An Integrative Review of the LupusQoL Measure

2020 ◽  
Vol 28 (2) ◽  
pp. E139-E174
Author(s):  
Pamela Coombs Delis ◽  
Jacqueline Dowling

Background and PurposeSystemic Lupus Erythematosus negatively affects health related quality of life (HRQOL). The purpose of this review is to synthesize and evaluate findings related to the psychometric properties of the LupusQoL and its variations.MethodsA search of CINAHL, PubMed, and Medline for the timeframe of 2007–2019 for English-language articles using any form of the LupusQoL was completed. Thirty-five studies were reviewed to determine psychometric soundness.ResultsCronbach alpha results supported the internal consistency with test–retest data supporting stability. Factor structure and Scree plots varied. Content, construct, criterion, convergent, and discriminate validity were supported. Ceiling and floor effects occurred.ConclusionsThe LupusQoL and its variations offer a disease-specific measure with supported reliability and validity for use in culturally disparate populations. Factor structure and ceiling/floor effects need further edification.

2020 ◽  
Vol 103 (11) ◽  
pp. 1185-1193

Background: The systemic lupus erythematosus (SLE) patients oftentimes suffer from both physical and psychosocial challenges that may lead to low health-related quality of life (HRQoL). However, limited research has been done in this area. Objective: To examined mental health status and HRQoL among SLE patients in Thailand. Materials and Methods: The present study was a cross-sectional study conducted at the rheumatology clinic of four major hospitals in Thailand. The paper-based questionnaire consisted of demographic, health history such as depression, anxiety, stress Scale (DASS-21), and the Rosenberg self-esteem scale (RSE), and the disease-specific Lupus Quality of Life scale (LupusQoL). Depending on the variable’s level of measurement such as categorical or continuous, Spearman’s Rho or Pearson’s product moment correlation coefficients were used to explore the relationships among the variables. Hierarchical multiple regression was used to identify the predictors of LupusQoL. Results: Among the 387 participants, many might have experienced depression, anxiety, and stress (30%, 51%, and 29%, respectively). Self-esteem among the participants was good (31.8 out of 40). All eight domains of LupusQoL were affected with intimate relationship domain being impacted the most. The overall LupusQoL was significantly associated with the number of prescribed medications (r=–0.23), depression (r=–0.70), anxiety (r=–0.58), stress (r=–0.67), and self-esteem (r=0.59), p<0.001. Significant predictors of the overall LupusQoL were mental health status (depression, anxiety, and stress) and self-esteem, F (3, 81)=43.10, p<0.001, adjusted R²=0.60. Conclusion: SLE patients should be holistically assessed in both physical and psychological aspects. In addition to proper medical treatments, healthcare providers should use a multidisciplinary team approach to resolve the patients’ psychosocial issues, which in turn, may increase the patients’ quality of life. Self-care education may be necessary to help the patients manage the condition and decrease the number of medications. Keywords: Mental health, Quality of life, SLE, Thailand


2017 ◽  
Vol 26 (7) ◽  
pp. 1767-1775 ◽  
Author(s):  
Benjamin Chaigne ◽  
◽  
Axel Finckh ◽  
Deshire Alpizar-Rodriguez ◽  
Delphine Courvoisier ◽  
...  

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 668-669
Author(s):  
A. Gomez ◽  
F. H. Butrus ◽  
P. Johansson ◽  
E. Åkerström ◽  
S. Soukka ◽  
...  

Background:Patients with systemic lupus erythematosus (SLE) experience a considerably impaired health-related quality of life (HRQoL) compared with the general population. Previous literature has implied an association between high body mass index (BMI) and HRQoL diminutions. However, data are scarce and further exploration in large study populations and, importantly, with regard to the clinical significance of this association is needed.Objectives:The aim of this study was to determine whether overweight and/or obesity were associated with impaired physical and/or mental HRQoL aspects in the SLE population of two large clinical trials.Methods:We utilised pooled baseline data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) clinical trials of belimumab (N=1684). Access to data was granted by GlaxoSmithKline. The patients were stratified into four groups based on their body mass index (BMI), according to WHO guidelines. We conducted comparisons between non-overweight versus overweight, and non-obese versus obese SLE patients. HRQoL was self-reported using the Medical Outcomes Study (MOS) short form 36 (SF-36) health survey, the functional assessment of chronic illness therapy (FACIT)-Fatigue scale and the three-level EuroQol- 5 Dimension (EQ-5D) questionnaire. We explored whether the differences in scores were clinically meaningful using previously determined thresholds for minimal clinically important differences (MCIDs). The non-parametric Mann-Whitney U test was used for comparisons between different BMI groups. Linear regression analysis was next applied to test independence in multivariable models, adjusting for age, sex, ethnicity, disease duration, disease activity, organ damage and standard of care treatment.Results:Forty-four per cent (44%) of the patients had a BMI score over the normal range, and 18% were obese. The overweight group performed worse than the non-overweight with regard to FACIT-Fatigue scores (mean ± standard deviation: 27.7 ± 12.1 vs 32.0 ± 11.3; P<0.001), EQ-5D score (0.70 ± 0.19 vs 0.76 ± 0.18; P<0.001) and all SF-36 subscales and component summaries. The differences were greater than the MCIDs for physical component summary (PCS) scores (36.9 ± 9.3 vs 40.8 ± 9.6; P<0.001), physical functioning (53.3 ± 25.1 vs 63.6 ± 25-1; P<0.001), role physical (48.0 ± 27.1 vs 55.6 ± 26.9; P<0.001), bodily pain (43.8 ± 22.4 vs 52.5 ± 25.1; P<0.001), vitality (39.6 ± 21.7 vs 46.6 ± 21.3; P<0.001), and social functioning scores (55.8 ± 25.2 vs 62.6 ± 25.2; P<0.001). Likewise, obese patients reported worse FACIT-Fatigue scores (25.7 ± 11.9 vs 31.1 ± 11.6; P<0.001), EQ-5D scores (0.68 ± 0.20 vs 0.75 ± 0.18; P<0.001) and clinically important diminutions of HRQoL in all SF-36 items, except for the mental component summary (MCS), role emotional and mental health.In multivariable linear regression analysis, the overweight and obese group showed worse PCS scores (standardised coefficient: β=-0.09; P<0.001 and β=-0.13; P<0.001, respectively) and FACIT-Fatigue scores (β=-0.11; P<0.001 and β=-0.10; P<0.001, respectively), and overweight patients had significantly impaired MCS scores (β=-0.05; P=0.039), irrespective of other factors. High disease activity and organ damage were associated with impaired HRQoL in all aspects, while Asian patients reported better PCS scores (and β=0.29; P=0.007) and FACIT-Fatigue scores (β=0.33; P=0.002).Conclusion:BMI above normal was highly associated with HRQoL impairment, especially in physical aspects. Further survey to examine causality is warranted to support structured weight control strategies as an intervention towards a more favourable HRQoL.Disclosure of Interests:None declared


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