title: Psychological stress as a predictor of psychological adjustment and health status in patients with rheumatoid arthritis.
abstract: This study examined the extent to which perceived stress, social support, coping and clinical disease indicators predict physical, psychological and social adjustment in patients with rheumatoid arthritis (RA). Participants were 59 women recruited at an outpatient clinic at University College Hospital, Galway. A range of psychological measures was administered and disease status was assessed by physician ratings of joint involvement and blood assays of inflammatory indices. Findings from correlational and hierarchical regression analyses revealed a number of statistically significant relationships (p<.01). Perceived stress was a better predictor than disease severity of positive and negative emotionality. Coping explained variability on positive and negative affect. Social support was linked to level of social activity. Results demonstrated that disease status predicted illness related functioning but did not predict emotional or social adjustment. Results suggest that a cognitive behavioural intervention to facilitate patient adjustment could usefully include management of stress and its appraisal, the fostering of adaptive coping strategies and utilization of social support resources. It is concluded that improving patient adjustment to rheumatoid arthritis has implications for medical care seeking.
authors.affiliation: Department of Psychology, National University of Ireland, Galway University Rd., Galway, Ireland. ruth.curtis@nuigalway.ie
authors.forename: Ruth
authors.initials: R
authors.lastname: Curtis
authors.forename: Annmarie
authors.initials: A
authors.lastname: Groarke
authors.forename: Robert
authors.initials: R
authors.lastname: Coughlan
authors.forename: Amina
authors.initials: A
authors.lastname: Gsel
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000339:Affect; D001172:Arthritis, Rheumatoid / Q000145:classification / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D001294:Attitude to Health; D017281:Cost of Illness; D005163:Factor Analysis, Statistical; D005260:Female; D006304:Health Status; D006785:Hospitals, University; D006801:Humans; D007494:Ireland; D008603:Mental Health; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D012944:Social Support; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D016387:Women's Health