scholarly journals Quality of Life, Social Support, Coping Strategies, and Psychiatric Morbidity in Patients with Rheumatoid Arthritis

Author(s):  
Naresh Nebhinani ◽  
Surendra Kumar Mattoo ◽  
Ajay Wanchu

Abstract Background and Objectives Patients with rheumatoid arthritis (RA) have greater psychological morbidity, despite that research in this area is scarce from developing countries. This study was aimed to assess the association of quality of life, social support, coping strategies, and psychological morbidity in patients with RA. Materials and Methods In this cross-sectional study, 40 patients with RA, who were not receiving steroids or disease modifying antirheumatic drugs, were recruited through purposive sampling. Social support questionnaire, coping strategy check list, and World Health Organization quality of life-BREF (WHOQOL-BREF) were administered to assess social support, coping, and quality of life, respectively. Results More than half of the patients had psychiatric disorders (60%), with depression being the commonest disorder (52.5%). Internalization coping and disease severity indicators like tender joints counts, swollen joints counts, pain, and disease activity were found as significant predictors for psychiatric disorders, while externalization coping, quality of life (all domains), and physical functions were found to protect against psychiatric morbidity. Conclusions Coping, quality of life, disease severity, and physical functions predicted the psychiatric disorders in RA. Multipronged interventions to enhance quality of life with promoting adaptive coping and timely treatment may further improve their mental health and overall disease course.

Author(s):  
Marta Castro ◽  
Isabela Freitas ◽  
Sofia Sarmento ◽  
Flávio Teixeira ◽  
Rosália Coelho ◽  
...  

Introduction: High rates of survival in Congenital Heart Disease (CHD) allowed patients to face different challenges in life cycle, and made the topics on adjustment and quality of life more and more central in healthcare. Hypothesis: We tested the hypothesis that CHD has a negative impact over psychosocial adjustment, psychiatric morbidity, quality of life and school performance, and that the severity of disease and the number of surgeries increase the negative impact over adjustment and the social support generates a buffer, good effect on it. Objective: We aimed to study Quality of Life (QOL), Psychosocial Adjustment (PSA), Psychiatric Morbidity, School Performance, Physical Limitations, and Social Support of adolescents and young adults with CHD. Methods: We evaluated 110 CHD patients, 62 males, aged from 12 to 26 years old (M=18.00 ± 3.62), 58 cyanotic. The participants were interviewed on such topics as social support, family/educational background, self-image, physical limitations and emotional adjustment, were administered a standardized psychiatric interview (SADS-L) and completed self-report questionnaires on QOL (WHOQOL-BREF) and PSA (YSR and ASR). Observational versions of the same questionnaires (CBCL, ABCL) were filled by one of their relatives. Full clinical and demographic history was collected. Results: We found a 22% rate of lifetime prevalence of psychopathology (14.5% in males and 31.3% in females) and 50% of school retentions (M=1.50 years + 0.50). Patients with severe forms of CHD showed worse PSA than those with moderate and mild forms of illness (internalization: u=939.000; p=0.030), the cyanotic versus acyanotic and those with moderate-to-severe residual lesions versus mild ones have worse QOL on physical dimension; those submitted to surgery showed worse QOL on physical (t=-2.525; p=0.013), psychological (t=-2.394; p=0,018), social relationships (t=-2.502; p=0,014) and general (u=1294,000; p=0.006) dimensions, and worse PSA (more withdrawn: u=719,000; p=0,037). Social support has a great impact improving patients’ physical (t=2.707; p=0,008), psychological (t= 2.755; p=0.007), social relationships (t=4.976; p=0,000), environment (t=3.085; p=0,003) and general (u=623.500; p=0,000) QOL and poorer social support resulted in more withdrawn (u=557.500; p=0.000) and social problems (u=748.500; p=0,023). Patients with more physical limitations showed worse physical (t=-2.093; p=0,039), psychological (t=-2.674; p=0.009) and general (u=971.500; p=0,002) QOL and more withdrawn (u=1023.000; p=0,015). Female patients showed more somatic complaints (u=260.000;p=0,011), anxiety/ depression (u=984.000;p=0,002), aggressive behavior (u=920.500;p=0,001), thought problems (u=1069.500;p=0,010), internalization (u=869.000;p=0,000) and externalization (u=1163.000; p=0,050). Good performance in school also showed a significant impact incrementing QOL and PSA. Conclusion: We concluded that we should set a special emphasis in maximizing social support and improving school performance, when supplying care in CHD, as they have a positive impact over self-confidence of patients and life adjustment.


1993 ◽  
Vol 20 (2-3) ◽  
pp. 101-120 ◽  
Author(s):  
Boudien Krol ◽  
Robbert Sanderman ◽  
Theo P.B.M. Suurmeijer

2014 ◽  
Vol 13 (3) ◽  
pp. 517-525 ◽  
Author(s):  
Daniela B. Sorato ◽  
Flávia L. Osório

AbstractObjective:To assess hopelessness, anxiety, depression, and quality of life in cancer patients undergoing palliative treatment by comparing their scores at the onset of treatment and one month later and by assessing possible correlations with coping strategies.Method:Participants included 85 patients of both genders (56.5% female) diagnosed with advanced cancer who did not have curative therapeutic options who were assessed with self-applied instruments (the Beck Hopelessness Scale, the European Organization for the Research and Treatment of Cancer Quality of Life Core Questionnaire–Cancer 30, the Hospital Anxiety and Depression Scale, and the Coping Strategies Inventory by Folkman and Lazarus) at two timepoints: first before their appointment with doctors and other professionals in their first visit to the palliative care outpatient clinic (PCOC) and then as soon as patients arrived at the PCOC for their first medical follow-up visit (approximately 30 days after the first appointment).Results:The scores for hopelessness, anxiety, and depression remained stable (p = 0.24). The results were the same for the quality-of-life (QoL) variables, except for the fatigue and pain scores, which decreased (p = 0.01), and social impairment, which increased (p = 0.03). Analysis of the correlations between the coping mechanisms used after the onset of palliative treatment showed that confronting coping, seeking social support, and positive reappraisal were inversely correlated with hopelessness. Seeking social support, planful problem solving, and positive reappraisal were inversely correlated with indicators of depression. In contrast, use of the escape–avoidance strategy and reduced use of the planful problem-solving strategy were associated with increased anxiety.Significance of results:The employment of problem-focused coping strategies exerted a positive impact on the end-of-life process and, above all, protected patients from the negative experiences associated with psychiatric symptoms, thus enabling them to look for alternative solutions for experiencing the end-of-life process in a more well-adjusted manner.


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