Effect Of Stress on Quality of Life in Patients with Chronic Rheumatoid Arthritis
Stress on Quality of Life in Patients with Chronic Rheumatoid Arthritis
Keywords:Quality of life, Rheumatoid Arthritis, Stress
Stress symptoms affect one’s body, thoughts and feelings. Stress may decrease an individual’s self-esteem, increasing anxiety and sadness, and adversely affecting the general quality of life (QoL) in rheumatoid arthritis (RA) patients. Objective: To determine the effect of stress on quality of life in patients with chronic rheumatoid arthritis. Methods: This cross-sectional study was conducted on 196 participants at The University of Lahore Teaching Hospital. Stress in RA patients was measured using a perceived stress score (PSS). PSS scores were calculated by inverting replies to the four positively stated items (items 4, 5, 7, and 8) and then accumulating all scale items (e.g., 0 = 4, 1 = 3, 2 = 2, 3 = 1 & 4 = 0). The SF-36 questionnaire was used to measure QoL. The lower the score, the greater the degree of impairment; for example, a score of zero equals maximum disability and a score of 100 equals no disability. A non-probability convenient sampling strategy was used to compute sample size. Results: The results showed that the average value of age was 44.14± 6.842 years with a lowest value of 32.00 and a highest value of 58.00 years. Male had a frequency of 13 (6.6%) and patients with a frequency of 183 (93.4%). According to the results, the average value of physical health component scoring was 37.12± 9.96 and the average value of mental health component scoring was 44.00± 5.738. The results showed that the average value of perceived stress score was 25.32± 7.47. The significant value of 0.000 was smaller than the p-value in the study, indicating that there is a link between stress and quality of life. Conclusion: These findings led to the conclusion that stress had an impact on RA Patient's quality of life.
Gombart AF, Pierre A, Maggini S. A review of micronutrients and the immune system–working in harmony to reduce the risk of infection. Nutrients. 2020;12(1):236. doi.org/10.3390/nu12010236
Vojdani A, Vojdani E, Vojdani C. The Immune System: Our Body’s Homeland Security Against Disease. Integrative and Functional Medical Nutrition Therapy: Springer; 2020;285-302. doi.org/10.1007/978-3-030-30730-1_19
Wang D, Zhang J, Lau J, Wang S, Taneja V, Matteson EL, et al. Mechanisms of lung disease development in rheumatoid arthritis. Nature Reviews Rheumatology. 2019;15(10):581-96. doi.org/10.1038/s41584-019-0275-x
Marcucci E, Bartoloni E, Alunno A, Leone M, Cafaro G, Luccioli F, et al. Extra-articular rheumatoid arthritis. Reumatismo. 2018;70(4):212-24. doi.org/10.4081/reumatismo.2018.1106
Conforti A, Di Cola I, Pavlych V, Ruscitti P, Berardicurti O, Ursini F, et al. Beyond the joints, the extra-articular manifestations in rheumatoid arthritis. Autoimmunity Reviews. 2021;20(2):102735.doi.org/10.1016/j.autrev.2020.102735
Chirila RM, Berianu F, Abril A, Butendieck Jr RR. Extra‐articular involvement of rheumatoid arthritis in three seropositive patients in the absence of initial joint involvement. Immunity, Inflammation and Disease. 2021;9(4):1613-7. doi.org/10.1002/iid3.514
Gulati M, Farah Z, Mouyis M. Clinical features of rheumatoid arthritis. Medicine. 2018;46(4):211-5. doi.org/10.1016/j.mpmed.2018.01.008
Colquhoun M, Gulati M, Farah Z, Mouyis M. Clinical features of rheumatoid arthritis. Medicine. 2022. doi.org/10.1016/j.mpmed.2021.12.002
Cush JJ. Rheumatoid arthritis: early diagnosis and treatment. Medical Clinics. 2021;105(2):355-65. doi.org/10.1016/j.mcna.2020.10.006
Lo J, Chan L, Flynn S. A systematic review of the incidence, prevalence, costs, and activity and work limitations of amputation, osteoarthritis, rheumatoid arthritis, back pain, multiple sclerosis, spinal cord injury, stroke, and traumatic brain injury in the United States: a 2019 update. Archives of physical medicine and rehabilitation. 2021;102(1):115-31. doi.org/10.1016/j.apmr.2020.04.001
Almutairi K, Nossent J, Preen D, Keen H, Inderjeeth C. The global prevalence of rheumatoid arthritis: a meta-analysis based on a systematic review. Rheumatology International. 2021;41(5):863-77. doi.org/10.1007/s00296-020-04731-0
Otón T, Carmona L. The epidemiology of established rheumatoid arthritis. Best Practice & Research Clinical Rheumatology. 2019;33(5):101477. doi.org/10.1016/j.berh.2019.101477
edunjobi as. rheumatoid arthritis among patients presenting at the rheumatology out-patient clinic of the olabisi onabanjo university teaching hospital, sagamu, western nigeria. faculty of internal medicine. 2016.
