Factors Influencing Health-Related Quality of Life in Thai Patients with Rheumatoid Arthritis

Introduction: Health-related quality of life is one of the indicator identify whether a person could live in a society happiness with life.Especially,patients with rheumatoid arthritis are suffered from signs and symptoms.The illness has various impacts on the physical,psychological ,social well being and general health perception.Those are affected on their health-related quality of life.Thus,nurse should enhance the patients’ health-related quality of life.

Purposes:The purposes of this research are to examine  health-related quality of life and to   analyze selected factors affecting health-related quality of life.The selected factors composed of joint pain, pain coping, depression, fatigue, sleep quality, functional ability and illness beliefs.

Methods: A sample of  one hundred and fifty out- patients with rheumatoid arthritis aged 20-59 years old, who follow up at the Department of Rheumatology of the Police general hospital and Faculty of Medicine Vajira Hospital by a multistage random selection. Questionnaires were composed of The Demographic Patients’ Data, The short form of the McGill Pain Questionnaire, the Pain Coping Inventory, Beck Depression Inventory, the Multidimensional Assessment of Fatigue ,the Pittsburgh Sleep Quality Index, Health Assessment Questionnaire Disability Index, the Brief Perception Questionnaire ,and the Short Form Health Survey-36. All questionnaires were tested for content validities by five panel of experts, and the alpha Cronbach reliabilities were .70 to .93.  Descriptive statistics (Percentage, mean, and standard deviation), Pearson’s production-moment correlation and Stepwise multiple regression were used to analyze data.

Results:the results showed as follows:

1. Mean score of health-related quality of life in patients with rheumatoid arthritis was in good level. (X=440.36 ,SD=173.10)
2. Model 1:The variables that explained health-related quality of life were  illness beliefs, fatigue ,functional ability, depression and sleep quality were the variables that significantly predicted health-related quality of life at the level of .05(F=68.58).The predictive power was 71.8% (R² = .718) of the variance.
3. Model 2: The variables that explained  illness beliefs are fatigue, depression, functional ability, joint pain.It was accounted for 50.7% of the variance.
4. Model 3: The variables that explained depression are illness beliefs,passive pain coping, sleep quality, fatigue. It was accounted for 43.7% of the variance.

    According to path analysis, we found that illness beliefs, fatigue, functional ability, depression and sleep quality  were both  direct and indirect effects on health-related quality of life while joint pain  and passive  pain coping  were  only  indirect effects on health-related quality of life by passing illness beliefs and depression respectively.

Conclusions: The results of this study indicated that  nurses should promote health-related quality of life in patients with rheumatoid arthritis not only phisical signs and symptoms but also psychological signs and symptoms of patients.