Figure - available from: Rheumatology International
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Flow diagram of survey design. The arrows indicate the order in which the survey was completed. Those who responded yes to RA diagnosis, answered questions relating to disease characteristics (i.e. VAS pain, VAS fatigue, HAQ and RAQoL) while those who responded no to RA diagnosis, completed VAS fatigue and the WHOQOL-BREF. RA, rheumatoid arthritis; VAS pain, visual analogue scale pain; VAS fatigue, visual analogue scale fatigue; HAQ, health assessment questionnaire; RAQoL, rheumatoid arthritis quality of life questionnaire; WHOQOL-BREF, World Health Organization Quality of Life Questionnaire Short Form; SWEMWBS, Short Warwick Edinburgh Mental Wellbeing Scale
Source publication
The COVID-19 pandemic and social distancing restrictions have significantly reduced population-wide physical activity (PA) levels. However, the impact of the pandemic and relevant restrictions on PA participation, and any potential barriers to it, in people with rheumatoid arthritis (RA) are not clear. Furthermore, we are unsure if any such PA chan...
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Citations
... It also found that worse mental health predicted worse physical health outcomes, with depression significantly affecting physical health for !5 months. A number of studies reported worsening of mental health for inflammatory arthritis patients [13][14][15], but several also demonstrated the impact of unique challenges, such as infection stress, social isolation and barriers to physical activity [8,9,12,16]. The present study expands on the monitoring of physical health symptoms over time and examines the long-term changes in mental health, quality of life and self-management behaviours through the first year of the pandemic. ...
Objective
Patients with inflammatory arthritis were especially vulnerable to the psychosocial and health impacts of coronavirus disease 2019 (COVID-19) and the lockdowns. This study investigated the impact of these changes on mental health, physical health and quality of life for inflammatory arthritis patients over 1 year following the initial lockdown in the UK.
Methods
Three hundred and thirty-eight participants with inflammatory arthritis completed an ambidirectional study consisting of online questionnaires at four time points for 1 year. The questionnaires assessed demographic information, inflammatory arthritis condition, mental health, physical symptoms, self-management behaviours, COVID-19 status and impacts. Means, linear regressions and structural equation modelling for mediations were conducted over 12 months.
Results
Physical health concerns peaked during June 2020, then declined, but did not return to baseline. Depression was associated with worse quality of life at baseline, as shown by the beta coefficient, (β= 0.94, P < 0.01), September (β = 0.92, P < 0.01), November (β= 0.77, P < 0.01) and 1 year (β = 0.77, P < 0.01). Likewise, anxiety was associated with worse quality of life at baseline (β = 1.92, P < 0.01), September (β = 2.06, P < 0.01), November (β = 1.66, P = 0.03) and 1 year (β = 1.51, P = 0.02). The association between depression and quality of life was mediated by physical activity (β= 0.13, P < 0.01) at baseline. The association between anxiety and quality of life was also mediated by physical activity (β = 0.25, P = 0.04) at baseline.
Conclusion
Physical health continued to be worse 1 year later compared with before the COVID-19 lockdowns in patients with inflammatory arthritis. Mental health showed long-term effects on quality of life, with an impact for ≥12 months. Lastly, physical activity mediated between mental health and quality of life in the short term.
... COVID-19 has been tied to widespread decreases in individual activity levels, especially for individuals with chronic health conditions. 24,25 Similarly, multiple participants described significantly limited community activity as a direct result of the COVID-19 pandemic in the qualitative findings. Emerging evidence also indicates that people with MS and individuals with other chronic health conditions experienced a higher burden of mental distress in relation to the pandemic. ...
Background:
People with multiple sclerosis (MS) who use a wheelchair or scooter full-time fall frequently; however, fall prevention programming that meets the unique needs of this population is limited. This study examined the preliminary efficacy of a group-based online fall prevention and management intervention designed specifically for people with MS.
Methods:
This pre/post intervention, mixed-methods study included people with MS who used a wheelchair or scooter full-time, experienced at least 1 fall within the past year, and transferred independently or with minimal or moderate assistance. Participants engaged in a 6-week, online, individualized, multicomponent fall prevention and management intervention: Individualized Reduction of Falls-Online (iROLL-O).
Results:
No statistically significant change in fall incidence occurred after iROLL-O. However, fear of falling significantly decreased (P < .01) and knowledge related to fall management (P = .04) and fall prevention and management (P = .03) significantly improved. Qualitative results indicated that participants valued the opportunity for peer learning and iROLL-O's attention to diverse influences on fall risk.
Conclusions:
This study is the first to examine the preliminary efficacy of an online fall prevention and management intervention for people with MS who use a wheelchair or scooter full-time. iROLL-O has promise, and participants found it valuable. Further efforts are needed to retain iROLL-O participants with lower confidence and functional mobility, and more research is needed to investigate the impact of the intervention on key outcomes over time.
... Barriers to PA include the disease, resource, social and environmental factors [12,13]. Physical distancing measures imposed during the coronavirus disease 2019 (COVID-19) pandemic disproportionately affected PA levels adversely in people with RA owing to disrupted access to specialist exercise equipment and facilities, despite rapid transformation of health-care delivery [14][15][16]. ...
... Most studies investigating social participation among certain COVID-19 risk groups did so in a cross-sectional design at one time point (33)(34)(35). Mergel and Schützwohl also observed increased impairments in social participation by using the IMET questionnaire during the first year of the COVID-19 pandemic, when no COVID-19 vaccination was available (25). ...
Introduction
The coronavirus disease 2019 (COVID-19) pandemic impacted how people perform their daily lives in manifold and sometimes massive ways. Particularly, individuals who are at high risk for a severe disease progression, like immunocompromised people, may have experienced drastic changes in social participation during the pandemic. A COVID-19 basic vaccination may have changed the safety behavior of immunocompromised individuals in terms of infection risk and thereby influence social participation and mental wellbeing.
Methods
This study aims to investigate self-perceived social participation at baseline before and at follow-up 1 and 6 months after basic vaccination. Beginning in March 2021, 274 immunocompromised persons 18 years or older were enrolled in the COVID-19 Contact Immune study (CoCo study) in Lower Saxony, Germany. Measurements were performed at three time points regarding social participation [Index for the Assessment of Health Impairments (IMET)], mental health [Patient Health Questionnaire-4 (PHQ-4)], subjective health status (five-point Likert-scale) and quality of life (five-point Likert-scale).
Results
In total, 126 participants were included in the final analysis. About 60% of the participants showed increasing social participation over time. The greatest increase in social participation was observed within the first month after basic vaccination (p < 0.001). During the following 5 months, social participation remained stable. The domains “social activities,” “recreation and leisure” and “close personal relationships” were responsible for the overall change in social participation. No association was found between social participation and mental health, sociodemographic or medical factors (except hypertension).
Discussion
It is unclear why social participation increased after basic vaccination. Perceived vaccine efficacy and a feeling of being protected by the vaccine may have caused relaxed social distancing behaviors. Reducing safety behaviors may, however, increase the risk of a COVID-19 infection for immunocompromised individuals. Further investigations are needed to explore the health-related consequences of more social participation among immunocompromised persons.
... In the case of Spain, a state of alarm was declared throughout the national territory where the freedom of movement of people was limited during its validity, prohibiting outings even to carry out physical activity (RD 463/2020, de 14 de marzo, n.d.). This confinement drastically affected the reduction in the practice of physical activity and the increase in sedentary lifestyle in the general population (Ammar et al., 2020;L opez-Bueno et al., 2020;Wunsch et al., 2022), and in people with rheumatoid arthritis in particular (Balchin et al., 2022;Lévy-Weil et al., 2021). In the case of people with rheumatoid arthritis, the decrease in sports and physical activity has been correlated with an increase in relapses (Ammar et al., 2020), an increase in body weight (World Health Organization, n.d.) and a worse quality of life (Lévy-Weil et al., 2021), while performing physical activity, especially light physical activity and walking, is positively associated with less mental and physical fatigue and better psychological well-being (Brady et al., 2021), and the European Alliance of Associations for Rheumatology (EULAR) in 2012 determined that the role of the nurse in the management of chronic inflammatory arthritis (CIA) is essential. ...
... The results of this study make it clear that even though the patients declared that physical activity is essential for people with rheumatoid arthritis to deal with their disease, most of the participants affirmed that they significatively reduced their levels of physical activity during the pandemic. Balchin et al. (2022) concluded in their cross-sectional study that more people with rheumatoid arthritis reported decreased physical activity than the general population during the COVID-19 lockdown. Overall, people with rheumatoid arthritis are less physically active and experience more barriers than the general population (Sokka et al., 2008;Veldhuijzen van Zanten et al., 2015), and sadly, the pandemic has exacerbated this inactive behaviour. ...
Aim:
The aim of this study was to explore experiences of people with rheumatoid arthritis during and after COVID-19 induced quarantine in terms of physical activity and health status.
