Psychosocial factors and health status in women with rheumatoid arthritis: predictive models.
BACKGROUND
Health status, and consequently productivity and quality of life, depends on a multitude of factors. Numerous psychosocial factors have been associated with the concurrent health status of individuals with chronic disease. Previous studies have examined the relationship between singular psychosocial factors and health status in rheumatoid arthritis. This study evaluated the simultaneous interrelationships among selected psychosocial variable and health outcomes using data from a study of younger women diagnosed with rheumatoid arthritis (RA).


METHODS
The hypothesized models were examined using data from a survey of 185 women with a mean age of 43 years, diagnosed with RA for an average of 6.6 years. Participants in the study completed the following measures: (1) Arthritis Impact Measurement Scales, (2) Multidimensional Pain Inventory, (3) Daily Hassles Scale, (4) Interpersonal Support Evaluation List, and (5) Perceived Self-Efficacy Scale.


RESULTS
Using path analysis, the information provided by the LISREL program, and extant theory, two models were tested. The data provided support for all but two of the hypothesized relationships in the model predicting physical functioning. Pain severity and self-efficacy emerged as important variables in understanding individual variations in perceived physical functioning. In the second model, using perceived well-being as the outcome, two bidirectional relationships were noted: one between affective distress and social support, and the second between perceived well-being and daily stress.


CONCLUSIONS
The models evaluated in this study support the provision of multifaceted interventions aimed at enhancing a woman's ability to manage her pain and stress while also enhancing her beliefs in her own abilities.
Dwyer
K A
KA
School of Nursing, Vanderbilt University, Nashville, TN 37240, USA. kathy.dwyer@mcmail
D000203:Activities of Daily Living; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000523:psychology*; D002908:Chronic Disease; D005069:Evaluation Studies as Topic; D005260:Female; D006304:Health Status; D006801:Humans; D008960:Models, Psychological; D010146:Pain / Q000150:complications / Q000523:psychology; D013714:Tennessee