Abstract
ObjectiveHealth-related quality of life (HRQOL) in patients with fibromyalgia (FM) is lower than in patients with other chronic diseases and the general population. Although various factors affect HRQOL, no study has examined a structural equation model of HRQOL as an outcome variable in FM patients. The present study assessed relationships among physical function, social factors, psychological factors, and HRQOL, and the effects of these variables on HRQOL in a hypothesized model using structural equation modeling (SEM).MethodsHRQOL was measured using SF-36, and the Fibromyalgia Impact Questionnaire (FIQ) was used to assess physical dysfunction. Social and psychological statuses were assessed using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Arthritis Self-Efficacy Scale (ASES), and the Social Support Scale. SEM analysis was used to test the structural relationships of the model using the AMOS software.ResultsOf the 336 patients, 301 (89.6%) were women with an average age of 47.9±10.9 years. The SEM results supported the hypothesized structural model (χ2 = 2.336, df = 3, p = 0.506). The final model showed that Physical Component Summary (PCS) was directly related to self-efficacy and inversely related to FIQ, and that Mental Component Summary (MCS) was inversely related to FIQ, BDI, and STAI.ConclusionsIn our model of FM patients, HRQOL was affected by physical, social, and psychological variables. In these patients, higher levels of physical function and self-efficacy can improve the PCS of HRQOL, while physical function, depression, and anxiety negatively affect the MCS of HRQOL.
Highlights
Fibromyalgia (FM) is a relatively common syndrome, characterized by chronic widespread musculoskeletal pain, accompanied by various somatic and psychological symptoms [1]
The final model showed that Physical Component Summary (PCS) was directly related to self-efficacy and inversely related to Fibromyalgia Impact Questionnaire (FIQ), and that Mental Component Summary (MCS) was inversely related to FIQ, Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI)
We provide a comprehensive model that illustrates the relationships between diverse variables and healthrelated quality of life (HRQOL) in patients with FM
Summary
Fibromyalgia (FM) is a relatively common syndrome, characterized by chronic widespread musculoskeletal pain, accompanied by various somatic and psychological symptoms [1]. The prevalence of FM has been estimated to range from 2% to 7% [2, 3]. FM patients describe diverse clinical manifestations, including fatigue, sleep disturbances, stiffness, skin tenderness, post-exertional pain, irritable bowel syndrome, cognitive disturbance, irritable bladder syndrome, headaches, dizziness, fluid retention, paresthesias, restless legs, and mood disturbances. These long-term somatic and psychological symptoms may lead to the deterioration of healthrelated quality of life (HRQOL). HRQOL is an emerging issue in FM. Previous studies have compared FM patients with other subjects and have found that FM patients have a worse health status than patients with other chronic diseases, including osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, myocardial infarction, chronic obstructive pulmonary disease, congestive heart failure, hypertension, and diabetes, as well as healthy control subjects [4,5,6,7,8,9,10]
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