Effect of coping strategies on patient and physician perceptions of disease severity and disability in systemic sclerosis

Dana D DiRenzo; Theresa R Smith; Tracy M Frech; Ami A Shah; John D Pauling

doi:10.3899/jrheum.201612

Effect of coping strategies on patient and physician perceptions of disease severity and disability in systemic sclerosis

Dana D DiRenzo, Theresa R Smith, Tracy M Frech, Ami A Shah, John D Pauling

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Abstract

Objective. Systemic sclerosis (SSc) results in impaired function, disability, and reduced health-related quality of life. We investigated the effect of coping strategies on the patient global assessment of health (PtGA) and Health Assessment Questionnaire–Disability Index (HAQ-DI), after controlling for clinical characteristics and disease activity. We also explored the relationship between coping strategies and the correlation between the PtGA and physician global assessment (PGA) in SSc. Methods. We undertook posthoc analyses using baseline data obtained from the Raynaud Symptom Study (RSS). The PtGA, Coping Strategies Questionnaire, Pain Catastrophizing Scale, and Scleroderma Health Assessment Questionnaire were collected alongside the PGA, clinical characteristics, and patient demographics. Multivariable linear regression models and correlations were used to evaluate the relationship between coping strategies with the PtGA, HAQ-DI, and PGA. Results. Of the 107 patients with SSc enrolled in the RSS, there were sufficient data available for the analysis of 91 participants. The mean PtGA was 40/100 (SD 27) and the mean HAQ-DI was 0.87/3.0 (SD 0.73). After controlling for clinical and patient demographics, pain catastrophizing and maladaptive coping skills were significantly associated with the PtGA and HAQ-DI scores (P < 0.05 for both), but not the PGA. Conclusion. The effect of coping strategies on PtGA and HAQ-DI (but not PGA in SSc) could influence the result of composite measures incorporating these outcome measures. Interventions to improve patient coping skills may support increased resilience and improve patient-perceived functional status and PtGA in SSc.

Original language	English
Pages (from-to)	1569 - 1573
Number of pages	5
Journal	The Journal of Rheumatology
Volume	48
Issue number	10
Early online date	1 May 2021
DOIs	https://doi.org/10.3899/jrheum.201612
Publication status	Published - 1 Oct 2021

Bibliographical note

Funding Information:
DDD is supported by the Jerome L. Greene Foundation. 1D.D. DiRenzo, MD, MHS, A.A. Shah, MD, MHS, Johns Hopkins Division of Rheumatology, Baltimore, Maryland, USA; 2T.R. Smith, PhD, Department of Mathematical Sciences, University of Bath, Bath, UK; 3T.M. Frech, MD, MS, University of Utah, Salt Lake City, Utah, USA; 4J.D. Pauling, BMedSci, BMBS, PhD, FRCP, Royal National Hospital for Rheumatic Diseases (at Royal United Hospitals), and Department of Pharmacy and Pharmacology, University of Bath, Bath, UK. A.A. Shah and J.D. Pauling are joint senior authors. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. J.D. Pauling, Consultant Rheumatologist & Senior Lecturer, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases (part of the Royal United Hospitals Bath NHS Foundation Trust), Combe Park, Avon, Bath, BA1 3NG, UK. Email: [email protected]. Accepted for publication April 14, 2021.

Publisher Copyright:
© 2021 The Journal of Rheumatology.

Keywords

Coping
Disability
Pain
Quality of life
Scleroderma
Systemic sclerosis

ASJC Scopus subject areas

Immunology and Allergy
Rheumatology
Immunology

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title = "Effect of coping strategies on patient and physician perceptions of disease severity and disability in systemic sclerosis",

abstract = "Objective. Systemic sclerosis (SSc) results in impaired function, disability, and reduced health-related quality of life. We investigated the effect of coping strategies on the patient global assessment of health (PtGA) and Health Assessment Questionnaire–Disability Index (HAQ-DI), after controlling for clinical characteristics and disease activity. We also explored the relationship between coping strategies and the correlation between the PtGA and physician global assessment (PGA) in SSc. Methods. We undertook posthoc analyses using baseline data obtained from the Raynaud Symptom Study (RSS). The PtGA, Coping Strategies Questionnaire, Pain Catastrophizing Scale, and Scleroderma Health Assessment Questionnaire were collected alongside the PGA, clinical characteristics, and patient demographics. Multivariable linear regression models and correlations were used to evaluate the relationship between coping strategies with the PtGA, HAQ-DI, and PGA. Results. Of the 107 patients with SSc enrolled in the RSS, there were sufficient data available for the analysis of 91 participants. The mean PtGA was 40/100 (SD 27) and the mean HAQ-DI was 0.87/3.0 (SD 0.73). After controlling for clinical and patient demographics, pain catastrophizing and maladaptive coping skills were significantly associated with the PtGA and HAQ-DI scores (P < 0.05 for both), but not the PGA. Conclusion. The effect of coping strategies on PtGA and HAQ-DI (but not PGA in SSc) could influence the result of composite measures incorporating these outcome measures. Interventions to improve patient coping skills may support increased resilience and improve patient-perceived functional status and PtGA in SSc.",

keywords = "Coping, Disability, Pain, Quality of life, Scleroderma, Systemic sclerosis",

author = "DiRenzo, {Dana D} and Smith, {Theresa R} and Frech, {Tracy M} and Shah, {Ami A} and Pauling, {John D}",

