Background African American women with Systemic Lupus Erythematosus (SLE) disproportionately experience poor emotional and physical health, loss of self-esteem and earning potential compared to other women with the disease (Baker K, 2009) (Guillermo P, 2010) (Yuen H K, 2012) (Utset T, 2006). Despite ethic variations among African Americans, differences are rarely considered for SLE quality of life factors and therapeutic strategies such as corticosteroids.
Objectives This study investigated the association among corticosteroids, emotional health, physical health, and work and regular daily activities among a racially-and ethnically-diverse sample of women with SLE (n=224) and controls (n=60).
Methods A secondary analysis of data from the Medical University of South Carolina Lupus Database was conducted. Included in the sample were 57 Caucasian Americans, 141 Gullah African Americans, a subpopulation of African Americans from the Sea Islands of South Carolina and 86 non-Gullah African Americans. Linear regression analyses were performed to assess associations among corticosteroid use, emotional health, physical health and work and regular daily activities. Statistical models were also constructed to assess any moderating effects of ethnicity on emotional health and work and regular daily activities among women with SLE.
Results Emotional health outcomes were better for women with SLE compared with controls. High emotional health scores may be influenced by cultural factors such as masking emotion, disease-coping mechanisms, religion and strong familial and social support. While a significant association was not detected for emotional health and work and regular daily activities, after adjusting for corticosteroid use, a significant association was detected. These findings suggest corticosteroid use does influence the strength of the association between emotional health and work and regular daily activities
Conclusions These study findings highlight the importance of considering the impact of corticosteroids on emotional health among women with SLE. In particular, among African American women who disproportionately experience poor emotional health outcomes. Although this therapeutic strategy improves physical health, the emotional health implications should not be overlooked. Compounded poor emotional health can negatively influence health outcomes for women with SLE. Since SLE is such a debilitating chronic condition, researchers and practitioners must put equal emphasis on improving quality of life and decreasing mortality. However, these improvements in SLE outcomes can only be accomplished if racial and ethnic-sociocultural factors are examined in research and accounted for in the administering of corticosteroids and the development and implementation of interventions
Baker K, P. J. (2009). Employment and work disability in systemic lupus erythematosus. Rheumatology, 281–284.
Guillermo P, A. G. (2010). Understanding the epidemiology and progression of systemic lupus erythematosus. Arthritis Rheum., 257.
Utset T, F. J. (2006). Prevalence of neurocognitive dysfunction and other clinical manifestations in disabled patients with systemic lupus erythematosus. Journal of Rheumatology , 531–538.
Yuen HK, H. K. (2012). Using wii fit to reduce fatigue among African American women with systemic lupus erythematosus. Lupus, 1293–1299.
Disclosure of Interest None declared
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