Multidimensional Model of Disability and Role Functioning in Rheumatoid Arthritis.
|Title||Multidimensional Model of Disability and Role Functioning in Rheumatoid Arthritis.|
|Publication Type||Journal Article|
|Year of Publication||2015|
|Authors||Ormseth SR, Draper TL, Irwin MR, Weisman MH, Aréchiga AE, Hartoonian N, Bui T, Nicassio PM|
|Journal||Arthritis Care Res (Hoboken)|
|Date Published||2015 Dec|
|Keywords||Adult, Affect, Aged, Arthralgia, Arthritis, Rheumatoid, Cost of Illness, Cross-Sectional Studies, Disability Evaluation, Female, Health Status, Humans, Male, Middle Aged, Models, Theoretical, Mood Disorders, Motor Activity, Pain Measurement, Predictive Value of Tests, Prognosis, Severity of Illness Index, Surveys and Questionnaires|
OBJECTIVE: To examine a model addressing the roles of rheumatoid arthritis (RA) disease burden, mood disturbance, and disability as determinants of impairments in role functioning.
METHODS: In a cross-sectional design, 103 RA patients recruited from the community to participate in a clinical trial completed assessments of self-assessed disease burden (total joint pain and disease activity), mood disturbance (Center for Epidemiological Studies Depression Scale depressed mood, somatic symptoms, lack of positive affect, and interpersonal problems), disability (Health Assessment Questionnaire disability index gross and fine motor), and role functioning (Short Form 36 health survey physical and social). Structural equation modeling (SEM) was used to examine direct and indirect mechanisms linking disease burden to role functioning.
RESULTS: SEM results indicated that the model had excellent fit: S-Bχ(2)(30) = 38.59, P = 0.135; comparative fit index = 0.977, standardized root mean residual = 0.062, and root mean square error of approximation = 0.053. Mediational analyses demonstrated that, while disease burden was associated with poor role functioning, its effects were jointly mediated by mood disturbance and disability. After the effects of mood disturbance and disability were taken into account, the effect of disease burden on role functioning was not significant.
CONCLUSION: The results indicate that mood disturbance and disability may serve as important pathways through which RA disease burden affects role functioning. Future longitudinal research is suggested to replicate these findings and further explore the mediational mechanisms examined in this study.
|Alternate Journal||Arthritis Care Res (Hoboken)|
|PubMed Central ID||PMC4715712|
|Grant List||AR-R01-049840 / AR / NIAMS NIH HHS / United States |
HL-R0-079955 / HL / NHLBI NIH HHS / United States
P30 AG028748 / AG / NIA NIH HHS / United States
P30-AG-028748 / AG / NIA NIH HHS / United States
R01 AG026364 / AG / NIA NIH HHS / United States
R01 AR049840 / AR / NIAMS NIH HHS / United States
R01 CA119159 / CA / NCI NIH HHS / United States
R01 HL079955 / HL / NHLBI NIH HHS / United States
R01 HL095799 / HL / NHLBI NIH HHS / United States
R01-AG-026364 / AG / NIA NIH HHS / United States
R01-AG-034588 / AG / NIA NIH HHS / United States
R01-CA-119159 / CA / NCI NIH HHS / United States
R01-HL-095799 / HL / NHLBI NIH HHS / United States
UL-RR-033176 / RR / NCRR NIH HHS / United States
UL1 RR033176 / RR / NCRR NIH HHS / United States