note = "Funding Information: DDD is supported by the Jerome L. Greene Foundation. 1D.D. DiRenzo, MD, MHS, A.A. Shah, MD, MHS, Johns Hopkins Division of Rheumatology, Baltimore, Maryland, USA; 2T.R. Smith, PhD, Department of Mathematical Sciences, University of Bath, Bath, UK; 3T.M. Frech, MD, MS, University of Utah, Salt Lake City, Utah, USA; 4J.D. Pauling, BMedSci, BMBS, PhD, FRCP, Royal National Hospital for Rheumatic Diseases (at Royal United Hospitals), and Department of Pharmacy and Pharmacology, University of Bath, Bath, UK. A.A. Shah and J.D. Pauling are joint senior authors. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. J.D. Pauling, Consultant Rheumatologist & Senior Lecturer, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases (part of the Royal United Hospitals Bath NHS Foundation Trust), Combe Park, Avon, Bath, BA1 3NG, UK. Email: [email protected]. Accepted for publication April 14, 2021. Publisher Copyright: {\textcopyright} 2021 The Journal of Rheumatology.",

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doi = "10.3899/jrheum.201612",

language = "English",

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journal = "The Journal of Rheumatology",

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AU - Smith, Theresa R

AU - Frech, Tracy M

AU - Shah, Ami A

AU - Pauling, John D

N1 - Funding Information: DDD is supported by the Jerome L. Greene Foundation. 1D.D. DiRenzo, MD, MHS, A.A. Shah, MD, MHS, Johns Hopkins Division of Rheumatology, Baltimore, Maryland, USA; 2T.R. Smith, PhD, Department of Mathematical Sciences, University of Bath, Bath, UK; 3T.M. Frech, MD, MS, University of Utah, Salt Lake City, Utah, USA; 4J.D. Pauling, BMedSci, BMBS, PhD, FRCP, Royal National Hospital for Rheumatic Diseases (at Royal United Hospitals), and Department of Pharmacy and Pharmacology, University of Bath, Bath, UK. A.A. Shah and J.D. Pauling are joint senior authors. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. J.D. Pauling, Consultant Rheumatologist & Senior Lecturer, Department of Rheumatology, Royal National Hospital for Rheumatic Diseases (part of the Royal United Hospitals Bath NHS Foundation Trust), Combe Park, Avon, Bath, BA1 3NG, UK. Email: [email protected]. Accepted for publication April 14, 2021. Publisher Copyright: © 2021 The Journal of Rheumatology.

PY - 2021/10/1

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N2 - Objective. Systemic sclerosis (SSc) results in impaired function, disability, and reduced health-related quality of life. We investigated the effect of coping strategies on the patient global assessment of health (PtGA) and Health Assessment Questionnaire–Disability Index (HAQ-DI), after controlling for clinical characteristics and disease activity. We also explored the relationship between coping strategies and the correlation between the PtGA and physician global assessment (PGA) in SSc. Methods. We undertook posthoc analyses using baseline data obtained from the Raynaud Symptom Study (RSS). The PtGA, Coping Strategies Questionnaire, Pain Catastrophizing Scale, and Scleroderma Health Assessment Questionnaire were collected alongside the PGA, clinical characteristics, and patient demographics. Multivariable linear regression models and correlations were used to evaluate the relationship between coping strategies with the PtGA, HAQ-DI, and PGA. Results. Of the 107 patients with SSc enrolled in the RSS, there were sufficient data available for the analysis of 91 participants. The mean PtGA was 40/100 (SD 27) and the mean HAQ-DI was 0.87/3.0 (SD 0.73). After controlling for clinical and patient demographics, pain catastrophizing and maladaptive coping skills were significantly associated with the PtGA and HAQ-DI scores (P < 0.05 for both), but not the PGA. Conclusion. The effect of coping strategies on PtGA and HAQ-DI (but not PGA in SSc) could influence the result of composite measures incorporating these outcome measures. Interventions to improve patient coping skills may support increased resilience and improve patient-perceived functional status and PtGA in SSc.

AB - Objective. Systemic sclerosis (SSc) results in impaired function, disability, and reduced health-related quality of life. We investigated the effect of coping strategies on the patient global assessment of health (PtGA) and Health Assessment Questionnaire–Disability Index (HAQ-DI), after controlling for clinical characteristics and disease activity. We also explored the relationship between coping strategies and the correlation between the PtGA and physician global assessment (PGA) in SSc. Methods. We undertook posthoc analyses using baseline data obtained from the Raynaud Symptom Study (RSS). The PtGA, Coping Strategies Questionnaire, Pain Catastrophizing Scale, and Scleroderma Health Assessment Questionnaire were collected alongside the PGA, clinical characteristics, and patient demographics. Multivariable linear regression models and correlations were used to evaluate the relationship between coping strategies with the PtGA, HAQ-DI, and PGA. Results. Of the 107 patients with SSc enrolled in the RSS, there were sufficient data available for the analysis of 91 participants. The mean PtGA was 40/100 (SD 27) and the mean HAQ-DI was 0.87/3.0 (SD 0.73). After controlling for clinical and patient demographics, pain catastrophizing and maladaptive coping skills were significantly associated with the PtGA and HAQ-DI scores (P < 0.05 for both), but not the PGA. Conclusion. The effect of coping strategies on PtGA and HAQ-DI (but not PGA in SSc) could influence the result of composite measures incorporating these outcome measures. Interventions to improve patient coping skills may support increased resilience and improve patient-perceived functional status and PtGA in SSc.

KW - Coping

KW - Disability

KW - Pain

KW - Quality of life

KW - Scleroderma

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Effect of coping strategies on patient and physician perceptions of disease severity and disability in systemic sclerosis

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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