Article Text

Download PDFPDF

Determinants of happiness and quality of life in patients with rheumatoid arthritis: a structural equation modelling approach
  1. Eduardo José Ferreira Santos1,2,3,
  2. Cátia Duarte1,4,
  3. Ricardo J O Ferreira1,3,
  4. Ana Margarida Pinto1,4,
  5. Rinie Geenen5,
  6. Jose A P da Silva1,6
  7. On behalf of the ‘Promoting Happiness Through Excellence of Care’ Group
    1. 1 Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
    2. 2 Escola Superior de Enfermagem do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
    3. 3 Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
    4. 4 Clínica Universitária de Reumatologia, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
    5. 5 Department of Psychology, Utrecht University, Utrecht, The Netherlands
    6. 6 Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine – University of Coimbra, Coimbra, Portugal
    1. Correspondence to Professor Jose A P da Silva, Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, Coimbra 3000-076, Portugal; jdasilva{at}ci.uc.pt

    Abstract

    Objectives Besides increasing longevity, the ultimate goal of medical care is to improve patients’ enjoyment of life, a concept akin to happiness. This study examined the determinants of happiness and quality of life (QoL) in patients with rheumatoid arthritis (RA).

    Methods In this observational, cross-sectional study, patients were assessed on disease activity, disease impact, personality, QoL and happiness. Structural equation modelling estimation was used to analyse the associations between these dimensions, pursuing three hypotheses: H1—disease activity and perceived impact of disease are negatively associated with overall QoL and happiness in patients with RA; H2—‘positive’ personality traits are related to happiness both directly and indirectly through perceived disease impact; H3—happiness has a mediating effect in the relation between impact of disease and QoL.

    Results Data from 213 patients were analysed. Results supported all driving hypotheses. Happiness was positively related to ‘positive’ personality and, to a lesser extent, negatively related to impact of disease. Impact of disease, in turn, was positively related to disease activity and mitigated by ‘positive’ personality traits. Impact of disease had a much stronger relation with QoL than with happiness. Happiness mitigated the negative effect of disease impact on QoL.

    Conclusion Optimisation of QoL and happiness of people with RA requires effective control of the disease process and also improvement of the disease impact domains. Personality seems to play a pivotal mediating role in these relations.

    • rheumatoid arthritis
    • patient perspective
    • outcomes research

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

    View Full Text

    Statistics from Altmetric.com

    Supplementary materials

    • Lay summary

      Disclaimer : This is a summary of a scientific article written by a medical professional (“the Original Article”). The Summary is written to assist non medically trained readers to understand general points of the Original Article. It is supplied “as is” without any warranty. You should note that the Original Article (and Summary) may not be fully relevant nor accurate as medical science is constantly changing and errors can occur. It is therefore very important that readers not rely on the content in the Summary and consult their medical professionals for all aspects of their health care and only rely on the Summary if directed to do so by their medical professional. Please view our full Website Terms and Conditions.
      Copyright © 2018 BMJ Publishing Group Ltd & European League Against Rheumatism. Medical professionals may print copies for their and their patients and students non commercial use. Other individuals may print a single copy for their personal, non commercial use. For other uses please contact our Rights and Licensing Team.

    Footnotes

    • Handling editor Josef S Smolen

    • Contributors EJFS performed the statistical analyses (assisted by RJOF and AMP) and wrote the manuscript. CD, RJOF and JAPdS designed the study. AMP and RG revised the final manuscript from their respective specialist perspective. JAPdS supervised and contributed to all steps of the work. All members of the ‘Promoting Happiness Through Excellence of Care ’ contributed through inspiring discussions on the topic of happiness and medical care, through examining and interviewing patients and revising the manuscript. Co-authors: “Promoting Happiness Through Excellence of Care” is the registered moto of the Rheumatology Department at the Faculty of Medicine and University Hospital of Coimbra. Additional members of this group: Alexandra Daniel, Ana Pinto, Anabela Silva, Andréa Marques, Armando Malcata, Carlos Costa, Cristiana Silva, Diogo Jesus, Flávio Costa, Gisela Eugénio, João Freitas, João Rovisco, Jorge Silva, José Laranjeiro, Luísa Brites, Margarida Coutinho, Maria Salvador, Mariana Luís, Mariana Santiago, Marília Rodrigues, Mary Marques, Pedro Carvalho, Pedro Freitas, Sara Serra, Tânia Santiago.

    • Funding No specific funding was received from any bodies in the public, commercial or not-for-profit sectors to carry out the work described in this article.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval University of Coimbra’s Faculty of Medicine Ethics Committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.