Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2017

Open Access 01-01-2017 | Research

Functional disability associated with disease and quality-of-life parameters in Chinese patients with rheumatoid arthritis

Authors: Juan Ji, Lijuan Zhang, Qiuxiang Zhang, Rulan Yin, Ting Fu, Liren Li, Zhifeng Gu

Published in: Health and Quality of Life Outcomes | Issue 1/2017

Login to get access

Abstract

Background

As an important outcome measure among rheumatoid arthritis (RA) patients, functional disability may contribute to unemployment, loss of work productivity, and impaired quality of life. However, little is known about the risk factors of functional disability in Chinese RA patients. This study aimed (1) to examine the prevalence of functional disability in Chinese RA patients; (2) to explore factors associated with the health assessment questionnaire-disability index (HAQ-DI).

Methods

A total of 101 RA patients in this cross-sectional study underwent standardized laboratory examinations and responded to the questionnaire for demographic data, the HAQ-DI for functional disability, the Compliance Questionnaire on Rheumatology (CQR) for medication adherence, the Hospital Anxiety and Depression Scale (HADS) for psychological status, and the Short Form 36 health survey (SF-36) for quality of life. Pain, grip/pinch strength, disease activity, and large joint mobility were recorded. Independent samples t-tests, chi-square analyses, and logistic regression modeling were used to analyze the data.

Results

The mean ± SD age of RA patients was 54.9 ± 11.9 years. Approximately 15.8% RA patients in mainland China experience functional disability (defined as a HAQ-DI score ≥ 1). Long disease duration, pain, high disease activity, a larger number of tender and swollen joints, high C-reactive protein (CRP) level, decreased grip strength, and limitation of shoulder, elbow, wrist, knee, and ankle motion were associated with the HAQ-DI. Participants with functional disability tended to have more severe depressive symptoms and a lower quality of life compared with individuals without functional disability. Stepwise logistic regression analyses found that limitation of wrist extension (P = 0.001) and lower body pain (BP) score (P = 0.001) explained higher HAQ-DI score.

Conclusions

The present study reported that functional disability was common in Chinese RA patients. A low quality of life and limitation of joint mobility had great impacts on functional disability in Chinese RA patients. Targeted and culturally sensitive interventions should be strengthened to delay the onset of disabilities of this population.
Literature
1.
Gong G, Mao J. Health-related quality of life among Chinese patients with rheumatoid arthritis: the predictive roles of fatigue, functional disability, self-efficacy, and social support. Nurs Res. 2016;65:55–67.CrossRefPubMed
2.
Michaud K, Strand V, Shadick NA, Degtiar I, Ford K, Michalopoulos SN, Hornberger J. Outcomes and costs of incorporating a multibiomarker disease activity test in the management of patients with rheumatoid arthritis. Rheumatology (Oxford). 2015;54:1640–9.CrossRef
3.
Olofsson T, Petersson IF, Eriksson JK, Englund M, Simard JF, Nilsson JA, Geborek P, Jacobsson LT, Askling J, Neovius M. Predictors of work disability during the first 3 years after diagnosis in a national rheumatoid arthritis inception cohort. Ann Rheum Dis. 2014;73:845–53.CrossRefPubMed
4.
Wallman JK, Eriksson JK, Nilsson JA, Olofsson T, Kristensen LE, Neovius M, Geborek P. Costs in relation to disability, disease activity, and health-related quality of life in rheumatoid arthritis: observational data from southern Sweden. J Rheumatol. 2016;43:1292–9.CrossRefPubMed
5.
Johnsson PM, Eberhardt K. Hand deformities are important signs of disease severity in patients with early rheumatoid arthritis. Rheumatology (Oxford). 2009;48:1398–401.CrossRef
6.
Karpouzas GA, Draper T, Moran R, Hernandez E, Nicassio P, Weisman MH, Ormseth S. Trends in functional disability and determinants of clinically meaningful change over time in Hispanics with Rheumatoid arthritis in the United States. Arthritis Care Res (Hoboken). 2017;69(2):294–8.
7.
Li Z. Facing the challenge of low recognition and high status in rheumatoid arthritis. Natl Med J China. 2009;89:1873–5.
8.
Fries JF, Spitz P, Kraines RG, Holman HR. Measurement of patient outcome in arthritis. Arthritis Rheum. 1980;23:137–45.CrossRefPubMed
9.
Welsing PM, van Gestel AM, Swinkels HL, Kiemeney LA, van Riel PL. The relationship between disease activity, joint destruction, and functional capacity over the course of rheumatoid arthritis. Arthritis Rheum. 2001;44:2009–17.CrossRefPubMed
10.
Kapetanovic MC, Lindqvist E, Nilsson JA, Geborek P, Saxne T, Eberhardt K. Development of functional impairment and disability in rheumatoid arthritis patients followed for 20 years: relation to disease activity, joint damage, and comorbidity. Arthritis Care Res (Hoboken). 2015;67:340–8.CrossRef
11.
Ruban TN, Jacob B, Pope JE, Keystone EC, Bombardier C, Kuriya B. The influence of age at disease onset on disease activity and disability: results from the Ontario Best Practices Research Initiative. Clin Rheumatol. 2016;35(3):759–63.
12.
Zhao S, Chen Y, Chen H. Sociodemographic factors associated with functional disability in outpatients with rheumatoid arthritis in Southwest China. Clin Rheumatol. 2015;34:845–51.CrossRefPubMed
13.
Marques WV, Cruz VA, Rego J, Silva NA. The impact of comorbidities on the physical function in patients with rheumatoid arthritis. Rev Bras Reumatol. 2016;56(1):14–21.
14.
Marques WV, Cruz VA, Rego J, Silva NA. The impact of comorbidities on the physical function in patients with rheumatoid arthritis. Rev Bras Reumatol (Rio J). 2016;56:14–21.CrossRef
15.
Sokka T, Kankainen A, Hannonen P. Scores for functional disability in patients with rheumatoid arthritis are correlated at higher levels with pain scores than with radiographic scores. Arthritis Rheum. 2000;43:386–9.CrossRefPubMed
16.
Karpouzas GA, Dolatabadi S, Moran R, Li N, Nicassio PM, Weisman MH. Correlates and predictors of disability in vulnerable US Hispanics with rheumatoid arthritis. Arthritis Care Res (Hoboken). 2012;64:1274–81.CrossRef
17.
Pincus T, Callahan LF, Brooks RH, Fuchs HA, Olsen NJ, Kaye JJ. Self-report questionnaire scores in rheumatoid arthritis compared with traditional physical, radiographic, and laboratory measures. Ann Intern Med. 1989;110:259–66.CrossRefPubMed
18.
Simon-Campos JA, Padilla-Hernandez RO. Correlation between C reactive protein and erythrosedimentation rate with rheumatoid arthritis disease activity. Rev Med Inst Mex Seguro Soc. 2008;46:591–6.PubMed
19.
Pascual-Ramos V, Contreras-Yanez I, Villa AR, Cabiedes J, Rull-Gabayet M. Medication persistence over 2 years of follow-up in a cohort of early rheumatoid arthritis patients: associated factors and relationship with disease activity and with disability. Arthritis Res Ther. 2009;11:R26.CrossRefPubMedPubMedCentral
20.
Hakkinen A, Kautiainen H, Hannonen P, Ylinen J, Arkela-Kautiainen M, Sokka T. Pain and joint mobility explain individual subdimensions of the health assessment questionnaire (HAQ) disability index in patients with rheumatoid arthritis. Ann Rheum Dis. 2005;64:59–63.CrossRefPubMed
21.
Sariyildiz MA, Batmaz I, Bozkurt M, Bez Y, Cetincakmak MG, Yazmalar L, Ucar D, Celepkolu T. Sleep quality in rheumatoid arthritis: relationship between the disease severity, depression, functional status and the quality of life. J Clin Med Res. 2014;6:44–52.PubMed
22.
Jamshidi AR, Banihashemi AT, Paragomi P, Hasanzadeh M, Barghamdi M, Ghoroghi S. Anxiety and depression in rheumatoid arthritis: an epidemiologic survey and investigation of clinical correlates in Iranian population. Rheumatol Int. 2016;36(8):1119–25.