Kuang S, Yap ES, Wang DA, Lahiri M, Pattapola S, Gendi N, et al. 001. Pure Red Cell Aplasia: A Rare and Challenging Extra-Articular Manifestation of Rheumatoid Arthritis. Rheumatology. 2017;56(suppl_2):ii49-ii95. doi.org/10.1093/rheumatology/kex062
Moradi B, Schnatzer P, Hagmann S, Rosshirt N, Gotterbarm T, Kretzer JP, et al. CD4+ CD25+/high CD127 low/-regulatory T cells are enriched in rheumatoid arthritis and osteoarthritis joints—analysis of frequency and phenotype in synovial membrane, synovial fluid and peripheral blood. Arthritis research & therapy. 2014;16(2):1-13. doi.org/10.1186/ar4545
Smith MD, Weedon H, Papangelis V, Walker J, Roberts-Thomson PJ, Ahern MJ. Apoptosis in the rheumatoid arthritis synovial membrane: modulation by disease-modifying anti-rheumatic drug treatment. Rheumatology. 2010;49(5):862-75. doi.org/10.1093/rheumatology/kep467
Choy E. Understanding the dynamics: pathways involved in the pathogenesis of rheumatoid arthritis. Rheumatology. 2012;51(suppl_5):v3-v11. doi.org/10.1093/rheumatology/kes113
Noss EH, Brenner MB. The role and therapeutic implications of fibroblast‐like synoviocytes in inflammation and cartilage erosion in rheumatoid arthritis. Immunological reviews. 2008;223(1):252-70. doi.org/10.1111/j.1600-065X.2008.00648.x
Grabiec AM, Korchynskyi O, Tak PP, Reedquist KA. Histone deacetylase inhibitors suppress rheumatoid arthritis fibroblast-like synoviocyte and macrophage IL-6 production by accelerating mRNA decay. Annals of the rheumatic diseases. 2012;71(3):424-31.doi.org/10.1136/ard.2011.154211
Wong CK, Chen DP, Tam LS, Li EK, Yin YB, Lam CW. Effects of inflammatory cytokine IL-27 on the activation of fibroblast-like synoviocytes in rheumatoid arthritis. Arthritis research & therapy. 2010;12(4):1-15.doi.org/10.1186/ar3067
Najm A, Masson FM, Preuss P, Georges S, Ory B, Quillard T, et al. MicroRNA‐17‐5p reduces inflammation and bone erosions in mice with collagen‐induced arthritis and directly targets the JAK/STAT pathway in rheumatoid arthritis fibroblast‐like synoviocytes. Arthritis & Rheumatology. 2020;72(12):2030-9. doi.org/10.1002/art.41441
van der Woude D, van der Helm-van AH. Update on the epidemiology, risk factors, and disease outcomes of rheumatoid arthritis. Best Practice & Research Clinical Rheumatology. 2018;32(2):174-87. doi.org/10.1016/j.berh.2018.10.005
Sowmya T. Tumbe Group of International Journals 2019.
Mandal U, Mahalik G. Ethnomedicinal plants used in rheumatoid arthritis. Medico-Bio wealth of India. 2021;2:140-7.
Rawla P. Cardiac and vascular complications in rheumatoid arthritis. Reumatologia. 2019;57(1):27-36. doi: 10.5114/reum.2019.83236.
Roongta R, Ghosh A. Managing rheumatoid arthritis during COVID-19. Clinical rheumatology. 2020;39(11):3237-44. doi.org/10.1007/s10067-020-05358-z
Sturgeon JA, Finan PH, Zautra AJ. Affective disturbance in rheumatoid arthritis: psychological and disease-related pathways. Nature Reviews Rheumatology. 2016;12(9):532-42. doi.org/10.1038/nrrheum.2016.112
Finan PH, Zautra AJ. Stress affects rheumatoid arthritis, but via what mechanisms? Nature Reviews Rheumatology. 2013;9(10):569-70. doi.org/10.1038/nrrheum.2013.139
Conceição CTM, Meinão IM, Bombana JA, Sato EI. Psychoanalytic psychotherapy improves quality of life, depression, anxiety and coping in patients with systemic lupus erythematosus: a controlled randomized clinical trial. Advances in Rheumatology. 2019;59. doi.org/10.1186/s42358-019-0047-y
Bucourt E, Martaillé V, Goupille P, Joncker-Vannier I, Huttenberger B, Réveillère C, et al. A comparative study of fibromyalgia, rheumatoid arthritis, spondyloarthritis, and Sjögren’s syndrome; impact of the disease on quality of life, psychological adjustment, and use of coping strategies. Pain Medicine. 2021;22(2):372-81. doi.org/10.1093/pm/pnz255
Vallerand IA, Patten SB, Barnabe C. Depression and the risk of rheumatoid arthritis. Current opinion in rheumatology. 2019;31(3):279.doi.org/10.1097/BOR.0000000000000597
Englbrecht M, Alten R, Aringer M, Baerwald CG, Burkhardt H, Eby N, et al. New insights into the prevalence of depressive symptoms and depression in rheumatoid arthritis–Implications from the prospective multicenter VADERA II study. PLoS One. 2019;14(5):e0217412. doi.org/10.1371/journal.pone.0217412
Taylor JM. Psychometric analysis of the ten-item perceived stress scale. Psychological assessment. 2015;27(1):90. doi.org/10.1037/a0038100
Agrawal R, D’Silva C. Assessment of quality of life in normal individuals using the SF36 questionnaire. Int J Cur Res Rev. 2017;9(3):43-7.
