Jolly Meenakshi, Peters Kristin F, Mikolaitis Rachel, Evans-Raoul Kali, Block Joel A
From the *Rush University, Chicago, IL; †University of Missouri, Columbia, MO; and ‡Image Studios, Chicago, IL.
J Clin Rheumatol. 2014 Dec;20(8):403-10. doi: 10.1097/RHU.0000000000000141.
Systemic lupus erythematosus (SLE) can be disfiguring, disabling, and debilitating. In this proof-of-concept study, our goal was to determine the feasibility and effectiveness of a novel body image (BI) intervention in improving (1) BI and (2) health outcomes among women with cutaneous SLE.
A tailored weekly intervention for 10 weeks consisting of education, cognitive behavioral therapy, and cosmetic training was offered, along with usual fscare, to 10 SLE patients with inactive to mildly active disease and cutaneous involvement. For comparison, we followed up 5 patients with inactive to mildly active SLE and cutaneous involvement, receiving only usual care. Data on outcomes were obtained at baseline, immediately postintervention, and 18 and 24 weeks postintervention using the following tools: Body Image in Lupus Scale (BI), Multidimensional Body Self-Relations Questionnaire-Appearance Scale, State Trait Anxiety Index and Center for Epidemiological Studies Depression (psychological health), and LupusPRO (lupus health outcomes). Paired t tests (2-tailed) were done for between-groups comparisons. P ≤ 0.05 was considered significant.
The mean ages of the intervention and control groups were 44.4 (SD, 8.7) and 43.2 (SD, 12.2) years, respectively. Scores on measures of BI, psychological well-being, and quality of life improved over time only in the intervention group; the benefits were retained over time. The observed effect size of the improvements in BI was large.
Body image is modifiable in SLE. The results suggest that our intervention is feasible for SLE populations and that the SLE patients who participated improved on several measures of BI and overall well-being.
系统性红斑狼疮(SLE)会导致容貌受损、功能受限和身体衰弱。在这项概念验证研究中,我们的目标是确定一种新型身体意象(BI)干预措施在改善(1)皮肤型SLE女性的身体意象和(2)健康结局方面的可行性和有效性。
为10例疾病处于非活动期至轻度活动期且有皮肤受累的SLE患者提供为期10周的量身定制的每周干预措施,包括教育、认知行为疗法和美容培训,同时给予常规护理。作为对照,我们随访了5例疾病处于非活动期至轻度活动期且有皮肤受累的SLE患者,他们仅接受常规护理。使用以下工具在基线、干预后即刻、干预后18周和24周获取结局数据:狼疮身体意象量表(BI)、多维身体自我关系问卷-外貌量表、状态特质焦虑指数和流行病学研究中心抑郁量表(心理健康)以及狼疮PRO(狼疮健康结局)。进行两组间比较的配对t检验(双侧)。P≤0.05被认为具有统计学意义。
干预组和对照组的平均年龄分别为44.4(标准差8.7)岁和43.2(标准差12.2)岁。仅干预组的BI、心理健康和生活质量测量得分随时间改善;这些益处随时间得以保持。观察到的BI改善的效应量很大。
SLE患者的身体意象是可改变的。结果表明我们的干预措施对SLE人群是可行的,且参与的SLE患者在多项BI和总体幸福感测量指标上有所改善。