scholarly journals Need for Palliative Care in Patient with Rheumatoid Arthritis: A Cross-sectional Observational Study

2021 ◽  
Vol 27 ◽  
pp. 275-280
Author(s):  
Kiran Mahendru ◽  
Nishkarsh Gupta ◽  
Manish Soneja ◽  
Rajeev Kumar Malhotra ◽  
Vinod Kumar ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Palliative Care ◽  
Observational Study ◽  
Disease Activity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Short Form ◽  
Emotional Problem ◽  
Well Being ◽  
Cross Sectional

Objectives: Rheumatoid arthritis (RA) is a chronic disorder causing inflammation in the joints and achieving remission is often the primary goal of physicians. We evaluated the suffering from RA and assessed the need for palliative care services in these patients. Materials and Methods: This cross-sectional observational study was done in 100 adult RA cases who attended the outpatient department. The Disease Activity Score 28 (DAS28), Health Assessment Questionnaire Disability Index, depression, anxiety and stress score, Short Form 36 Health Survey and numeric rating scale were assessed. The relationship between DAS28 with the other parameters and scores was assessed using Spearman’s rho correlation coefficient. Results: About 90% of patients in our study were female and majority (50%) had a moderate disease activity. The DAS28 showed a positive correlation with the degree of depression (r = 0.671, P = 0.000), anxiety (r = 0.609, P = 0.000) and stress levels (r = 0.474, P = 0.000). The patients with severe disease had a poor quality of life (QoL) [physical functioning (r = –0.737, P = 0.000); role limitation (r = –0.662, P = 0.000); emotional problem (r = –0.676, P = 0.000); energy/fatigue (r = –0.638, P = 0.000); social functioning (r = –0.658, P = 0.000); emotional well-being (r = –0.605, P = 0.000); general health (r = –0.643, P = 0.000); health change (r = –0.376, P = 0.000) and numerical rating scale score for pain (r = 0.656, P = 0.000)]. Conclusion: RA patients with high disease activity suffer from depression, anxiety, stress and poor QoL. Palliative care physicians and rheumatologists must be vested with the power to provide comprehensive care to these patients.

scholarly journals Impact of clinical and psychological factors associated with depression in patients with rheumatoid arthritis: comparative study between Germany and Brazil

2020 ◽  
Author(s):  
Harriet Morf ◽  
Geraldo da Rocha Castelar-Pinheiro ◽  
Ana Beatriz Vargas-Santos ◽  
Christoph Baerwald ◽  
Olga Seifert
Keyword(s):  
Rheumatoid Arthritis ◽  
Depressive Symptoms ◽  
Disease Activity ◽  
Psychological Factors ◽  
Short Form ◽  
Statistical Significance ◽  
Well Being ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Pain Status

Abstract Objective To investigate the prevalence of depressive symptoms and its association with clinical and psychological factors in patients with rheumatoid arthritis (RA) in Germany and in Brazil. Method A convenience sample of 267 RA patients, 176 from Germany (age 62.4 ± 12.3 years) and 91 from Brazil (age 56.3 ± 12.6 years), was used in this cross-sectional study. The following questionnaires were used: Beck Depression Inventory (BDI), painDETECT test, Perceived Stress Questionnaire, fatigue questionnaire (FACIT), Health Assessment Questionnaire Disability Index (HAQ-DI), and the SF–36 questionnaires (Short-Form 36 Health Survey). Disease activity score (DAS 28-CRP) and visual analogue scale (VAS) for pain were also evaluated. Statistical analysis is based on comparison of means and proportions. Statistical significance for non-normal data was evaluated by non-parametrical tests. Results Depressive symptoms were more prevalent in the Brazilian sample (44% vs 22.9%, p = 0.025). Compared to German patients, the Brazilian ones also experienced more pain (current pain status on VAS: 4.67 ± 3.4 vs 3.67 ± 2.31 respectively, p < 0.01), were physically more limited (1.89 ± 1.85 vs 1.01 ± 0.75, p = 0.012), and had higher C-reactive protein levels (7.78 ± 18.3 vs 5.82 ± 10.45, p = 0.028). Despite receiving a more intensive treatment, German patients presented similar disease activity when compared to Brazilian patients (DAS28-CRP: Brazil 3.4 ± 1.5 vs Germany 3.3 ± 1.3, p = 0.307). Conclusion Depressive symptoms are frequent in RA patients from different countries and interact with psychological disorders and the experience of pain. They contribute negatively to their well-being suggesting the need for psychoeducational strategies. Key Points• New psychoeducational strategies for RA management.• Higher inflammation marker in rheumatoid arthritis patients is associated with depression.• Medical treatment in RA influences depressive symptoms.• Depressive symptoms are dependent on population group.• High disease activity is related to depression.

