Determinants of quality of life in patients with fibromyalgia: A structural equation modeling approach.
OBJECTIVE
Health-related quality of life (HRQOL) in patients with fibromyalgia (FM) is lower than in patients with other chronic diseases and the general population. Although various factors affect HRQOL, no study has examined a structural equation model of HRQOL as an outcome variable in FM patients. The present study assessed relationships among physical function, social factors, psychological factors, and HRQOL, and the effects of these variables on HRQOL in a hypothesized model using structural equation modeling (SEM).


METHODS
HRQOL was measured using SF-36, and the Fibromyalgia Impact Questionnaire (FIQ) was used to assess physical dysfunction. Social and psychological statuses were assessed using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Arthritis Self-Efficacy Scale (ASES), and the Social Support Scale. SEM analysis was used to test the structural relationships of the model using the AMOS software.


RESULTS
Of the 336 patients, 301 (89.6%) were women with an average age of 47.9±10.9 years. The SEM results supported the hypothesized structural model (χ2 = 2.336, df = 3, p = 0.506). The final model showed that Physical Component Summary (PCS) was directly related to self-efficacy and inversely related to FIQ, and that Mental Component Summary (MCS) was inversely related to FIQ, BDI, and STAI.


CONCLUSIONS
In our model of FM patients, HRQOL was affected by physical, social, and psychological variables. In these patients, higher levels of physical function and self-efficacy can improve the PCS of HRQOL, while physical function, depression, and anxiety negatively affect the MCS of HRQOL.
Division of Rheumatology, Department of Internal Medicine, Chonnam National University Hospital & Medical School, Gwangju, Korea.
Jeong-Won
JW
Lee
Division of Rheumatology, Department of Internal Medicine, Chonnam National University Hospital & Medical School, Gwangju, Korea.
Kyung-Eun
KE
Lee
Division of Rheumatology, Department of Internal Medicine, Chonnam National University Hospital & Medical School, Gwangju, Korea.
Dong-Jin
DJ
Park
Division of Rheumatology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.
Seong-Ho
SH
Kim
Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University, College of Medicine, Cheonan, Korea.
Seong-Su
SS
Nah
Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center, Busan, Korea.
Ji Hyun
JH
Lee
Division of Rheumatology, Department of Internal Medicine, Catholic University of Daegu, School of Medicine, Daegu, Korea.
Seong-Kyu
SK
Kim
Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.
Yeon-Ah
YA
Lee
Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.
Seung-Jae
SJ
Hong
Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.
Hyun-Sook
HS
Kim
Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine and the Hospital for Rheumatic Diseases, Seoul, Korea.
Hye-Soon
HS
Lee
Division of Rheumatology, Department of Internal Medicine, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
Hyoun Ah
HA
Kim
Division of Rheumatology, Department of Internal Medicine, Konyang University Medical School, Daejeon, Korea.
Chung-Il
CI
Joung
Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keimyung University, Daegu, Korea.
Sang-Hyon
SH
Kim
Division of Rheumatology, Department of Internal Medicine, Chonnam National University Hospital & Medical School, Gwangju, Korea.
Shin-Seok
http://orcid.org/0000-0001-6810-7355
SS
Lee
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011446:Prospective Studies; D011788:Quality of Life; D012984:Software; D011795:Surveys and Questionnaires; D055815:Young Adult