP-HM, Service Evaluation Médicale, Marseille, France
| | - Mickaël Bobot
- C2VN, INRA 1263, INSERM 1260, Aix-Marseille Université, Marseille, France
- AP-HM, Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception, Marseille, France
| | - Elisabeth Whalen
- Department of Systems Immunology, Benaroya Research Institute, Seattle, WA, USA
| | - Bertrand Dussol
- C2VN, INRA 1263, INSERM 1260, Aix-Marseille Université, Marseille, France
- AP-HM, Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception, Marseille, France
| | - Stéphanie Gentile
- EA 3279 CEReSS, AP-HM, Service Evaluation Médicale, Marseille, France
| | - Stéphane Burtey
- C2VN, INRA 1263, INSERM 1260, Aix-Marseille Université, Marseille, France
- AP-HM, Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception, Marseille, France
| | - Philippe Halfon
- Service de Médecine Interne, Hôpital Européen, Marseille, France
| | | | | | - Laurent Chiche
- Service de Médecine Interne, Hôpital Européen, Marseille, France
| | - Noémie Jourde-Chiche
- C2VN, INRA 1263, INSERM 1260, Aix-Marseille Université, Marseille, France
- AP-HM, Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception, Marseille, France
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5
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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: 22] [Impact Index Per Article: 4.4] [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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Tanaka Y, Bass D, Chu M, Egginton S, Ji B, Roth D. Organ system improvements in Japanese patients with systemic lupus erythematosus treated with belimumab: A subgroup analysis from a phase 3 randomized placebo-controlled trial. Mod Rheumatol 2019; 30:313-320. [DOI: 10.1080/14397595.2019.1630897] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health Japan, Kitakyushu, Japan
| | - Damon Bass
- Immuno-Inflammation, GSK, Philadelphia, PA, USA
| | - Myron Chu
- Immuno-Inflammation, GSK, Philadelphia, PA, USA
| | | | - Beulah Ji
- R&D Clinical Development, GSK, Uxbridge, UK
| | - David Roth
- Immuno-Inflammation, GSK, Philadelphia, PA, USA
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Wang Y, Zhao R, Gu C, Gu Z, Li L, Li Z, Dong C, Zhu J, Fu T, Gao J. The impact of systemic lupus erythematosus on health-related quality of life assessed using the SF-36: a systematic review and meta-analysis. PSYCHOL HEALTH MED 2019; 24:978-991. [PMID: 30943791 DOI: 10.1080/13548506.2019.1587479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Yilin Wang
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
- Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong, China
| | - Rui Zhao
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
- Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong, China
| | - Chaoyu Gu
- School of Medicine, Nantong University, Nantong, China
| | - Zhifeng Gu
- Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong, China
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Liren Li
- Department of Gastroenterology, Affiliated Hospital of Nantong University, Nantong, China
| | - Zhenyu Li
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
- Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong, China
| | - Chen Dong
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
- Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong, China
| | - Jinjin Zhu
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong, China
| | - Ting Fu
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Jianlin Gao
- Research Center of Gerontology and Longevity, Affiliated Hospital of Nantong University, Nantong, China
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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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Baba S, Katsumata Y, Okamoto Y, Kawaguchi Y, Hanaoka M, Kawasumi H, Yamanaka H. Reliability of the SF-36 in Japanese patients with systemic lupus erythematosus and its associations with disease activity and damage: a two-consecutive year prospective study. Lupus 2017; 27:407-416. [DOI: 10.1177/0961203317725586] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We aimed to validate the reliability of the Medical Outcomes Study Short Form-36 (SF-36) among Japanese patients with systemic lupus erythematosus (SLE). Japanese patients with SLE ( n = 233) completed the SF-36 and other related demographic questionnaires, and physicians simultaneously completed the SLE Disease Activity Index 2000 (SLEDAI-2K) and the Systemic Lupus International Collaborating Clinics Damage Index (SDI). Patients were prospectively followed for a repeat assessment the following year. The SF-36 subscales demonstrated acceptable internal consistency (Cronbach’s α of 0.85–0.89), and an overall good test–retest reliability (intraclass correlation coefficient >0.70). The average baseline SF-36 subscale/summary scores except for “bodily pain” were significantly lower than those of the Japanese general population ( p < 0.05). The SDI showed an inverse correlation with the SF-36 subscale/summary scores except for “vitality” and “mental component summary” at baseline, whereas the SLEDAI-2K did not. In the second year, “social functioning” and “mental component summary” of the SF-36 deteriorated among patients whose SDI or SLEDAI-2K score increased (effect sizes < −0.20). In conclusion, the SF-36 demonstrated acceptable reliability among Japanese patients with SLE. Health-related quality of life measured by the SF-36 was reduced in Japanese patients with SLE and associated with disease damage, rather than disease activity.
