Spinsterhood and its impact on disease features in women with rheumatoid arthritis

Health and Quality of Life Outcomes

Research

Yousra Ibn Yacoub¹  Najia Hajjaj-Hassouni¹  Bouchra Amine¹  Assia Laatiris¹ 

[1] Department of Rheumatology (Pr N. Hajjaj-Hassouni), El Ayachi Hospital, University Hospital of Rabat-Sale, Morocco;

关键词: Rheumatoid Arthritis;    Rheumatoid Arthritis Patient;    Functional Disability;    Health Assessment Questionnaire;    High Disease Activity;   

DOI  :  10.1186/1477-7525-9-58

 received in 2011-03-15, accepted in 2011-08-01,  发布年份 2011

来源: Springer

【 摘 要 】

ObjectiveTo evaluate the impact of spinsterhood on disease characteristics and quality of life (QoL) in Moroccan women with rheumatoid arthritis (RA).Methods185 women with RA were recruited in this study. Marital status was specified as follow: 1. Spinsterhood (never-married woman aged 38 or over), 2. Distressed marriage; 3. Nondistressed marriage and 4. Divorced or widowed. Marital distress was assessed by a self-report concerning coping efficacy and burden caring of husbands. Assessment criteria included the evaluation of: age at onset (years), diagnosis delay (months), disease duration (years), disease activity (evaluated by physical examination, biological inflammatory tests; and disease activity score (DAS 28)), pain intensity (measured with a visual analogue scale (VAS)); and radiographic damage (evaluated by the Sharp's method as modified by van der Heijde). Treatments (doses and duration) were specified. The Health Assessment Questionnaire (HAQ) was used to evaluate functional disability. QoL was measured using the Arabic version of the generic instrument SF-36.ResultsIn our data, spinsterhood was detected in 42 (22.7%) patients vs. 88 (47.5%) with distressed marriage, 28 (15.1%) with nondistressed marriage and 27 (14.6%) divorced or widowed. Comparing the 4 groups, we found that QoL in never-married women was damaged in a significant way comparing to the other groups. Mental as well as physical aspects were affected. Also, we found that spinsterhood was associated to an early age at onset (p = 0.009), pain intensity (p < 0.001); clinical (p < 0.001) and biological disease activity (C-reactive protein; p = 0.02) and functional disability (p < 0.001). Logistic regression analysis revealed a significant relationship between spinsterhood and early age at onset and severe functional disability (for all p ≤ 0.01).ConclusionThis study suggests that spinsterhood in our RA patients was associated with an altered QoL even compared with distressed married women. Also, we state that spinsterhood was associated with an early age at onset, severe joint pain; higher disease activity and with altered functional ability. It seems important to consider not only disease-related parameters but also social status as a determinant factor of poor course in RA.

【 授权许可】

CC BY   
© Ibn Yacoub et al; licensee BioMed Central Ltd. 2011