Skip to main content
PMC home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 2003 Dec;62(12):1178–1184. doi: 10.1136/ard.2002.004861

Quality of life and work in patients with rheumatoid arthritis and ankylosing spondylitis of working age

A Chorus, H Miedema, A Boonen, S van der Linden
PMCID: PMC1754383  PMID: 14644855

Abstract

Objective: To investigate the relationship between work and quality of life (QOL) in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) aged 16–59.

Methods: 1056 patients with RA and 658 with AS were included in the study. Data were obtained by postal questionnaire, which included several generic and disease related QOL instruments. Separate dimensions and physical and mental summary scores from the SF-36 were compared. Stepwise multiple regression was performed to study the relationship between work and physical and mental health related QOL, including disease related factors, coping, and fatigue.

Results: Physical health related QOL was reported to be worse, and mental health related QOL better, in RA than in AS in people of working age. No differences between RA and AS were found in somatic pain, physical role functioning, social functioning, emotional role functioning, vitality, or general health perception; nor were there any significant differences in fatigue and behavioural coping styles. Work was positively associated with physical health related QOL in both groups and, after disease characteristics, was the most important determinant. No association was found with mental health related QOL.

Conclusions: Although physical health related QOL was worse in patients with RA, the impact on several dimensions of health related QOL in patients with RA and AS of working age under rheumatological care was comparable. Patients with RA and AS experienced similar limitations in physical role functioning, including work. Work is an important independent external determinant of physical health related QOL, but not of mental health related QOL.

