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Illness intrusiveness explains race-related quality-of-life differences among women with systemic lupus erythematosus

Culture, Community, and Health Studies, Centre for Addiction and Mental Health (Clarke Division), University of Toronto, and University Health Network (Princess Margaret Hospital), Toronto, Ontario, Canada; Centre for Addiction and Mental Health (Clarke Division), 250 College Street, Toronto, Ontario, M5T 1R8 Canada Tel: (+ 1) 416 979-6905; Fax: (+ 1) 416 979-4679 gerald_devins{at}camh.net

S M Edworthy

McCaig Center for Joint Injury and Arthritis and Department of Community Medicine, University of Calgary, and Calgary Regional Health Authority, Calgary, Alberta, Canada

the ARAMIS Lupus State Models Research Group

Our objective was to investigate whether quality of life in systemic lupus erythematosus (SLE) differs across ethnoracial groups and to identify factors that may explain race-related differences.

Self-administered questionnaire data from 335 White, 40 Black, and 30 Asian women with SLE were obtained from a multi-center database. Measures assessed illness intrusiveness, psychological well-being, depressive symptoms, musculoskeletal pain, and learned helplessness. Extent of SLE disease activity was indexed by self-reported functional-system involvement. Educational attainment was indicated by number of years in school.

Principal-components analysis reduced the four psychosocial measures to a single factor score. This represented psychosocial well-being in path analysis. Psychosocial well-being differed significantly across the three groups, with Whites reporting the highest, and Blacks the lowest, levels. Path analysis indicated that illness intrusiveness accounted for this race-related difference. Although disease activity was significantly associated with psychosocial well-being, it did not differ across ethnoracial groups. Illness intrusiveness and educational attainment emerged as independent mediators of the race-related difference in psychosocial well-being.

We conclude that race-related quality-of-life differences exist among women with SLE and are mediated independently by illness intrusiveness and educational attainment.

Key Words: systemic lupus erythematosus • psychosocial • quality of life • race

Lupus, Vol. 9, No. 7, 534-541 (2000)
DOI: 10.1177/096120330000900710


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