Coping strategies, emotional distress and perceived disease severity in a cohort of patients with rheumatoid arthritis: a mediation analysis. (3rd August 2022)

• Record Type: Journal Article
• Authors: Tosato, Sarah; Bonetto, Chiara; Zanini, Alice; Montanari, Ilaria; Piccinelli, Anna; Bixio, Riccardo; Rossini, Maurizio; Pacenza, Giulio; Cristofalo, Doriana; Fracassi, Elena; Carletto, Antonio
• Is Part Of: Rheumatology. Volume 62:Number 3(2023)
• Page Start: 1078
• Page End: 1086
• Publication Date: 2022-08-03
• Subjects: Coping -- emotional distress -- PGA -- disease severity -- HADS -- RA; Rheumatism -- Periodicals; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1093/rheumatology/keac445
• Languages: English
• ISSNs: 1462-0324

Abstract

Abstract: Objectives: Few data are available on the role of emotional distress as a possible mediator of the relationship between coping strategies and the Patient Global Assessment (PGA). This study aims to investigate, in a large cohort of patients affected by RA, the relationship between specific copying strategies and PGA, and the role of emotional distress as a mediator. Methods: A total of 490 patients with RA completed a set of standardized assessments including the self-reported PGA, the Coping Orientation to the Problems Experienced (COPE-NVI) and the Hospital Anxiety and Depression Scale (HADS). A mediation analysis was conducted to investigate the role of emotional distress. Results: The effect of coping strategies on the PGA score was significantly mediated by the emotional distress for religious (total effect mediated 42.0%), planning (total effect mediated 17.5%), behavioural disengagement (total effect mediated 10.5%), and focus on and venting of emotions (total effect mediated 9.8%). Seven coping strategies (acceptance, positive reinterpretation and growth, active coping, denial, humour, substance use-mental disengagement) resulted directly associated to PGA total score, but no mediation effect was found. The remaining four coping strategies were not associated to the PGA score. Conclusion: This study suggests that coping strategies could be an important factor in the perceived disease severity. Consequently, in order to reduce PGA in patients with RA, a useful tool could be represented by the implementation of psychological interventions aiming to modify the specific coping styles. Moreover, to prevent or treat emotional distress seems to further reduce PGA.