Full Text

The Full Text of this article is available as a PDF (203.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aaronson N. K., Muller M., Cohen P. D., Essink-Bot M. L., Fekkes M., Sanderman R., Sprangers M. A., te Velde A., Verrips E. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol. 1998 Nov;51(11):1055–1068. doi: 10.1016/s0895-4356(98)00097-3. [DOI] [PubMed] [Google Scholar]
  2. Boonen A., Chorus A., Miedema H., van der Heijde D., van der Tempel H., van der Linden S. Employment, work disability, and work days lost in patients with ankylosing spondylitis: a cross sectional study of Dutch patients. Ann Rheum Dis. 2001 Apr;60(4):353–358. doi: 10.1136/ard.60.4.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Boonen A., de Vet H., van der Heijde D., van der Linden S. Work status and its determinants among patients with ankylosing spondylitis. A systematic literature review. J Rheumatol. 2001 May;28(5):1056–1062. [PubMed] [Google Scholar]
  4. Calin A., Nakache J. P., Gueguen A., Zeidler H., Mielants H., Dougados M. Defining disease activity in ankylosing spondylitis: is a combination of variables (Bath Ankylosing Spondylitis Disease Activity Index) an appropriate instrument? Rheumatology (Oxford) 1999 Sep;38(9):878–882. doi: 10.1093/rheumatology/38.9.878. [DOI] [PubMed] [Google Scholar]
  5. Calin A. The individual with ankylosing spondylitis: defining disease status and the impact of the illness. Br J Rheumatol. 1995 Jul;34(7):663–672. doi: 10.1093/rheumatology/34.7.663. [DOI] [PubMed] [Google Scholar]
  6. Chorus A. M., Miedema H. S., Wevers C. J., van Der Linden S. Labour force participation among patients with rheumatoid arthritis. Ann Rheum Dis. 2000 Jul;59(7):549–554. doi: 10.1136/ard.59.7.549. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Dalyan M., Güner A., Tuncer S., Bilgiç A., Arasil T. Disability in ankylosing spondylitis. Disabil Rehabil. 1999 Feb;21(2):74–79. doi: 10.1080/096382899298007. [DOI] [PubMed] [Google Scholar]
  8. Eaker S., Bergström R., Bergström A., Adami H. O., Nyren O. Response rate to mailed epidemiologic questionnaires: a population-based randomized trial of variations in design and mailing routines. Am J Epidemiol. 1998 Jan 1;147(1):74–82. doi: 10.1093/oxfordjournals.aje.a009370. [DOI] [PubMed] [Google Scholar]
  9. Escalante A., del Rincón I. How much disability in rheumatoid arthritis is explained by rheumatoid arthritis? Arthritis Rheum. 1999 Aug;42(8):1712–1721. doi: 10.1002/1529-0131(199908)42:8<1712::AID-ANR21>3.0.CO;2-X. [DOI] [PubMed] [Google Scholar]
  10. Guillemin F., Briançon S., Pourel J., Gaucher A. Long-term disability and prolonged sick leaves as outcome measurements in ankylosing spondylitis. Possible predictive factors. Arthritis Rheum. 1990 Jul;33(7):1001–1006. doi: 10.1002/art.1780330712. [DOI] [PubMed] [Google Scholar]
  11. Mason J. H., Anderson J. J., Meenan R. F., Haralson K. M., Lewis-Stevens D., Kaine J. L. The rapid assessment of disease activity in rheumatology (radar) questionnaire. Validity and sensitivity to change of a patient self-report measure of joint count and clinical status. Arthritis Rheum. 1992 Feb;35(2):156–162. doi: 10.1002/art.1780350206. [DOI] [PubMed] [Google Scholar]
  12. Miedema H. S., van der Linden S. M., Rasker J. J., Valkenburg H. A. National database of patients visiting rheumatologists in The Netherlands: the standard diagnosis register of rheumatic diseases. A report and preliminary analysis. Br J Rheumatol. 1998 May;37(5):555–561. doi: 10.1093/rheumatology/37.5.555. [DOI] [PubMed] [Google Scholar]
  13. Smets E. M., Garssen B., Bonke B., De Haes J. C. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res. 1995 Apr;39(3):315–325. doi: 10.1016/0022-3999(94)00125-o. [DOI] [PubMed] [Google Scholar]
  14. Sprangers M. A., de Regt E. B., Andries F., van Agt H. M., Bijl R. V., de Boer J. B., Foets M., Hoeymans N., Jacobs A. E., Kempen G. I. Which chronic conditions are associated with better or poorer quality of life? J Clin Epidemiol. 2000 Sep;53(9):895–907. doi: 10.1016/s0895-4356(00)00204-3. [DOI] [PubMed] [Google Scholar]
  15. Ward M. M. Health-related quality of life in ankylosing spondylitis: a survey of 175 patients. Arthritis Care Res. 1999 Aug;12(4):247–255. [PubMed] [Google Scholar]
  16. Zink A., Braun J., Listing J., Wollenhaupt J. Disability and handicap in rheumatoid arthritis and ankylosing spondylitis--results from the German rheumatological database. German Collaborative Arthritis Centers. J Rheumatol. 2000 Mar;27(3):613–622. [PubMed] [Google Scholar]
  17. de Buck P. D. M., van Amstel R. J., Buijs P. C., Maasen J. H. W., van Dijk F. J. H., Hazes J. M. W., Vliet Vlieland T. P. M. Communication between Dutch rheumatologists and occupational physicians in the occupational rehabilitation of patients with rheumatic diseases. Ann Rheum Dis. 2002 Jan;61(1):62–65. doi: 10.1136/ard.61.1.62. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. van Lankveld W., Näring G., van der Staak C., van 't Pad Bosch P., van de Putte L. Stress caused by rheumatoid arthritis: relation among subjective stressors of the disease, disease status, and well-being. J Behav Med. 1993 Jun;16(3):309–321. doi: 10.1007/BF00844762. [DOI] [PubMed] [Google Scholar]
  19. van Lankveld W., van't Pad Bosch P., van de Putte L., Näring G., van der Staak C. Disease-specific stressors in rheumatoid arthritis: coping and well-being. Br J Rheumatol. 1994 Nov;33(11):1067–1073. doi: 10.1093/rheumatology/33.11.1067. [DOI] [PubMed] [Google Scholar]
  20. van Tubergen Astrid, Coenen Jolanda, Landewé Robert, Spoorenberg Anneke, Chorus Astrid, Boonen Annelies, van der Linden Sjef, van der Heijde Désirée. Assessment of fatigue in patients with ankylosing spondylitis: a psychometric analysis. Arthritis Rheum. 2002 Feb;47(1):8–16. doi: 10.1002/art1.10179. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES