SOCIOECONOMIC AND PSYCHOLOGICAL FACTORS AS PREDICTORS OF OUTCOME IN RHEUMATOTOID ARTHRITIS PATIENTS
Naidoo, P., University of the Western Cape, Lindegger, G.C., University of Natal and Mody, G.M., Nelson Mandela School of Medicine, South Africa
In this South African study one-hundred and eighty-six recent onset and established disease male and female clinic-based rheumatoid arthritis (RA) out-patients, with a mean age of 49.51 years, were subjected to a series of both subjective (self-report questionnaires) and objective measures. Multivariate analysis was conducted to construct predictive models of the factors that contribute to each of the outcome variables associated with RA, namely self-report of pain and functional status, swollen and tender joint status, helplessness and depression. In predictive model one, psychological factors (negative-internal coping and overall coping) were found to be significant predictors of pain and functional status. For predictive model two, both socioeconomic (being engaged in paid work activities) and psychological factors (negative-internal coping) were found to be significant predictors of swollen and tender joint status. Significant predictors of helplessness (predictive model three) were also found to be both socioeconomic (average monthly household income) and psychological (overall coping). Finally, in predictive model four, socioeconomic factors (educational level, average monthly household income, and gender) and psychological factors (negative-internal coping and positive-interactive coping) were found to be significant predictors of depression. These findings are discussed within the context of public health service provision in South Africa, and more specifically, the implications of these findings for the quality of life of hospital, clinical -based, low socioeconomic RA patients are also discussed.