[The quality of life of patients who suffer from rheumatoid arthritis in reference to their physical fitness and mental state].
BACKGROUND
A chronic inflammation leads to joints deformations, which in consequence results in disability and decrease in quality of life. In the 1960s, the evaluation of the treatment of patients with chronic disease started to include quality of life.


OBJECTIVE
to evaluate quality of life in patients with rheumatoid arthritis (RA) on the basis of chosen questionnaires; to determine the usefulness of chosen questionnaires in assessing quality of life of patients suffering from rheumatoid arthritis; to investigate whether quality of life of patients with rheumatoid arthritis depends on radiological and functional stage of disease, its duration, their age, sex and activity of the disease.


METHODS
The study involved RA patients treated in the Department ofRheumatology and Rheumatologic Outpatient Clinic SPSK-1 in Szczecin. Patients' quality of life was evaluated with following questionnaires: Medical Outcomes Study 36-Item Short Form (SF-36), the Health Assessment Questionnaire (HAQ) and Arthritis Impact Measurement Scale (AIMS). The quality and understanding of all scales were tested with Cronbach test for reliability. The results were statistically analyzed using Spearman test, the chi2 test or the chi2 test with Yates' correction, Kruskal-Wallis test and analysis of variance and covariance. The study group consisted of 155 RA patients (117 females and 38 males). No significant differences were found between males and females in age and in degree of radiological changes.


RESULTS
The value of alpha-Cronbach's reliability factor accounted 0.99, 0.93, 0.81 in AIMS, HAQ and SF-36 questionnaires respectively. There were significant correlations between questionnaires and their scales, particularly in regard to physical fitness. The correlation between HAQ score and AIMS Physical Functioning scales in total and SF Physical Functioning accounted 0.78 and 0.67 (p < 0.001) respectively. No differences in evaluation of quality of life between men and women were found. No correlation was found between both the duration of RA and the age of patients and the activity of the disease as measured with DAS 28 indicator; correlation coefficient accounted 0.07 (p = 0.39) and 0.11 (p = 0.16) respectively. However, older subjects with longer duration of a disease and more active inflammatory process assessed their quality of life as poorer (correlation coefficient between DAS 28 and HAQ, AIMS Physical Functioning scales in total, SF-36 Physical Functioning accounted = 0.44, 0.43, -0.41 respectively; p = 0.0000. In addition, the radiological and functional stage of disease influenced essentially the assessment of the quality of life in examined group.


CONCLUSIONS
1. The questionnaires used in the study: HAQ, AIMS and SF-36 were highly useful and they mutually correlated significantly in assessing quality of life of patients suffering from rheumatoid arthritis. 2. High mutual correlation of the questionnaires assessing Quality of Life of RA patients, that was found in the study, indicates, that each of them could be interchangeably used in everyday medical practice. 3. Quality of life of rheumatoid arthritis patients depends on: radiological and functional stage of the disease, its duration and activity.
Klinika Reumatologii Pomorskiej Akademii Medycznej w Szczecinie, Szczecin.
Krzysztof
K
Prajs
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D011788:Quality of Life; D011859:Radiography; D011795:Surveys and Questionnaires; D016896:Treatment Outcome