Strating Mathilde M H, Suurmeijer Theo P B M, van Schuur Wijbrandt H
Department of Sociology, Interuniversity Center for Social Science Theory and Methodology, University of Groningen, Groningen, The Netherlands.
Arthritis Rheum. 2006 Oct 15;55(5):736-44. doi: 10.1002/art.22231.
To examine the strength and stability of the relationships between disease-related factors (joint tenderness, pain, and functional disability), social support, and distress over time, and to investigate to what extent disease-related factors and social support can predict distress in short-term and long-term rheumatoid arthritis (RA).
The study was a Dutch extension of the European Research on Incapacitating Diseases and Social Support and started with 292 patients. After 5 waves of data collection, 129 patients remained. Composite measures were computed following the area under the curve approach. Interaction terms were computed between functional disability and social support satisfaction. Correlational and hierarchical regression analyses were performed.
In patients with short-term RA, disease-related factors and social support were important in determining distress. Also, a buffering effect of social companionship was found. In total, 51% of the variance in distress in short-term RA could be explained primarily by mean distress over the previous years. In patients with long-term RA, disease-related factors remained important in determining distress, but to a lesser extent. Seventeen percent of the variance in distress in long-term RA could be explained primarily by mean distress over the years before.
During the course of the disease, patients may learn to adjust to their disease and its consequences and are able to maintain a normal distress level. The effect of the disease on psychological distress decreased over the years. Some support for the buffering hypothesis of social support was found in short-term RA, but not in long-term RA.
探讨疾病相关因素（关节压痛、疼痛和功能障碍）、社会支持与痛苦感之间随时间变化的关系强度和稳定性，并研究疾病相关因素和社会支持在短期和长期类风湿关节炎（RA）中能在多大程度上预测痛苦感。
该研究是欧洲致残性疾病与社会支持研究的荷兰扩展版，起始有292名患者。经过5轮数据收集后，剩余129名患者。采用曲线下面积法计算综合指标。计算功能障碍与社会支持满意度之间的交互项。进行相关性和分层回归分析。
在短期RA患者中，疾病相关因素和社会支持在决定痛苦感方面很重要。此外，还发现了社会陪伴的缓冲作用。总体而言，短期RA患者痛苦感差异的51%主要可由前几年的平均痛苦感来解释。在长期RA患者中，疾病相关因素在决定痛苦感方面仍然重要，但程度较轻。长期RA患者痛苦感差异的17%主要可由之前几年的平均痛苦感来解释。
在疾病过程中，患者可能学会适应他们的疾病及其后果，并能够维持正常的痛苦水平。多年来，疾病对心理痛苦的影响有所下降。在短期RA中发现了对社会支持缓冲假说的一些支持，但在长期RA中未发现。