scholarly journals An observational study on quality of life and preferences to sustain life in locked-in state

Neurology ◽  
2019 ◽  
Vol 93 (10) ◽  
pp. e938-e945 ◽  
Author(s):  
Magdalena Kuzma-Kozakiewicz ◽  
Peter M. Andersen ◽  
Katarzyna Ciecwierska ◽  
Cynthia Vázquez ◽  
Olga Helczyk ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Observational Study ◽  
Physical Function ◽  
Rating Scale ◽  
Well Being ◽  
Psychosocial Adaptation ◽  
Subjective Well Being ◽  
Cross Sectional ◽  
Hastened Death

ObjectiveThis is an observational study on well-being and end-of-life preferences in patients with amyotrophic lateral sclerosis (ALS) in the locked-in state (LIS) in a Polish sample within the EU Joint Programme–Neurodegenerative Disease Research study NEEDSinALS (NEEDSinALS.com).MethodsIn this cross-sectional study, patients with ALS in LIS (n = 19) were interviewed on well-being (quality of life, depression) as a measure of psychosocial adaptation, coping mechanisms, and preferences towards life-sustaining treatments (ventilation, percutaneous endoscopic gastroscopy) and hastened death. Also, clinical data were recorded (ALS Functional Rating Scale–revised version). Standardized questionnaires (Anamnestic Comparative Self-Assessment [ACSA], Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW), ALS Depression Inventory–12 items [ADI-12], schedule of attitudes toward hastened death [SAHD], Motor Neuron Disease Coping Scale) were used, which were digitally transcribed; answers were provided via eye-tracking control. In addition, caregivers were asked to judge patients' well-being.ResultsThe majority of patients had an ACSA score >0 and a SEIQoL score >50% (indicating positive quality of life) and ADI-12 <29 (indicating no clinically relevant depression). Physical function did not reflect subjective well-being; even more, those with no residual physical function had a positive well-being. All patients would again choose the life-sustaining techniques they currently used and their wish for hastened death was low (SAHD <10). Caregivers significantly underestimated patient's well-being.InterpretationSome patients with ALS in LIS maintain a high sense of well-being despite severe physical restrictions. They are content with their life-sustaining treatments and have a strong will to live, which both may be underestimated by their families and public opinion.

scholarly journals IMPACT OF DIFFERENT LEVELS OF DISEASE ACTIVITY IN PAINFUL PROFILE AND QUALITY OF LIFE IN PEOPLE WITH RHEUMATOID ARTHRITIS

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Selena Márcia Dubois Mendes ◽  
Bárbara Liliane Lôbo Queiroz ◽  
Larissa Vieira Santana ◽  
Abrahão Fontes Baptista ◽  
Mittermayer Barreto Santiago ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Pain Perception ◽  
Short Form ◽  
Care Service ◽  
Cross Sectional ◽  
Sf 36 ◽  
Different Levels

Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disease with impact on increasing the morbidity and mortality rates. Different levels of disease activity (LDA) have been established, however, its impact on pain and quality of life have yet to be been evidenced. The aim of this study was to evaluate the relationship of different levels of disease activity on the painful profile and quality of life (QOL) of patients diagnosed with RA. This was a cross-sectional study, conducted in RA patients attending an Educational Outpatient Care Service in Salvador, Bahia, Brazil. The LDA was defined according to values of Erythrocyte Sedimentation Rate (ESR), Visual Analog Scale (VAS), and number of swollen and sore joints, according to the Disease Activity Score in 28 joints (DAS28). Types of pain were assessed using the Douleur Neuropathique en 4 questions (DN4). To evaluate QOL, the Short Form (36) Health Survey (SF-36) and Health Assessment Questionnaire (HAQ) were applied. The association between LDA, QOL and painful profile was verified using One Way-ANOVA and Bonferroni correction post-test. A high LAD was observed in 67.7% of the 96 patients  evaluated in this study. Pain sensation was reported by 94.8 % of participants with 40.6 % reporting it as nociceptive and 80.2% as intense. It was also observed that the higher LAD found the higher was the pain intensity reported (p=0.001) and lower QOL scores (p<0.001). Although the LDA did not correlate with the type of pain (p=0.611), it was correlated with the total score obtained in the QOL from the HAQ (p=0.001). The greatest impact on QOL evaluated through the SF-36 were physical (p<0.001) and functional capacity (p<0.001). In conclusion, RA patients who had high LDA reported more severe pain perception and obtained the lowest scores in the assessment of quality of life.

scholarly journals Sex Differences in the Effects of a Biological Drug for Rheumatoid Arthritis on Depressive State

2015 ◽  
Vol 9 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Takahiro Tokunaga ◽  
Yusuke Miwa ◽  
Airi Nishimi ◽  
Shinichiro Nishimi ◽  
Mayu Saito ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Sex Differences ◽  
Disease Activity ◽  
Rating Scale ◽  
Activity Index ◽  
Short Form ◽  
Depressive State ◽  
Biological Drug ◽  
Female Patients ◽  
Sf 36

Objective : Sex-specific medicine has attracted attention in recent years, but no report on rheumatoid arthritis (RA) has examined sex differences in the effectiveness of biologics on activities of daily living (ADL), quality of life (QOL), or depressive state. Methods : The study subjects were 161 RA patients (female: 138; male: 23) attending regular doctor visits at our hospital. We compared the changes in disease activity, which was evaluated using the simplified disease activity index (SDAI), ADL (using the modified health assessment questionnaire; mHAQ), QOL (using short form-36; SF-36), and the Hamilton Depression Rating Scale (HAM-D) for RA patients between each sex over a six-month observation period while administering biologic treatment. Results : The female patients reported significant improvements in the following metrics: SDAI: from 22.1 ± 11.9 to 8.9 ± 7.8 (p < 0.001); mHAQ: from 0.46 ± 0.50 to 0.32 ± 0.45 (p < 0.001); and HAM-D: from 6.2 ± 4.8 to 3.8 ± 4.1 (p < 0.001). Moreover, all eight items of the SF-36 were significantly improved (p < 0.01). In contrast, the male patients improved on the SDAI (from 27.9 ± 11.7 to 12.7 ± 8.6 (p < 0.001)), but we did not observe significant improvements in the mHAQ or HAM-D scores or in any items on the SF-36. Conclusion : Both male and female patients with RA improved when using a biological drug. Sex differences in the improvement of depressive state were observed.

scholarly journals Prevalence of Pruritus in Cutaneous Lupus Erythematosus: Brief Report of a Multicenter, Multinational Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Dominik Samotij ◽  
Justyna Szczęch ◽  
Carolyn J. Kushner ◽  
Mohammad Rafiqul Mowla ◽  
Aleksandra Dańczak-Pazdrowska ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Clinical Characteristics ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Cutaneous Lupus Erythematosus ◽  
Connective Tissue Diseases ◽  
Well Being ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Pruritus is an important symptom frequently accompanying various inflammatory skin conditions. Some recent data have indicated that it may also be associated with autoimmune connective tissue diseases, including systemic sclerosis and dermatomyositis; however, studies on the prevalence and clinical characteristics of pruritus in CLE are limited. We have performed a multinational, prospective, cross-sectional study in order to assess the prevalence and intensity of pruritus in adult patients suffering from various subtypes of CLE. After developing a questionnaire assessing various aspects of pruritus, we have surveyed 567 patients with cutaneous involvement during the course of LE regarding the presence and intensity of pruritus. Pruritus was present in 425 of all patients (75.0%) and was most frequently reported by subjects with acute CLE (82.1%), followed by chronic CLE (78.8%), subacute CLE (65.9%), and intermittent CLE (55.6%) (p<0.001). Based on the Numerical Rating Scale, the severity of itch was mild, moderate, and severe in 264 (62.1%), 98 (23.1%), and 63 (14.8%) patients, respectively. The highest mean pruritus intensity was reported by subjects with hypertrophic LE (5.1±3.0 points) followed by generalized discoid LE (3.6±3.0 points), subacute CLE (3.0±3.0 points), chilblain LE (3.0±1.0 points), localized discoid LE (2.6±2.0 points), intermittent CLE (2.6±3.0 points), acute CLE (2.5±1.2 points), and lupus erythematosus profundus (1.9±2.7 points). In conclusion, pruritus is a frequent phenomenon in CLE; however, in most patients it is of mild severity. Further studies are needed to better characterize its clinical characteristics and influence on patients’ well-being.

