Background There is clear epidemiological evidence for a relationship between social support and health. Though, the mechanism remains unclear whether a poor social support precedes or follows a poor health status. Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting particularly quality of life.
Objectives First, to investigate cross-sectional relationships between quality of life and social support (SS) and support network (SN) in patients with early RA. Then to look at how baseline SS or SN influence quality of life over time; and last, to explore how variations over time in SS or SN affect quality of life over time.
Methods Subjects were members of the EURIDISS population-based cohort from France, the Netherlands and Norway, and had suffered from RA for less than 5 years. Yearly assessments were made of SS, SN, psychological well-being (GHQ), and functional disability (HAQ). Variance and covariance analyses with repeated measures were calculated and adjusted for potential confounding variables.
Results A total of 542 subjects had yearly assessment for three years. On average, those receiving a greater amount of specific SS (daily emotional support or social companionship) (p = 0.05 to p = 0.0001) or surrounded by a stronger specific SN (those aspects providing emotional support) (p < 0.001) experienced a better quality of life. No statistically significant relationship was observed between baseline level of SS or SN and changes in quality of life over time. Similarly, changes in SS or SN did not appear to be associated with improvements in quality of life over time.
Conclusion Better specific SS and specific SN are cross-sectionally associated with better quality of life in early RA patients. Baseline or changes in SS or SN do not seem to predict changes in quality of life over time for these patients. It may be useful to measure SS in early RA patients in order to identify individuals who receive little specific SS. Further work is needed to devise simple ways to measure SS, to develop interventions that provide additional support, and to investigate whether provision of structured SS by relevant professionals would be more useful than increasing non-specific intervention.