title: Illness intrusiveness explains race-related quality-of-life differences among women with systemic lupus erythematosus.
abstract: Our objective was to investigate whether quality of life in systemic lupus erythematosus (SLE) differs across ethnoracial groups and to identify factors that may explain race-related differences. Self-administered questionnaire data from 335 White, 40 Black, and 30 Asian women with SLE were obtained from a multi-center database. Measures assessed illness intrusiveness, psychological well-being, depressive symptoms, musculoskeletal pain, and learned helplessness. Extent of SLE disease activity was indexed by self-reported functional-system involvement. Educational attainment was indicated by number of years in school. Principal-components analysis reduced the four psychosocial measures to a single factor score. This represented psychosocial well-being In path analysis. Psychosocial well-being differed significantly across the three groups, with Whites reporting the highest, and Blacks the lowest, levels. Path analysis indicated that illness intrusiveness accounted for this race-related difference. Although disease activity was significantly associated with psychosocial well-being, it did not differ across ethnoracial groups. Illness intrusiveness and educational attainment emerged as independent mediators of the race-related difference in psychosocial well-being. We conclude that race-related quality-of-life differences exist among women with SLE and are mediated independently by illness intrusiveness and educational attainment.
authors.affiliation: Culture, Community, and Health Studies, Centre for Addiction and Mental Health (Clarke Division), University of Toronto, and University Health Network (Princess Margaret Hospital), Toronto, Ontario, Canada. gerald_devins@camh.net
authors.forename: G M
authors.initials: GM
authors.lastname: Devins
authors.forename: S M
authors.initials: SM
authors.lastname: Edworthy
mesh_terms: D001208:Asia / Q000208:ethnology; D001294:Attitude to Health; D044383:Black People; D002170:Canada; D019992:Databases as Topic; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006380:Helplessness, Learned; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000503:physiopathology / Q000523:psychology*; D008603:Mental Health; D010146:Pain; D011788:Quality of Life; D044469:Racial Groups; D012917:Social Adjustment; D044465:White People