Department of Rheumatology, Trakya University Medical School, Edirne, Turkey.
Department of Psychiatry, Bezmialem Vakif University Medical Faculty, İstanbul, Turkey.
Int J Rheum Dis. 2021 Feb;24(2):223-230. doi: 10.1111/1756-185X.14041. Epub 2020 Dec 30.
This study aimed to explore loneliness and associated factors in Turkish patients with inflammatory arthritis.
Adult patients with rheumatoid arthritis (RA) (n = 58), ankylosing spondylitis (AS) (n = 53), and psoriatic arthritis (PsA) (n = 30), respectively, were included in the study. A single-item visual analog scale (VAS) for loneliness, UCLA Loneliness Scale-8 (ULS-8), Beck depression inventory (BDI), Beck anxiety inventory (BAI), revised multidimensional scale of perceived social support, Health Assessment Questionnaire-Disability Index (HAQ-DI) were used for the psychometric and functional assessments. Multiple regression models were generated for predicting the ULS-8 and HAQ-DI scores.
There was no difference between disease groups in terms of the ULS-8 and HAQ-DI scores. Among demographic and clinical parameters, only the education status and number of drugs used had associations with the ULS-8 score. Single-item VAS score for loneliness did not predict the ULS-8 score well. There were significant correlations between the ULS-8 and HAQ-DI, depression, anxiety, social support, and physician global VAS scores. Only the education status significantly predicted (β = -0.208) the ULS-8 score in multiple regression analysis (adjusted R = 0.15, P < .001). Beck depression, anxiety, and patient global VAS scores remained significant for predicting the HAQ-DI after multiple regression with the covariates ULS-8, depression, anxiety, social support, patient and physician global VAS scores, and the number of drugs used (adjusted R = 0.53, P < .001). Disease activity and the ULS-8 scores were not found to be associated in any disease group.
Loneliness is associated with depression, anxiety, lack of social support, disability, higher number of drugs used, and lower education but not with disease activity in Turkish patients with RA, AS, and PsA. Perception and expression of loneliness vary according to the cultural background. Single-item scales for loneliness may lack reliability compared to the more comprehensive ULS-8.
本研究旨在探讨土耳其炎症性关节炎患者的孤独感及其相关因素。
纳入成年类风湿关节炎（RA）（n=58）、强直性脊柱炎（AS）（n=53）和银屑病关节炎（PsA）（n=30）患者。采用孤独感单项目视觉模拟量表（VAS）、洛杉矶孤独量表-8 项（ULS-8）、贝克抑郁量表（BDI）、贝克焦虑量表（BAI）、修订多维感知社会支持量表、健康评估问卷残疾指数（HAQ-DI）进行心理测量和功能评估。建立多元回归模型预测 ULS-8 和 HAQ-DI 评分。
在 ULS-8 和 HAQ-DI 评分方面，疾病组之间无差异。在人口统计学和临床参数中，只有教育程度和使用药物的数量与 ULS-8 评分相关。孤独感单项目 VAS 评分不能很好地预测 ULS-8 评分。ULS-8 与 HAQ-DI、抑郁、焦虑、社会支持和医生总体 VAS 评分之间存在显著相关性。在多元回归分析中，只有教育程度（β=-0.208）显著预测 ULS-8 评分（调整 R²=0.15，P<0.001）。在调整 ULS-8、抑郁、焦虑、社会支持、患者和医生总体 VAS 评分以及使用药物数量的协变量后，贝克抑郁、焦虑和患者总体 VAS 评分仍然可以显著预测 HAQ-DI（调整 R²=0.53，P<0.001）。在任何疾病组中，疾病活动度与 ULS-8 评分均无相关性。
在土耳其 RA、AS 和 PsA 患者中，孤独感与抑郁、焦虑、缺乏社会支持、残疾、使用更多药物和较低的教育程度相关，但与疾病活动度无关。孤独感的感知和表达因文化背景而异。与更全面的 ULS-8 相比，孤独感单项目量表可能缺乏可靠性。
