Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
Department of Rheumatology, Military Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
Reumatol Clin (Engl Ed). 2023 Jun-Jul;19(6):299-305. doi: 10.1016/j.reumae.2022.11.004.
The aim of this study was to identify the associated factors with lower self-esteem and restriction in community reintegration in SpA patients.
This study was a cross-sectional study including SpA patients (ASAS criteria) aged 18-50 years. The level of self-esteem was assessed using the Rosenberg Self-Esteem Scale (RSES). The Reintegration to Normal Living Index (RNLI) evaluated the degree of reintegration to normal social activities. Anxiety, depression, and fibromyalgia were screened by the Hospital Anxiety and Depression Scale (HADS)-A, HADS-D, and FiRST, respectively. Statistical analysis was performed.
A total of 72 patients were enrolled (sex-ratio=1.88), with median (IQR) age of 39 years (28.25-46). Median (IQR) disease duration was 10 (6-14) years. Median (IQR) BASDAI and ASDAS were 3 (2.1-4.7) and 2.7 (1.9-3.48), respectively. Anxiety symptoms were screened in 10% of SpA patients, depression in 11%; and fibromyalgia in 10%. Median (IQR) RSES and RNLI scores were 30 (23.25-34), and 83 (53.25-93.25), respectively. Multivariate regression analysis identified the domain (work) of pain interference, VAS pain, HAD anxiety, PGA, marital status, and morning stiffness as factors associated with lower self-esteem. Restriction in the reintegration community was predicted by the presence of IBD, VAS pain, FIRST, deformity, enjoyment of life, and HAD depression.
Pain intensity and interference, deformities, extra-articular manifestations, and deterioration of mental health were associated with low self-esteem and severe restriction in community reintegration among patients with SpA rather than inflammatory parameters.
本研究旨在确定与 AS 患者自尊降低和社区再融入受限相关的因素。
本研究为横断面研究，纳入年龄 18-50 岁的 AS 患者（ASAS 标准）。自尊水平采用罗森伯格自尊量表（RSES）评估。社区再融入正常生活指数（RNLI）评估社会活动正常融入的程度。焦虑、抑郁和纤维肌痛分别用医院焦虑抑郁量表（HADS-A、HADS-D 和 FiRST）筛查。进行统计分析。
共纳入 72 例患者（性别比 1.88），年龄中位数（IQR）为 39 岁（28.25-46）。疾病中位数（IQR）持续时间为 10 年（6-14）。BASDAI 和 ASDAS 的中位数（IQR）分别为 3（2.1-4.7）和 2.7（1.9-3.48）。10%的 AS 患者有焦虑症状，11%有抑郁症状，10%有纤维肌痛。RSES 和 RNLI 的中位数（IQR）分别为 30（23.25-34）和 83（53.25-93.25）。多变量回归分析确定疼痛干扰、VAS 疼痛、HAD 焦虑、PGA、婚姻状况和晨僵等领域与自尊降低相关。社区再融入受限由 IBD、VAS 疼痛、FIRST、畸形、生活享受和 HAD 抑郁的存在预测。
疼痛强度和干扰、畸形、关节外表现和心理健康恶化与 AS 患者的自尊降低和社区再融入受限严重相关，而不是炎症参数。
