Abstract

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a wide spectrum of clinical manifestations such as organ damage, pain, fatigue, sleep disorders, depression and cognitive deficits. It is known that pain catastrophising may have serious impact in individuals with SLE. Furthermore, catastrophising and maladaptive coping strategies are linked to higher levels of functional impairment and depression in SLE. Objectives: The aim of this study was to identify factors associated with pain catastrophising to detect possible susceptible targets in individuals with systemic lupus erythematosus. Methods: A total of 104 individuals (mean age: 55.54±12.09 years; BMI: 27.17±4.01 kg/m2) with SLE participated to the study. The Pain Catastrophizing Scale (PCS) was used to measure the extent to which people catastrophize in response to pain. The Tampa Scale for Kinesiophobia (TSK) was used to assess pain-related fear of movement. The Beck’s Depression Inventory (BDI) was used to measure characteristic attitudes and symptoms of depression. The Body Awareness Rating Questionnaire (BARQ) was used to reflect on their self-reported body awareness. The multiple stepwise linear regression models with R-square (R2) were used to compare across the models and explain the total variance. Results: Mean PCS was 22.12±12.09; mean TSK was 42.94±7.76; mean BDI was 15.63±11.18 and mean BARS was 88.94±19.85. Linear regression analysis revealed that TSK, BDI, BARS and BMI were independently associated with PCS in predicting pain catastrophising in individuals with SLE (p≤0.001; R2=0.52). There were no correlations between PCS and disease activity (mean SLAM-R:5.39±3.68; r=0.105) and organ damage (mean SLICC-DI:0.58±0.87; r=0.153) (p>0.05). Conclusion: This study increases the understanding of the modifiable predictors to enhance pain coping behavior in accordance with the pharmacological treatment in SLE population. Results demonstrate major importance to explore the main stressors of pain catastrophising such as kinesiophobia, depression level, body awareness and BMI that affect coping behavior. Thus, pain catastrophising may limit the patients’ ability to perform from simple to complex activities. In addition, body image concerns SLE patients as they experience weight gain which negatively impact their self-esteem. The patient reported outcomes could guide health professionals to identify unmet needs of patients at risk to facilitate incorporation of the biopsychosocial model into SLE management.

Highlights

  • Patient activation describes the skills, abilities and confidence someone has to actively manage their health

  • Seventeen participants living with a rheumatic condition in the South West of England participated in semi-structured interviews as part of a wider qualitative study investigating perceptions of patient activation

  • Aspects of the Patient Activation Measure (PAM) that participants felt were not sufficiently recognised included how they managed the psychological impact of their condition, and how they discussed their condition with loved ones

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Summary

Introduction

Patient activation describes the skills, abilities and confidence someone has to actively manage their health. THU0719-HPR THE PATIENT ACTIVATION MEASURE (PAM): WHAT DO PATIENTS WITH RHEUMATIC CONDITIONS THINK ABOUT IT? The PAM has been widely adopted and used in a variety of populations both within the NHS and internationally, but case studies have reported that some patients found that the PAM was too broad to capture the skills they used to manage their health.

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