Background The assessment of quality of Life (QoL) in chronic rheumatic diseases such as systemic lupus erythematosus (SLE) is very important as it does not necessarily correlates with activity and damage. Recently it has been highlighted that QoL represents an important outcome to be considered in clinical trials. Coping represents the type of strategy adopted by a person to face a stressor event such as a disease. Three types of coping trategies have been described: avoidance- oriented, emotion oriented and task-oriented.
Objectives In the present study QoL and coping in a cohort of SLE patients were evaluated and their correlation with disease activity, disease duration and damage was also assessed.
Methods Consecutive in and out SLE patients followed at our clinic were asked to participate to the study. At enrollment disease activity and damage were evaluated with the ECLAM index and the SLICC/DI ACR respectively. Disease was defined as active if ECLAM >2. Damage was considered as present or absent (SLICC ≥1). The SF-36 and the CISS were administered to the patients to evaluate quality of life and coping strategies respectively.
Results Seventy-seven consecutive SLE patients (F 69, M 8), with a mean age of 41 years and a mean disease duration of 14 years, were enrolled; 76% had joint involvement, 56% had kidney involvement and 19% neuropsychiatric manifestations. Disease was active in 27% patients and 37% of patients had damage.
Although all SF36 scales were reduced in SLE patients, limitation in physical activities because of health problems and general health were the subscales mostly affected; a correlation between damage and the SF-36 scale of physical function was observed (p<0.001).
Fifty- four percent of patients presented an avoidance- oriented coping, 32% an emotion- oriented coping, while a task oriented coping was observed in 47% of patients. A positive correlation was observed between task- oriented coping and mental health (r=0.493 p<0.001); a negative association was observed between emotion-oriented coping and physical function (r= -0.321 p<0.01), limitations in usual role activities because of emotional problems (r= -0,429 p<0.001) emotional vitality (r= -0.358 p<0.01), mental health (r= -0.554 p<0.001).Finally a correlation was also noted between avoidance-oriented coping and mental health (r=0.250 p<0.01).
Conclusions A correlation was observed between emotion-oriented coping and avoidance-oriented coping and a number of scales of the SF36, suggesting that a lower QoL is associated with the tendency to adopt strategies that may determine a underestimation of disease, its severity and maybe a lower adherence to treatment and follow up. Interventions to modify QoL and coping strategies appear important to optimize the care offered to SLE patients.
Additional studies aimed at evaluating also the role of disease perception, mood status, adherence to treatment are underway.
Disclosure of Interest None Declared