Martinec Renata, Pinjatela Renata, Balen Diana
1University of Zagreb, Faculty of Education and Rehabilitation Sciences, Department of Motor Disturbances, Chronic Diseases and Art-Therapies, Zagreb, Croatia; 2Sestre milosrdnice University Hospital Centre, Department of Rheumatology, Physical Medicine and Rehabilitation, Zagreb, Croatia.
Acta Clin Croat. 2019 Mar;58(1):157-166. doi: 10.20471/acc.2019.58.01.20.
The most severe effects of rheumatoid arthritis (RA) are loss of physical function and chronic pain, which may have a major impact on different areas of the person's existence. The aim of this study was to get an insight into the quality of life (QOL) in subjects with RA in connection with pain perception and functional ability. The following instruments were used: the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), Short Form Health Survey (SF-36), Health Assessment Questionnaire Disability Index (HAQ-DI) and Visual Analog Scale for Pain (VAS Pain). The results indicated that there was no statistical difference in the QOL between subjects with RA and healthy population according to SF-36 Croatian norms. Also, the results showed that stronger pain experience was significantly associated with poorer social functioning assessment (SF36SF, Spearman's rho=-0.463, p<0.05), poorer general health perception (SF36GH, Spearman's rho=-0.432, p<0.05) and poorer physical functioning (WHOPH, Spearman's rho=-0.688, p<0.01). Furthermore, the subjects evaluating their general functional state worse were found to have worse physical functioning (SF36PF, Spearman's rho=-0.699 and WHOPH, Spearman's rho=-0.769), poorer social functioning (SF36SF, Spearman's rho=-0.580) and experienced greater pain intensity (SF36BP, Spearman's rho=-0.652). Therefore, additional efforts should be invested to define a holistic and integrative model of treatment and rehabilitation of people with RA, focused on pain relief, improvement of functional ability, encouraging social interaction and supporting positive emotional responses.
类风湿关节炎(RA)最严重的影响是身体功能丧失和慢性疼痛,这可能会对患者生活的不同方面产生重大影响。本研究的目的是深入了解RA患者的生活质量(QOL)与疼痛感知和功能能力之间的关系。使用了以下工具:世界卫生组织生活质量问卷(WHOQOL-BREF)、简短健康调查问卷(SF-36)、健康评估问卷残疾指数(HAQ-DI)和视觉模拟疼痛量表(VAS疼痛)。结果表明,根据SF-36克罗地亚标准,RA患者与健康人群在生活质量方面没有统计学差异。此外,结果显示,更强的疼痛体验与更差的社会功能评估(SF36SF,斯皮尔曼等级相关系数=-0.463,p<0.05)、更差的总体健康感知(SF36GH,斯皮尔曼等级相关系数=-0.432,p<0.05)和更差的身体功能(WHOPH,斯皮尔曼等级相关系数=-0.688,p<0.01)显著相关。此外,自我评估总体功能状态较差的患者身体功能更差(SF36PF,斯皮尔曼等级相关系数=-0.699;WHOPH,斯皮尔曼等级相关系数=-0.769),社会功能更差(SF36SF,斯皮尔曼等级相关系数=-0.580),疼痛强度更大(SF36BP,斯皮尔曼等级相关系数=-0.652)。因此,应做出更多努力来定义一种针对RA患者的全面综合治疗和康复模式,重点是缓解疼痛、改善功能能力、鼓励社会互动和支持积极的情绪反应。