DefinePK

Abstract

Background: Rheumatoid arthritis (RA) is a chronic, bilateral autoimmune disease that primarily affects small joints, leading to progressive bone erosion, joint deformities, and compromised musculoskeletal function. Its impact extends beyond physical disability, often causing early retirement, reduced quality of life, and severe psychological distress. Globally, up to 52% of RA patients report anxiety, while 80% suffer from depression. Despite this, limited research has explored the association between psychological factors and self-management abilities in RA patients, particularly in developing countries.
Objective: To determine the correlation between psychological factors (anxiety and depression) and self-management abilities among patients with rheumatoid arthritis.
Methods: A cross-sectional correlational study was conducted over six months, recruiting 385 diagnosed RA patients from the outpatient departments and inpatient wards of Lady Reading Hospital, Hayatabad Medical Complex, and Khyber Teaching Hospital in Peshawar. Participants aged ≥20 years, with a disease duration of over six months, were selected via consecutive sampling. Data were collected using validated and Urdu-translated versions of the Hospital Anxiety and Depression Scale (HADS) and the Arthritis Self-Efficacy Function Scale (ASEFS). The reliability scores for HADS and ASEFS were r=0.809 and r=0.80, respectively. Data analysis was performed using SPSS version 22, applying Spearman’s correlation to assess relationships between variables.
Results: Of the 385 participants, 197 (51.2%) were male and 188 (48.8%) female. Employment status revealed 131 (34%) were employed, while 254 (66%) were unemployed. Self-management abilities were high in 254 (66%) patients, moderate in 86 (22.3%), and mild in 45 (11.7%); no participant had low ability. Anxiety levels were abnormal in 289 (75.1%) and borderline in 82 (21.3%). Depression was abnormal in 346 (89.9%) and borderline in 39 (10.1%). A strong, statistically significant negative correlation was observed between psychological factors and self-management abilities (r = -0.731, p = 0.000).
Conclusion: Psychological factors are significantly and negatively associated with self-management abilities in RA patients. Routine screening and psychological support should be integrated into RA care to enhance patient self-efficacy and treatment outcomes.