scholarly journals High Burden of Sexual Dysfunction in Female Patients with Rheumatoid Arthritis: Results of a Cross-sectional Study

2018 ◽  
Vol 46 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Rudolf Puchner ◽  
Judith Sautner ◽  
Johann Gruber ◽  
Elia Bragagna ◽  
Andrea Trenkler ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Sexual Dysfunction ◽  
Disease Activity ◽  
Sexual Functioning ◽  
Activity Index ◽  
Short Form ◽  
Health Assessment ◽  
Disease Activity Index ◽  
Cross Sectional ◽  
Female Patients

Objective.To evaluate the effect of rheumatoid arthritis (RA) on impairing women’s sexuality regarding motivation, activity, and satisfaction, and to assess the correlation of disease-related physical impairment within sexual functioning.Methods.An anonymous survey among women with RA and healthy controls (HC) using standardized questionnaires, predominantly the Changes in Sexual Functioning Questionnaire-short form (CSFQ-14). In addition, disease activity, depression, and disability were evaluated.Results.There were 319 questionnaires distributed to patients and 306 to HC. Of these, 235 patient questionnaires (73.7%) and 180 HC questionnaires (58.8%) were returned, of which 203 and 169 were completed, respectively. Of the patients with RA, 47.8% had a total CSFQ-14 score of ≤ 41, indicating female sexual dysfunction (FSD), as compared to 14.2% of HC (p < 0.0001). The median CSFQ-14 score was lower in patients with RA [42 points, interquartile range (IQR) 36–48] than in HC (49 points, IQR 44–54; p < 0.0001), resulting in an OR of 5.53 (95% CI 3.19–9.57; p < 0.0001). After adjustment for confounders, given a higher mean age of patients (55.2 ± 11.3 yrs) than HC (47.4 ± 11.8 yrs; p < 0.0001), the OR for FSD in patients with RA was still 3.04 (95% CI 1.61–5.75; p = 0.001). Neither the Health Assessment Questionnaire–Disability Index nor the Clinical Disease Activity Index was associated with FSD after adjustment.Conclusion.FSD apparently is highly prevalent in female patients with RA, affects all subdomains of sexual function, and is most likely underestimated in daily clinical practice. Of note, FSD could not be linked to disability or RA disease activity.

scholarly journals Validity and reliability of the EULAR instrument RAID.7 as a tool to assess individual domains of impact of disease in rheumatoid arthritis: a cross-sectional study of 671 patients

RMD Open ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e001539
Author(s):  
Catia Duarte ◽  
Eduardo José Ferreira Santos ◽  
Ricardo J O Ferreira ◽  
Tore K Kvien ◽  
Maxime Dougados ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Sleep Disturbance ◽  
Rating Scale ◽  
Intraclass Correlation ◽  
Well Being ◽  
Validity And Reliability ◽  
Open Label ◽  
Cross Sectional ◽  
Data Set ◽  
Disease Impact