Background:
Rheumatoid arthritis affects multiple facets of the person, both physically and psychologically. Physical activity is considered a safe and effective intervention to improve symptoms and systemic manifestations of rheumatoid arthritis. In the context of the COVID-19 countries like Spain were forced to impose restrictions on mobility, prohibiting outings even to perform physical activity.
Methods:
Structured interviews were conducted and developed using the Tampa Scale for Kinesiophobia -11 questionnaire. Data were analysed using a six-step thematic analysis.
Results:
The results make it clear that even though the patients declared that physical activity is essential for them to deal with their disease, most of the participants affirmed that they significatively reduced their levels of physical activity during the pandemic.
Conclusions:
Physical activity should be promoted in people, even in difficult times, to improve disease outcomes, wellbeing and mental health.
Implications for nursing management:
Knowing the experiences of these patients enable nursing managers to develop interventions that ensure the delivery of comprehensive nursing care regarding physical activity and health status, in future situations like this pandemic.
... The assessment of quality of life in relation to health has been well established worldwide [1][2][3]. The World Health Organization Quality of Life (WHOQOL) assessment is the most widely used self-reporting measure for examining the quality of life among the general population [1,4], patients [5,6], students [7,8], community [9,10] and employees [11,12]. ...
The Malay version of the WHOQOL-BREF was published approximately 15 years ago. Since then, no known research has been conducted to identify the psychometric properties of the scale using confirmatory factor analysis. This study aimed to establish a model by applying a scientific approach to the translation and adaptation method. The back translation technique was used for the translation process. This cross-sectional study involved 282 employees at Universiti Kebangsaan Malaysia. The instrument received satisfactory Cronbach's alpha reliability values. The data were analysed with SEM using AMOS. Results showed that the model produced is parsimonious, with CMIN/df = 0.23, CFI = 0.93, SRMR = 0.08, RMSEA = 0.08 and PCLOSE = 0.07. Adopting the Malay version of the WHOQOL-BREF for future research is highly recommended due to its properties.
Background
We aimed to assess the role of the COVID‐19 pandemic in the association of clinical, physical, and psychological factors with pain in Rheumatoid Arthritis (RA) patients.
Methods
We included 103 RA patients (81.6% females; mean age 56.1 ± 13.8 years). Patients filled out the VAS‐pain, GAD‐7, PHQ‐9, MFI‐20, and B‐IPQ. Paired sample t ‐tests, correlations, and multiple regression analyses were used to analyse the data.
Results
Our results showed significantly worsened pain in the data collected post‐pandemic ( p ≤ 0.05). Pre‐pandemic, the final regression models showed an association between functional disability ( β = 0.24; p ≤ 0.05), illness perception ( β = 0.34; p ≤ 0.05) and pain. In post‐pandemic models, significant associations were found between fatigue ( β = 0.33; p ≤ 0.01) and illness perception ( β = 0.36; p ≤ 0.01) with pain. Positive illness perception was able to alleviate the associations between fatigue and depression with pain before and after the pandemic.
Conclusion
Findings indicate that patients with RA may have been negatively affected by the COVID‐19 pandemic given their vulnerability. Even though pharmacological treatment was not interrupted, post‐pandemic results showed significantly higher levels of experienced pain. Therefore, in addition to biological therapy, non‐pharmacological interventions, including psychological support aimed at diminishing negative illness perception, may be beneficial in reducing RA‐related pain, especially when dealing with a crisis.
Background:
The foot is one of the anatomical structures of the body most affected in rheumatoid arthritis (RA), associated with the disability of patients, even more during COVID-19. The aim of this study was to analyse whether the period of physical inactivity during COVID-19 is an influential factor on health-related quality of life and foot pain in patients with RA.
Methods:
162 patients with foot pain and RA, recruited from the Hospital Virgen de las Nieves, Granada (Spain) were included. Data was collected during two different periods: January - December 2018 in person and June - September 2021 by phone. Patients were asked to complete the Spanish adapted version of the 12-Item Short Form Survey (SF-12) and the Visual Analogue Scale (VAS).
Results:
The results from the SF-12 questionnaires were divided between its two subscales (i.e., mental, and physical component). The physical component shows an improvement between 2018 and 2021, from 32.05 in 2018-35.18 in 2021 (p < 0.05). The opposite happened with the mental component, showing a deterioration, from 39.69 in 2018-34.48 in 2021 (p < 0.05). Regarding pain, VAS shows higher levels of pain with statistically significant differences, both in general pain (from 6 in 2018-7 in 2012) and in foot pain (from 5 to 7), (p < 0.05).
Conclusion:
Mental quality of life and pain, both general and foot pain, are influenced by the period of physical inactivity during COVID-19.
Level of evidence:
Level II.
