Pain as an important predictor of psychosocial health in patients with rheumatoid arthritis
Pain as an important predictor of psychosocial health in patients with rheumatoid arthritis
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DOI：
10.1002/acr.20652
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发表时间：
2012-02-01
影响因子：
4.7
通讯作者：
Finckh, Axel
中科院分区：
文献类型：
--
作者：
Courvoisier, Delphine S.;Agoritsas, Thomas;Finckh, Axel
目的 研究类风湿性关节炎 (RA) 患者健康相关生活质量的心理社会方面的演变，并确定其预测因素。方法。瑞士 RA 队列和美国 RA 队列中所有在 4 年内至少完成两次简表 36 (SF-36) 量表的患者均被纳入。主要结局是通过 SF-36 的心理成分总结 (MCS) 评分来衡量的心理社会健康。使用结构方程模型分析该结果随时间的演变，该模型区分结果方差的稳定分量、变量分量和测量误差分量。结果。总共纳入了 15,282 名患者（48,323 个观察值）。 MCS 分数随着时间的推移大多保持稳定（69% 到 75% 之间的方差不是由于测量误差造成的）。 SF-36 的可变成分主要是由于测量时的波动，而不是心理社会健康的全球时间趋势。疼痛是心理社会健康的稳定和可变组成部分的最重要的预测因子，解释了与观察到的心理社会健康差异的 44% 类似的情况。结论。这项大型队列研究表明，疼痛是 RA 患者心理社会健康最重要的预测因素。这表明医生应该更加重视疼痛管理。
Objective To examine the evolution of psychosocial aspects of health-related quality of life in rheumatoid arthritis (RA) patients, and to identify their predictors.Methods. All patients within a Swiss RA cohort and a US RA cohort who completed a Short Form 36 (SF-36) scale at least twice within a 4-year period were included. The primary outcome was psychosocial health as measured by the mental component summary (MCS) score of the SF-36. The evolution of this outcome over time was analyzed using structural equation models, which distinguish between the stable, the variable, and the measurement error components of the outcome's variance.Results. A total of 15,282 patients (48,323 observations) were included. MCS scores were mostly stable over time (between 69% and 75% of the variance was not due to measurement error). The variable component of the SF-36 was mostly due to fluctuations at the moment of measurement and not to a global time trend of psychosocial health. Pain was the most important predictor of both the stable and variable components of psychosocial health, explaining similar to 44% of the observed psychosocial health variance.Conclusion. This large cohort study demonstrates that pain is the most important predictor of a patient's psychosocial health in RA patients. This suggests that physicians should place greater emphasis on pain management.