Stress caused by rheumatoid arthritis: relation among subjective stressors of the disease, disease status, and well-being.

Two integrated studies, examining the chronic stressors specific to the disease rheumatoid arthritis, are described. Pain, limitation, and dependence were rated as the most annoying chronic stressors of the disease. Pain was measured with the Visual Analog Scale and the McGill Pain Questionnaire. Both pain scores were only weakly related to the medical assessment variables. New scales were developed to measure perceived limitation and dependence. Perceived limitation was inversely related to both mobility and self-care, but this association was not strong. Perceived dependence was unrelated to any of the health status measures. All three stressors were associated with indicators of quality of life even after controlling for interaction with clinical assessment and functional status variables. It was concluded from these studies that patients with rheumatoid arthritis must cope simultaneously with pain, limitation, and dependence.