The relationship between personality, supportive transactions and support satisfaction, and mental health of patients with early rheumatoid arthritis. Results from the Dutch part of the Euridiss study:results from the Dutch part of the Euridiss study

The relationships between two personality characteristics (neuroticism, extraversion), three types of supportive transactions (emotional support, social companionship, instrumental support) and satisfaction with these transactions, and two aspects of mental health (feelings of anxiety and depressive mood) were studied among 280 patients with early rheumatoid arthritis. Structural equation modeling of the relevant variables showed that people with a more neurotic personality profile showed more anxiety and depressed feelings. Extraversion had no direct effect on depression or anxiety. Companionship, both transactions and satisfaction, had an independent positive effect on depression but not on anxiety. The effect of emotional support ran via social companionship: more emotional support (both transactions and satisfaction) was expressed in companionship leading to a less depressed mood. Finally, more depressed people received more instrumental supportive transactions while more satisfaction with this type of supportive transactions was related to less anxiety. Apart from the disturbing effect of a neurotic personality profile on mental health, the results once more underscore the importance of social companionship as a multifunctional activity for people's mental health. Maintaining this type of relationships despite a disabling condition gives people the opportunity to derive rewards that otherwise could not or only with more difficulty be achieved

Sick leave and work disability in patients with early arthritis

We studied the occurrence of sick leave and work disability, the presence of workplace adaptations and the usage of professional guidance related to working problems in patients with early arthritis. Inclusion criteria were arthritis symptoms of less than 2 years duration and a paid job at the time of diagnosis. Assessments were done in connection with an early arthritis clinic (EAC) at entry into the cohort and 12 months thereafter by means of a questionnaire comprising questions on sick leave (absenteeism from work reported to the employer), work disability (receiving a full or partial work disability pension), unemployment, work adaptations and professional guidance related to working problems. Fifty-seven of the 69 participants (83%) had an arthritis symptom duration of <6 months. The number of patients with sick leave due to arthritis in the past 12 months decreased from 28 (41%) at study entry to 18 (26%) after 12 months of follow-up. The number of patients receiving a work disability pension increased from 5 (7%) at study entry to 13 (19%) after 12 months of follow-up (10 partial and 3 full). Sick leave in the 12 months before study entry appeared to be the most important predictor of the institution or increase in a work disability pension (odds ratio, 16.1; 95%CI, 1.8–142.8). Between study entry and follow-up, the number of patients with workplace adaptations increased from 20 (29%) to 28 (42%), whereas the number of patients receiving vocational guidance decreased from 48 (70%) to 36 (52%). In patients with early arthritis and a paid job, arthritis-related sick leave was common and occurred in part before patients entered the EAC and a diagnosis was made. About 20% of the patients became permanently work disabled, with partial work disability being more common than full work disability. Considerable proportions of patients received workplace adaptations and professional guidance with working problems

Osteoarthritis and functional disability: results of a cross sectional study among primary care patients in Germany

Contains fulltext : 52359.pdf ( ) (Open Access)BACKGROUND: The aim of the study was to determine factors associated with functional disability in patients with OA. METHODS: 1250 questionnaires were distributed to OA outpatients from 75 general practices; 1021 (81.6%) were returned. Questionnaires included sociodemographic data, the short form of the Arthritis Impact Measurement Scale (AIMS2-SF), and the Patient Health Questionnaire (PHQ-9) to assess concomitant depression. A hierarchical stepwise multiple regression analysis with the AIMS2-SF dimension "lower body" as dependent was performed. RESULTS: Main factors associated with functional disability were depression symptoms, as reflected in a high score of the PHQ-9 (beta = 0.446; p < 0.0009), pain as reflected in the AIMS2-SF symptom scale (beta = 0.412; p = 0.001), and few social contacts (beta = 0.201; p < 0.042). A high body mass index was associated with lower functional ability (beta = 0.332; p = 0.005) whereas a higher educational level (beta = -0.279; p = 0.029) predicted less impairment. Increased age was a weak predictor (beta = 0.178; p = 0.001) of disability. With a p of 0.062 the radiological severity according to the grading of Kellgren and Lawrence slightly surpassed the required significance level for remaining in the final regression model. CONCLUSION: The results emphasize that psychological as well as physical factors need to be addressed similarly to improve functional ability of patients suffering from OA. More research with multifaceted and tailored interventions is needed to determine how these factors can be targeted appropriately

Impairment measures in rheumatic disorders for rehabilitation medicine and allied health care: a systematic review

The objective of this study is to provide a critical overview of available instruments to assess impairments in patients with rheumatic disorders, and to recommend reliable and valid instruments for use in allied health care and rehabilitation medicine. A computer-aided literature search (1982-2004) in several databases was performed to identify studies focusing on the clinimetric properties of instruments designed to assess impairments in function in patients with rheumatic disorders. Data on intra-rater reliability, inter-rater reliability and construct validity were extracted in a standardized way. Explicit criteria were applied for reliability and validity. Results: The search identified a total of 49 instruments to assess impairments in functions in patients with rheumatic disorders; 19 met the criteria for reliability, 22 met the criteria for validity, and 11 out of the 49 appeared to meet the criteria for both reliability and validity. In summary, evidence of both reliability and validity was only found for 11 out of 49 instruments for the assessment of impairments in patients with rheumatic disorders. Only a limited number of the identified instruments for the assessment of impairments is both reliable and valid. Allied health care professionals should be cautious in the selection of measurement instruments to assess their patient

The Aetiology of Anaphylaxis

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