Mental Health Status and Health-Related Quality of Life
among Systemic Lupus Erythematosus (SLE) Patients in
Thailand: A Multi-Site Study
Nop Ratanasiripong, PhD, RN, CNE¹, Rojana Warawitsaranggoon, MNS, RN², Tiraporn Junda, PhD, RN³,
Hathairat Sangchan, PhD, RN⁴, Phonpen Akarawatcharangura Goo, MD, MSc⁵, Boonjing Siripaitoon, MD, MSc⁶,
Paul Ratanasiripong, PhD⁷, Kanchana Panyathorn, MS, RN⁸
Affiliation : ¹ School of Nursing, California State University, Dominguez Hills, USA ² Boromarajonani College of Nursing, Udon Thani, Thailand ³ Ramathibodi School of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ⁴ Faculty of Nursing, Prince of Songkla University, Songkhla, Thailand ⁵ Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand ⁶ Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand ⁷ College of Education, California State University, Long Beach, USA ⁸ Rachathani University, Udon Thani, Thailand
Background: The systemic lupus erythematosus (SLE) patients oftentimes suffer from both physical and psychosocial challenges that may lead
to low health-related quality of life (HRQoL). However, limited research has been done in this area.
Objective: To examined mental health status and HRQoL among SLE patients in Thailand.
Materials and Methods: The present study was a cross-sectional study conducted at the rheumatology clinic of four major hospitals in Thailand. The paper-based questionnaire consisted of demographic, health history such as depression, anxiety, stress Scale (DASS-21), and the Rosenberg self-esteem scale (RSE), and the disease-specific Lupus Quality of Life scale (LupusQoL). Depending on the variable’s level of measurement such as categorical or continuous, Spearman’s Rho or Pearson’s product moment correlation coefficients were used to explore the relationships among the variables. Hierarchical multiple regression was used to identify the predictors of LupusQoL.
Results: Among the 387 participants, many might have experienced depression, anxiety, and stress (30%, 51%, and 29%, respectively). Self- esteem among the participants was good (31.8 out of 40). All eight domains of LupusQoL were affected with intimate relationship domain being impacted the most. The overall LupusQoL was significantly associated with the number of prescribed medications (r=–0.23), depression (r=–0.70), anxiety (r=–0.58), stress (r=–0.67), and self-esteem (r=0.59), p<0.001. Significant predictors of the overall LupusQoL were mental health status (depression, anxiety, and stress) and self-esteem, F (3, 81)=43.10, p<0.001, adjusted R²=0.60.
Conclusion: SLE patients should be holistically assessed in both physical and psychological aspects. In addition to proper medical treatments, healthcare providers should use a multidisciplinary team approach to resolve the patients’ psychosocial issues, which in turn, may increase the patients’ quality of life. Self-care education may be necessary to help the patients manage the condition and decrease the number of medications.
Received 20 February 2020 | Revised 12 May 2020 | Accepted 14 May 2020
doi.org/10.35755/jmedassocthai.2020.11.11156
Keywords : Mental health, Quality of life, SLE, Thailand
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