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Various factors related to demographics, psychosocial behavior variables, and clinical characteristics were linked to health-related quality of life in patients with gout.
Among male patients with gout, psychosocial factors, demographic characteristics, and clinical characteristics were linked to health-related quality of life (HRQoL). These results could be used to potentially improve quality of life in this patient population, according to a study published in Patient Preference and Adherence.1
“The promotion of a good quality of life is important for everyone, and the first urgent task is to explore the factors associated with the quality of life in patients with gout and to implement an intervention for the variable factors involved,” wrote Hong Chen, PhD, RN, professor at West China School of Nursing, West China Hospital, Sichuan University, China, and colleagues. “Understanding HRQoL in patients with gout and whether it is associated with factors such as information, motivation, and behavioral skills is necessary to improve health outcomes.”
In the cross-sectional study performed in the West China Hospital of Sichuan University, investigators used an information-motivation-behavioral skills model (IMB), the classical theory of behavior change, to analyze these features. The theory emphasizes the initiation of health behaviors and change in health outcomes should be based on disease-related knowledge, a motivation to cultivate a positive attitude, the maintenance of positive behaviors, and the individual’s positive psychology.2
A total of 230 patients were invited to participate in the assessment. The gout impact scale was used to determine HRQoL and the subject’s knowledge of their condition was analyzed using the gout knowledge questionnaire. Demographic information collected included age, marital status, employment status, educational level, body mass index (BMI), smoking and drinking status, and monthly family income, while clinical characteristics provided included a family history of gout, comorbidities, urate-lowering therapy (ULT), pain, tophi, the duration of symptoms, and serum uric acid levels. Motivation was assessed using the positive psycap questionnaire (PPQ) and the self-management assessment scale evaluated behavioral skills. Factors associated with HRQoL were identified using multiple linear regression.
Enrolled patients had a mean age of 40.4 years, mean BMI of 26.1 kg/m2, mean serum uric acid level of 480.5 µmol/L, and approximately half (46.7%) reported comorbidities. The HRQoL of this population was characterized as moderate, with an overall mean gout impact score of 52.7± 15.3 (maximum possible = 100). The factors associated with the total gout impact score were resiliency (β = −.282, P <.001), pain (β = .255, P <.001), and tophi (β = .138, P = .050).
Demographics, such as smoking status, marital status, and education level; psychosocial behavior variables, including hope, disease treatment management, diet management, and resilience; and clinical characteristics, including the number of affected joints, number of attacks over a 6-month period, tophi, and pain were linked to several dimensions of the gout impact scale.
Investigators noted limitations including the cross-sectional nature of the study design as well as a lack of a control group. Additionally, the mediating role of self-management behaviors was not assessed, as the study only focused on the relationship of the 3 elements of the IMB model. Lastly, the degree of diagnosis among participants was not recorded, which may potentially impact the practical application of the findings.
“The results indicated that healthcare providers should choose intervention strategies with variable factors, actively monitor clinical symptoms, and pay more attention to psychosocial factors to improve the quality of life of patients with gout,” investigators concluded.