title: Association between helplessness, disability, and disease activity with health-related quality of life among rheumatoid arthritis patients in a multiethnic Asian population.
abstract: To investigate the association between helplessness, disability, and disease activity with health-related quality of life (HRQoL) in a multiethnic cohort of rheumatoid arthritis (RA) patients in Singapore. This cross-sectional study was conducted at Tan Tock Seng Hospital, Department of Rheumatology, Allergy and Immunology, from October 2010 to October 2011. All patients fulfilled the American College of Rheumatology 1987 criteria for RA. Socio-demographics, clinical, and patient-reported outcome (PRO) variables were collected. HRQoL outcomes were Short Form 36 (SF-36) physical and mental component summary (PCS and MCS) scores and Short Form 6 Dimensions (SF-6D) utilities. Stepwise multiple linear regression analyses were performed using HRQoL outcomes as dependent variables in separate models and with adjustment for helplessness (Rheumatology Attitudes Index, RAI), disability (Health Assessment Questionnaire, HAQ), and disease activity (Disease Activity in 28 joints) followed by socio-demographic, clinical, and PRO variables. Complete data were provided by 473 consenting subjects [mean (SD) age: 60.02 (11.04) years, 85 % female, 77 % Chinese]. After adjustment for all measured covariates, only RAI and HAQ scores remained significantly associated with SF-36 MCS (β: -0.9, p < 0.001; β: -7.0, p < 0.001) and SF-6D utilities (β: -0.005, p < 0.001; β: -0.081, p < 0.001), respectively, while only HAQ scores were significantly associated with SF-36 PCS (β: -7.7, p < 0.001). Interventions to address the sense of helplessness and to prevent or reduce disability could improve HRQoL of RA patients.
authors.affiliation: Department of Pharmacy, Faculty of Science, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Republic of Singapore.
authors.forename: Yu Heng
authors.initials: YH
authors.lastname: Kwan
authors.forename: Ee Tzun
authors.initials: ET
authors.lastname: Koh
authors.forename: Khai Pang
authors.initials: KP
authors.lastname: Leong
authors.forename: Hwee-Lin
authors.initials: HL
authors.lastname: Wee
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology*; D044466:Asian People / Q000523:psychology*; D016009:Chi-Square Distribution; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004644:Emotions; D005260:Female; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008603:Mental Health / Q000208:ethnology*; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011594:Psychometrics; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires