From the Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano de Buenos Aires, and Fundacion PM Catoggio, Buenos Aires, Argentina.
J Clin Rheumatol. 2019 Mar;25(2):65-68. doi: 10.1097/RHU.0000000000000769.
The aims of this study were to compare learned helplessness (LH) and perceived self-efficacy (SE) in patients with fibromyalgia (FM) and rheumatoid arthritis (RA) and to assess their correlation with functional disability, level of perceived pain, and fatigue.
This multicenter, cross-sectional study included consecutive patients (aged ≥18 years) with RA, according to the 2010 American College of Rheumatology/European League Against Rheumatism criteria, and FM, according to 2010 American College of Rheumatology criteria. Learned helplessness was measured by the Rheumatology Attitude Index, Spanish version; SE with the Arthritis Self-efficacy Scale, Spanish version; functional capacity with the Health Assessment Questionnaire (HAQ), Argentine version; depression with Center for Epidemiological Studies-Depression Scale 7-item version and perceived pain and fatigue by the visual analog scale. Disease activity was measured by the Clinical Disease Activity Index (CDAI) and disease impact with the Fibromyalgia Impact Questionnaire (FIQ).
A total of 215 patients, 100 with FM and 115 with RA, were included. Mean age was 59 (SD, 14) years and 58 (SD, 13) years for FM and RA, patients respectively. Whereas LH and depression were significantly higher, SE was significantly lower in FM patients. We found a positive correlation between LH and HAQ, pain, depression, fatigue, FIQ, and CDAI in FM and RA patients. We observed a negative correlation between SE and HAQ, pain, depression, fatigue, FIQ (FM), and CDAI (RA) in both groups.
Both LH and SE correlate significantly with functional capacity, perceived pain, disease activity, and disease impact in RA and FM patients. Learned helplessness was higher in patients with active disease or high disease impact, as opposed to those in remission or with low disease impact, and the reverse was true for SE. Patients with FM had significantly more LH, pain, fatigue, and depression and less SE compared with those with RA.
本研究旨在比较纤维肌痛（FM）和类风湿关节炎（RA）患者的习得性无助（LH）和自我效能感（SE），并评估其与功能障碍、感知疼痛和疲劳的相关性。
这是一项多中心、横断面研究，纳入了符合 2010 年美国风湿病学会/欧洲抗风湿病联盟标准的 RA 连续患者（年龄≥18 岁）和符合 2010 年美国风湿病学会标准的 FM 患者。习得性无助通过西班牙语版风湿病态度指数（Rheumatology Attitude Index）进行评估；自我效能感通过西班牙语版关节炎自我效能量表（Arthritis Self-efficacy Scale）进行评估；功能能力通过阿根廷版健康评估问卷（Health Assessment Questionnaire，HAQ）进行评估；抑郁通过 7 项版流行病学研究中心抑郁量表（Center for Epidemiological Studies-Depression Scale）和视觉模拟量表进行评估；感知疼痛和疲劳。疾病活动度通过临床疾病活动指数（Clinical Disease Activity Index，CDAI）和疾病影响通过纤维肌痛影响问卷（Fibromyalgia Impact Questionnaire，FIQ）进行评估。
共纳入 215 例患者，其中 FM 组 100 例，RA 组 115 例。FM 和 RA 患者的平均年龄分别为 59（标准差 [SD]，14）岁和 58（SD，13）岁。FM 患者的 LH 和抑郁显著更高，而 SE 显著更低。我们发现 FM 和 RA 患者的 LH 与 HAQ、疼痛、抑郁、疲劳、FIQ 和 CDAI 呈正相关。我们观察到 SE 与 HAQ、疼痛、抑郁、疲劳、FIQ（FM）和 CDAI（RA）呈负相关。
在 RA 和 FM 患者中，LH 和 SE 与功能能力、感知疼痛、疾病活动度和疾病影响显著相关。与缓解或疾病影响低的患者相比，活动期或疾病影响高的患者的 LH 更高，而 SE 则相反。与 RA 患者相比，FM 患者的 LH、疼痛、疲劳和抑郁显著更高，而 SE 显著更低。