ObjectiveThe rheumatoid arthritis impact of disease (RAID) questionnaire comprises seven patient-important domains of disease impact (pain, function, fatigue, sleep disturbance, emotional well-being, physical well-being, coping). RAID was validated as a pooled-weighted score. Its seven individual items separately could provide a valuable tool in clinical practice to guide interventions targeting the patient’s experience of the disease. The aim was to separately assess the psychometric properties of each of the seven numeric rating scale (NRS) of the RAID (RAID.7).Material and methodsPost hoc analyses of data from the cross-sectional RAID study and from the Rainbow study, an open-label 12-week trial of etanercept in patients with RA. Construct validity of each NRS was assessed cross-sectionally in the RAID data set by Spearman’s correlation with the respective external instrument of reference. Using the rainbow data set, we assessed reliability through intraclass correlation coefficient between the screening and the baseline visits and responsiveness (sensitivity to change) by standardised response mean between baseline and 12 weeks.ResultsA total of 671 patients with RA with features of established disease were analysed, 563 and 108 from RAID and Rainbow, respectively. The NRS correlated moderately to strongly with the respective external instrument of reference (r=0.62–0.81). Reliability ranged from 0.64 (0.51–0.74) (pain) to 0.83 (0.76–0.88) (sleep disturbance) and responsiveness from 0.93 (0.73–1.13) (sleep disturbance) to 1.34 (1.01–1.64) (pain).ConclusionThe separate use of the individual NRS of RAID (RAID.7) is valid, feasible, reliable and sensitive to change, representing an opportunity to improve the assessment and treatment of disease impact with minimal questionnaire burden.Trial registration numberNCT00768053.

scholarly journals POS0577 EVALUATION OF COPING STRATEGIES IN RHEUMATOID ARTHRITIS PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 522.2-522
Author(s):  
B. A. Hiba ◽  
S. Meriem ◽  
S. Miladi ◽  
F. Alia ◽  
S. Leila ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Coping Strategies ◽  
Short Form ◽  
Well Being ◽  
Active Coping ◽  
Avoidant Coping ◽  
Cross Sectional ◽  
Brief Cope ◽  
Approach Coping ◽  
Disease Specific

Background:Studies have shown that the association of pain, stiffness, disability, and social restrictions in rheumatoid arthritis (RA) patients induce a significantly increased level of depressed mood and stress. The use of favorable coping strategies could lead to improve physical and psychological well-being.Objectives:To evaluate coping strategies of RA patients and their associations with health-related quality of life (HRQoL) outcomes.Methods:A cross-sectional sample of patients with established RA was evaluated using measures of coping: the Brief-COPE (scores presented for the two overarching coping styles: Approach coping including active coping, emotional support, use of informational support, positive reframing, planning and acceptance, and Avoidant coping including self-distraction, denial, substance use, behavioral disengagement, venting and self-blame), the HRQoL (Mental and Physical Components [MCS/PCS] of the Short Form 12), and the Rheumatoid Arthritis Impact of Disease score (RAID]. Multiple linear regression analyses were performed to evaluate the associations between coping strategies and HRQoL outcomes.Results:The study sample comprised 45 patients with a female predominance (91.9 %), and a mean age of 55.7± 9.9 years [38-77]. The median disease duration was 10 years [38-77]. The majority of patients (82.8 %) were positive for either rheumatoid factor or anti-CCP. Half of the patients were on biological disease-modifying antirheumatic drugs. Two active coping strategies were identified: Approach coping (E = 4.29) and Avoidant Coping (E=3.86), which explained 40% of the total variance. Mean RAID was 4.8± 1.6, while the mean PCS and MCS were 31.9 ± 9.4 and 39.7 ± 9.4, respectively. Approach coping and avoidant coping were associated with PCS (r= 0.4, p = 0.03), (r=0.3, p=0.008) respectively. However, no association was found between coping strategies and MCS or RAID (p>0.05). In the multivariate model, approach coping and avoidant coping were significant to explain lower disease-specific HRQoL (PCS) (Beta= 0.4, p= 0.008), (Beta=0.3, p=0.02) respectively.Conclusion:Approach and avoidance are associated with lower disease-specific HRQoL (PCS) but not with lower disease-specific HRQoL (MCS). Doctors should not forget to help their patients developing adaptive coping strategies.Disclosure of Interests:None declared

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