title: The impact of coping strategies on mental and physical well-being in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To investigate the relation of coping strategies to coping effectiveness, helplessness, and mental as well as physical well-being as indicators of quality of life.
  
  
  METHODS
  Cross-sectional international study. Coping strategies were assessed by a validated 18-item questionnaire, while coping effectiveness and helplessness were measured by numerical rating scales. The predictability of both and quality of life (SF-36) was evaluated by multiple linear regression including demographic and disease-related factors.
  
  
  RESULTS
  Four hundred thirty-four rheumatoid arthritis (RA) patients (77% female; mean age 55.96 ± 13.34 years) were included. Distancing was the coping strategy used most frequently in RA patients (mean ± SD 1.89 ± 0.78 on a scale ranging from 0 to 3). Female RA patients used coping strategies significantly more often than males, whereas age and duration of disease did not seem to influence the use of coping strategies. Cognitive reframing and active problem-solving contributed to coping effectiveness while emotional expression was related to helplessness. Coping effectiveness was positively related to general health perception, suggesting certain coping strategies to be effective in influencing the quality of life of RA patients.
  
  
  CONCLUSIONS
  Coping strategies used in RA are dependent on gender, but not on age. The use of problem-focused coping strategies may allow for an improved coping effectiveness in patients with RA, while also influencing mental and physical well-being as indicators of quality of life. Coping should therefore be considered as an important factor in determining the overall health state of patients with RA.
authors.affiliation: Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany. matthias.englbrecht@uk-erlangen.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Englbrecht
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
authors.forename: Anita
authors.initials: A
authors.lastname: DeLongis
authors.forename: Marieke
authors.initials: M
authors.lastname: Scholte-Voshaar
authors.forename: Tuulikki
authors.initials: T
authors.lastname: Sokka
authors.forename: Tore K
authors.initials: TK
authors.lastname: Kvien
authors.forename: Georg
authors.initials: G
authors.lastname: Schett
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000523:psychology*; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires