Background Dispositional optimism is defined as a stable, trait-like personality characteristic consisting of a general positive mood or attitude about the future with a tendency to expect favorable outcomes in life situations. It has been shown in some chronic disease groups (e.g. cancer) that dispositional optimism is related to both physical and psychological outcomes and seems to lead to better quality of life (QoL).
Objectives To review data concerning the relationship between optimism and QoL in rheumatic diseases.
Methods A Systematic literature review search was performed in December 2013 in PUBMED for studies involving the construct of optimism in various medical contexts. Only studies concerning rheumatic diseases were included. Keywords used were: optimism, quality of life, spondyloarthritis, rheumatic diseases, musculoskeletal, low back pain.
Data extraction: (a) description of patient populations, (b) level of optimism. Only studies using the Life Orientation Test- Revised (LOT-R) to assess optimism were included. The LOT-R has a scale ranging from 0-24 where higher levels indicate higher optimism. Of note, in the general population, the mean LOT-R results are reported around 14 points . (c) All available information about links between optimism, QoL and other disease aspects were collected. Data analysis: descriptive analysis.
Results Of 50 articles, 4 were analyzed: total 2327 patients, of whom 971 had a rheumatic complaint (49% knee osteoarthritis, 23% rheumatoid arthritis, and the rest other rheumatic complaints); 47% females, mean age 59 yrs. The LOT-R mean scores ranged between 15-16.7, which is equivalent to moderate optimism, slightly higher than scores usually reported in the general population. Optimism seemed to be an independent factor affecting QoL and appeared positively correlated with QoL. It was negatively correlated with disease activity in rheumatoid arthritis only. Optimism seemed to be in one study a stronger predictor of mental than physical health; all p values were highly significant.
Conclusions Although optimism has been repeatedly reported as related to QoL in chronic diseases, its importance in rheumatic diseases has been little explored. Existing studies indicate that optimism levels appear similar to the general population or higher. It seems that optimistic patients have higher QoL than less optimistic patients even after adjusting on confounding factors. The links between optimism and coping strategies should be further explored.
Scheier MF, Carver CS, Bridges MW. J Pers Soc Psychol 1994.
Disclosure of Interest None declared
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