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Affiliation(s)
- S Baba
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | - Y Katsumata
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | - Y Okamoto
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | - Y Kawaguchi
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | - M Hanaoka
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | - H Kawasumi
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
| | - H Yamanaka
- Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
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Shim EJ, Hahm BJ, Go DJ, Lee KM, Noh HL, Park SH, Song YW. Modeling quality of life in patients with rheumatic diseases: the role of pain catastrophizing, fear-avoidance beliefs, physical disability, and depression. Disabil Rehabil 2017; 40:1509-1516. [PMID: 28291952 DOI: 10.1080/09638288.2017.1300691] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To examine factors in the fear-avoidance model, such as pain, pain catastrophizing, fear-avoidance beliefs, physical disability, and depression and their relationships with physical and psychological quality of life in patients with rheumatic diseases. MATERIALS AND METHODS The data were obtained from 360 patients with rheumatic diseases who completed self-report measures assessing study variables. Structural equation modeling was used to examine the hypothesized relationships among factors specified in the fear-avoidance model predicting physical and psychological quality of life. RESULTS Final models fit the data well, explaining 96% and 82% of the variance in physical and psychological quality of life, respectively. Higher pain catastrophizing was related to stronger fear-avoidance beliefs that had a direct negative association with physical disability and depression, which, in turn, negatively affected physical quality of life. Pain severity was also directly related to physical disability. Physical disability also affected physical quality of life indirectly through depression. The hypothesized relationships specified in the model were also confirmed for psychological quality of life. However, physical disability had an indirect association with psychological quality of life via depression. CONCLUSION The current results underscore the significant role of cognitive, affective, and behavioral factors in perceived physical disability and their mediated detrimental effect on physical and psychological quality of life in patients with rheumatic diseases. Implications for rehabilitation The fear-avoidance model is applicable to the prediction of quality of life in patients with rheumatic diseases. As pain-catastrophizing and fear-avoidance beliefs are important factors linked to physical disability and depression, intervening these cognitive factors is necessary to improve physical function and depression in patients with rheumatic diseases. Considering the strong association between depression and physical and psychological quality of life, the assessment and treatment of the former should be included in the rehabilitation of patients with rheumatic diseases. Interventions targeting physical function and depression are likely to be effective in terms of improving physical and psychological quality of life in patients with rheumatic diseases.
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Affiliation(s)
- Eun-Jung Shim
- a Department of Psychology , Pusan National University , Busan , Republic of Korea
| | - Bong-Jin Hahm
- b Department of Neuropsychiatry , Seoul National University Hospital , Seoul , Republic of Korea.,c Department of Psychiatry and Behavioral Science , Seoul National University College of Medicine , Seoul , Republic of Korea
| | - Dong Jin Go
- d Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine , Medical Research Center, Seoul National University , Seoul , Republic of Korea.,e Department of Internal Medicine, Division of Rheumatology , Seoul National University College of Medicine , Seoul , Republic of Korea
| | - Kwang-Min Lee
- c Department of Psychiatry and Behavioral Science , Seoul National University College of Medicine , Seoul , Republic of Korea.,f Department of Psychiatry , Gyeonggi provincial Medical Center Uijeongbu Hospital , Uijeongbusi , Republic of Korea
| | - Hae Lim Noh
- a Department of Psychology , Pusan National University , Busan , Republic of Korea
| | - Seung-Hee Park
- a Department of Psychology , Pusan National University , Busan , Republic of Korea
| | - Yeong Wook Song
- d Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine , Medical Research Center, Seoul National University , Seoul , Republic of Korea.,e Department of Internal Medicine, Division of Rheumatology , Seoul National University College of Medicine , Seoul , Republic of Korea
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