Basavaraj KH, Navya MA, Rashmi R. Stress and quality of life in psoriasis: an update. International Journal of Dermatology. 2011;50(7):783-92. doi.org/10.1111/j.1365-4632.2010.04844.x
Cadena J, Vinaccia S, Pérez A, Rico MI, Hinojosa R, Anaya J-M. The impact of disease activity on the quality of life, mental health status, and family dysfunction in colombian patients with rheumatoid arthritis. JCR: Journal Of Clinical Rheumatology. 2003;9(3):142-50. doi.org/10.1097/01.RHU.0000073434.59752.f3
Bugajska J, Brzosko M, Jędryka-Góral A, Głuszko P, Żołnierczyk-Zreda D, Sagan A, et al. Psychological stress in rheumatoid arthritis patients: a comparative Polish–German study: summary of the current conceptualization of the role of stress in rheumatoid arthritis. Autoimmunity reviews. 2010;9(4):211-5. doi.org/10.1016/j.autrev.2009.08.005
Dardas LA, Ahmad MM. Coping strategies as mediators and moderators between stress and quality of life among parents of children with autistic disorder. Stress and Health. 2015;31(1):5-12.doi.org/10.1002/smi.2513
Javadi F, Ahmadzadeh A, Eghtesadi S, Aryaeian N, Zabihiyeganeh M, Rahimi Foroushani A, et al. The effect of quercetin on inflammatory factors and clinical symptoms in women with rheumatoid arthritis: a double-blind, randomized controlled trial. Journal of the American College of Nutrition. 2017;36(1):9-15.doi.org/10.1080/07315724.2016.1140093
García-González A, Gaxiola-Robles R, Zenteno-Savín T. Oxidative stress in patients with rheumatoid arthritis. Revista de investigacion clinica. 2015;67(1):46-53.
Mehta S, Rice D, Janzen S, Pope J, Harth M, Shapiro A, et al. Mood, disability, and quality of life among a subgroup of rheumatoid arthritis individuals with experiential avoidance and anxiety sensitivity. Pain research and management 2016. doi.org/10.1155/2016/7241856
Alishiri G, Bastani R, Ahmadi K, Saadat SH. Effect of Stress Management on Quality of Life in Females with Rheumatoid Arthritis. Iranian Journal of Psychiatry and Behavioral Sciences. 2017;11(3):5. doi.org/10.5812/ijpbs.9605
Goma SH, Razek MRA, Abdelbary NM. Impact of rheumatoid arthritis on the quality of life and its relation to disease activity. Egyptian Rheumatology and Rehabilitation. 2019;46(4):304-12. doi.org/10.4103/err.err_39_19
Vahedi Hemat A, Safaei Rad I. The Effect of Cognitive-Behavioral Group Therapy on Reducing Anxiety Symptoms (trait and state), Stress and Quality of Life in Second Grade High School Students with Rheumatoid Arthritis. Journal of Psychology New Ideas. 2020;6(10):1-13.
Englbrecht M, Gossec L, DeLongis A, Scholte-Voshaar M, Sokka T, Kvien TK, et al. editors. The impact of coping strategies on mental and physical well-being in patients with rheumatoid arthritis. Seminars in arthritis and rheumatism; 2012: Elsevier. doi.org/10.1016/j.semarthrit.2011.07.009
Isik A, Koca SS, Ozturk A, Mermi O. Anxiety and depression in patients with rheumatoid arthritis. Clinical rheumatology. 2007;26(6):872-8.doi.org/10.1007/s10067-006-0407-y
Connell J, Brazier J, O’Cathain A, Lloyd-Jones M, Paisley S. Quality of life of people with mental health problems: a synthesis of qualitative research. Health and quality of life outcomes. 2012;10(1):1-16. doi.org/10.1186/1477-7525-10-138
Leventhal hor, ian B. The common-sense model of self-regulation of health and illness. The self-regulation of health and illness behaviour: Routledge; 2012;56-79.
Dickens C, Jackson J, Tomenson B, Creed F. Association of depression and rheumatoid arthritis. Psychosomatics. 2003;44(3):209-15.doi.org/10.1176/appi.psy.44.3.209
Moosavian SP, Paknahad Z, Habibagahi Z. A randomized, double‐blind, placebo‐controlled clinical trial, evaluating the garlic supplement effects on some serum biomarkers of oxidative stress, and quality of life in women with rheumatoid arthritis. International journal of clinical practice. 2020;74(7):e13498. doi.org/10.1111/ijcp.13498
How to Cite
Copyright (c) 2022 Pakistan BioMedical Journal
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments email@example.com