23.
Kronisch C, McLernon DJ, Dale J, Paterson C, Ralston SH, Reid DM, Tierney A, Harvie J, McKay N, Wilson HE, et al. Brief report: predicting functional disability: one-year results from the Scottish early rheumatoid arthritis inception cohort. Arthritis Rheumatol. 2016;68:1596–602.CrossRefPubMed
24.
Prevoo ML, van ‘t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995;38:44–8.CrossRefPubMed
25.
van der Heijde DM, van ‘t Hof MA, van Riel PL, Theunisse LA, Lubberts EW, van Leeuwen MA, van Rijswijk MH, van de Putte LB. Judging disease activity in clinical practice in rheumatoid arthritis: first step in the development of a disease activity score. Ann Rheum Dis. 1990;49:916–20.CrossRefPubMedPubMedCentral
26.
Kim HH, Kim J, Park SH, Kim SK, Kim OD, Choe JY. Correlation of anti-cyclic citrullinated antibody with hand joint erosion score in rheumatoid arthritis patients. Korean J Intern Med. 2010;25:201–6.CrossRefPubMedPubMedCentral
27.
Terao C, Ohmura K, Ikari K, Kawaguchi T, Takahashi M, Setoh K, Nakayama T, Kosugi S, Sekine A, Tabara Y, et al. Effects of smoking and shared epitope on the production of anti-citrullinated peptide antibody in a Japanese adult population. Arthritis Care Res (Hoboken). 2014;66:1818–27.CrossRef
28.
de Klerk E, van der Heijde D, Landewe R, van der Tempel H, van der Linden S. The compliance-questionnaire-rheumatology compared with electronic medication event monitoring: a validation study. J Rheumatol. 2003;30:2469–75.PubMed
29.
Zwikker HE, van Dulmen S, den Broeder AA, van den Bemt BJ, van den Ende CH. Perceived need to take medication is associated with medication non-adherence in patients with rheumatoid arthritis. Patient Prefer Adherence. 2014;8:1635–45.CrossRefPubMedPubMedCentral
30.
Hughes LD, Done J, Young A. A 5 item version of the compliance questionnaire for rheumatology (CQR5) successfully identifies low adherence to DMARDs. BMC Musculoskelet Disord. 2013;14:286.CrossRefPubMedPubMedCentral
31.
Cordingley L, Prajapati R, Plant D, Maskell D, Morgan C, Ali FR, Morgan AW, Wilson AG, Isaacs JD, Biologics in Rheumatoid Arthritis G, et al. Impact of psychological factors on subjective disease activity assessments in patients with severe rheumatoid arthritis. Arthritis Care Res (Hoboken). 2014;66:861–8.CrossRef
32.
Wang W, Chair SY, Thompson DR, Twinn SF. A psychometric evaluation of the Chinese version of the hospital anxiety and depression scale in patients with coronary heart disease. J Clin Nurs. 2009;18:2436–43.CrossRefPubMed
33.
Li L, Wang HM, Shen Y. Chinese SF-36 health survey: translation, cultural adaptation, validation, and normalisation. J Epidemiol Community Health. 2003;57:259–63.CrossRefPubMedPubMedCentral
34.
Grindulis KA, Calverley M. Grip strength: peak or sustained pressure in rheumatoid arthritis? J Chronic Dis. 1983;36:855–8.CrossRefPubMed
35.
Heiberg T, Kvien TK. Preferences for improved health examined in 1,024 patients with rheumatoid arthritis: pain has highest priority. Arthritis Rheum. 2002;47:391–7.CrossRefPubMed
36.
Sokka T. Assessment of pain in patients with rheumatic diseases. Best Pract Res Clin Rheumatol. 2003;17:427–49.CrossRefPubMed
37.
Imran MY, Saira Khan EA, Ahmad NM, Farman Raja S, Saeed MA, Ijaz HI. Depression in rheumatoid arthritis and its relation to disease activity. Pak J Med Sci. 2015;31:393–7.CrossRefPubMedPubMedCentral
38.
Overman CL, Bossema ER, van Middendorp H, Wijngaards-de Meij L, Verstappen SM, Bulder M, Jacobs JW, Bijlsma JW, Geenen R. The prospective association between psychological distress and disease activity in rheumatoid arthritis: a multilevel regression analysis. Ann Rheum Dis. 2012;71:192–7.CrossRefPubMed
39.
Ferraz MB, Oliveira LM, Araujo PM, Atra E, Walter SD. EPM-ROM scale: an evaluative instrument to be used in rheumatoid arthritis trials. Clin Exp Rheumatol. 1990;8:491–4.PubMed
40.
Badley EM, Wagstaff S, Wood PH. Measures of functional ability (disability) in arthritis in relation to impairment of range of joint movement. Ann Rheum Dis. 1984;43:563–9.CrossRefPubMedPubMedCentral
Metadata
Title
Functional disability associated with disease and quality-of-life parameters in Chinese patients with rheumatoid arthritis
Authors
Juan Ji
Lijuan Zhang
Qiuxiang Zhang
Rulan Yin
Ting Fu
Liren Li
Zhifeng Gu
Publication date
01-01-2017
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2017
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-017-0659-z

Other articles of this Issue 1/2017

Health and Quality of Life Outcomes 1/2017 Go to the issue

Research

Development and validation of the Chinese version of dry eye related quality of life scale

Research

Validation of the Spanish version of the Oxford knee score and assessment of its utility to characterize quality of life of patients suffering from knee osteoarthritis: a multicentric study

Research

The Kessler psychological distress scale: translation and validation of an Arabic version

Research

Validity and reliability of the Mexican resilience measurement scale in families of children with chronic conditions

Research

Vision-related quality of life and visual outcomes from cataract surgery in patients with vision-threatening diabetic retinopathy: a prospective observational study

Research

On measuring and decomposing inequality of opportunity in access to health services among Tunisian children: a new approach for public policy