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Factors promoting health-related quality of life in people with rheumatic diseases: a 12 month longitudinal study
Research and Development Centre Spenshult, Spenshult hospital for rheumatic diseases, Oskarström, Sweden & School of Health Sciences, Jönköping University, Jönköping, Sweden.ORCID iD: 0000-0001-5647-086X
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Gjøvik University College, Faculty of Nursing Science, Gjøvik, Norway.
School of Health Sciences & Social Work, Växjö University, Växjö, Sweden & School of Health Sciences, Jönköping University, Jönköping, Sweden.
Research and Development Centre Spenshult, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.ORCID iD: 0000-0002-6294-538X
2011 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, Vol. 12, 102Article in journal (Refereed) Published
Abstract [en]

Background: Rheumatic diseases have a significant adverse impact on the individual from physical, mental and social aspects, resulting in a low health-related quality of life (HRQL). There is a lack of longitudinal studies on HRQL in people with rheumatic diseases that focus on factors promoting HRQL instead of risk factors. The aim of this study was to investigate the associations between suggested health promoting factors at baseline and outcome in HRQL at a 12 month follow-up in people with rheumatic diseases.

Methods: A longitudinal cohort study was conducted in 185 individuals with rheumatic diseases with questionnaires one week and 12 months after rehabilitation in a Swedish rheumatology clinic. HRQL was assessed by SF-36 together with suggested health factors. The associations between SF-36 subscales and the health factors were analysed by multivariable logistic regressions.

Results: Factors predicting better outcome in HRQL in one or several SF-36 subscales were being younger or middle-aged, feeling painless, having good sleep structure, feeling rested after sleep, performing low effort of exercise more than twice per week, having strong sense of coherence (SOC), emotional support and practical assistance, higher educational level and work capacity. The most important factors were having strong SOC, feeling rested after sleep, having work capacity, being younger or middle-aged, and having good sleep structure.

Conclusions: This study identified several factors that promoted a good outcome in HRQL to people with rheumatic diseases. These health factors could be important to address in clinical work with rheumatic diseases in order to optimise treatment strategies. © 2011 Arvidsson et al; licensee BioMed Central Ltd.

Place, publisher, year, edition, pages
London: BioMed Central, 2011. Vol. 12, 102
Keyword [en]
adult, aged, article, diet, exercise, female, follow up, human, longitudinal study, major clinical study, male, outcome assessment, quality of life, questionnaire, rheumatic disease, Short Form 36, sleep, work capacity
National Category
Nursing
Identifiers
URN: urn:nbn:se:hh:diva-16852DOI: 10.1186/1471-2474-12-102ISI: 000293015600001PubMedID: 21599884Scopus ID: 2-s2.0-79956191676OAI: oai:DiVA.org:hh-16852DiVA: diva2:471144
Note

The study was financed by the Halland County Council, the Swedish Rheumatism Association, the Rheumatism District in Gothenburg, the South Regional Health Care Committee, the Swedish Society of Nursing and the Association of Rheumatology Nurses in Sweden.

Available from: 2012-01-01 Created: 2012-01-01 Last updated: 2016-10-21Bibliographically approved
In thesis
1. Health promoting factors in people with chronic musculoskeletal pain or with rheumatic diseases: a desciptive and interventional study
Open this publication in new window or tab >>Health promoting factors in people with chronic musculoskeletal pain or with rheumatic diseases: a desciptive and interventional study
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis with a salutogenic approach was to describe health promoting factors in people with chronic musculoskeletal pain and in people with rheumatic diseases, and to evaluate the effects of an intervention study with a self-care promoting PBL-program for people with rheumatic diseases having chronic musculoskeletal pain, sleep disturbances and/or fatigue.

Methods: This thesis is comprised of four samples: a randomly selected sample from a Swedish general population (study I) and three different samples containing people with rheumatic diseases registered at a hospital for rheumatic diseases in the southwest of Sweden (studies II, III and IV). Study I had a longitudinal cohort design with an eight-year follow-up in a general population. There were 1109 participants without chronic pain and 700 participants with chronic musculoskeletal pain. Study II had a longitudinal cohort design with participants with rheumatic diseases (n=185) 12 months after rehabilitation at a hospital for rheumatic diseases. Study III had a descriptive qualitative design with a phenomenological approach based on a reflective life-world perspective. Twelve participants were interviewed about their experiences about health-promoting self-care. Study IV had a randomised controlled design with post-test six months after the one-year self-care promoting problem-based learning (PBL) program for people with rheumatic diseases. The participants were randomly assigned to the experimental group, 54 participants, or to the control group, 148 participants. Data in studies I, II and IV were analysed with statistics. In study III a Husserlian phenomenological approach based on a reflective life-world perspective was used in the data collection and analysis.

Results: Study I: Although participants without chronic musculoskeletal pain reported better health-related quality of life (HRQL) than participants with chronic musculoskeletal pain, similar health factors were found to promote a better HRQL in the eight-year follow-up. The most important factors were feeling rested after sleep and having good sleep structure. Study II: The most important factors promoting better outcome in HRQL 12 months after rehabilitation in participants with rheumatic diseases were having a strong sense of coherence (SOC), feeling rested after sleep, having work capacity, and having good sleep structure. Study III: The meaning of health-promoting self-care as experienced by people with rheumatic diseases was that self-care takes place against a background of continual hope and belief to be able to influence health in positive ways. Self-care was a way of life and implied being ready to understand and respond to signals from the body. Three interrelated constituents elucidated the experiences: dialogue, power struggle and choice. Study IV: At the six month follow-up the participants in the experimental group had stronger empowerment after participation in the self-care promoting PBL-program compared with the control group which only got standard care for people with rheumatic diseases. There were no differences in HRQL, self-care ability, SOC, pain, quality of sleep or fatigue between the experimental group and the control group. The participants in the experimental group also stated that they had implemented lifestyle changes which they had not done without the PBL-program.

Conclusion: The results of this thesis provide a valuable and useful insight in health promoting factors in people with chronic musculoskeletal pain and in people with rheumatic diseases, but also in that people with rheumatic diseases have benefit from taking part in patient education with a self-care promoting PBL-program. These results contribute to evidence supporting the introduction of a more salutogenic approach in rheumatology care and research.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, 2011. 164 p.
Series
Dissertation series (School of Health Sciences, Jönköping University), ISSN 1654-3602 ; 17
Keyword
Adult, chronic musculoskeletal pain, empowerment, health factors, HRQL, intervention, patient education, problem-based learning, rheumatic diseases, self-care
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-28606 (URN)978-91-85835-16-4 (ISBN)
Public defence
2011-06-01, Forum Humanum, Hälsohögskolan, Jönköping, 09:30 (Swedish)
Opponent
Supervisors
Available from: 2015-07-28 Created: 2015-06-16 Last updated: 2016-10-21Bibliographically approved

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