Abstract
BackgroundAs 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).MethodsA 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.ResultsThe 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.ConclusionsThe 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.
Highlights
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
For the health assessment questionnaire-disability index (HAQ-DI) score ≥ 1 patients, significant associations were found with long disease duration (P = 0.042), sever pain (P < 0.001), a large number of tender joints (P = 0.013) and swollen joints (P = 0.001), high disease activity (P < 0.001), high C-reactive protein (CRP) level (P < 0.001), medication adherence (P = 0.024), and grip strength (P = 0.016)
No statistically significant associations were found with regard to gender (P = 0.715), age (P = 0.904), body mass index (BMI) (P = 0.089), education (P = 0.755), income/person/month (P = 0.454), working status (P = 0.512), health insurance (P = 0.938), comorbidities (P = 0.425), erythrocyte sedimentation rate (ESR) (P = 0.077), rheumatoid factor (RF) positivity (P = 0.346), pinch strength (P = 0.205), shoulder abduction (P = 0.063), hip flexion (P = 0.304), and ankle dorsiflexion (P = 0.910)
Summary
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. 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). As an important outcome measure among rheumatoid arthritis (RA) patients, functional disability may contribute to unemployment, loss of work productivity, increased healthcare costs, and impaired quality of life for millions worldwide [1,2,3,4]. The aims of this study were to explore the possible risk factors of the HAQ-DI using RA patient population from China, in order to identify warning signs for delaying the onset of disabilities of this patients. It was hypothesized that some disease and quality-of-life parameters would affect functional disability
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