Impact of coping strategies on patient and physician perceptions of disease severity and disability in systemic sclerosis.

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Systemic sclerosis (SSc) results in impaired function, disability, and reduced health-related quality of life (HRQL). We investigated the impact of coping strategies on the patient global assessment of health (PtGA) and Health Assessment Questionnaire Disability Index (HAQ-DI), after controlling for clinical characteristics and disease activity. We also explored the relationship between coping strategies and correlation between PtGA and physician global health assessments (PhysGA) in SSc.We undertook post-hoc analyses using baseline data obtained from the Raynaud’s Symptom Study (RSS). The PtGA, coping strategies questionnaire (CSQ), pain catastrophizing scale (PCS), and scleroderma health assessment questionnaires (SHAQ) were collected alongside the PhysGA, clinical characteristics and patient demographics. Multivariable linear regression models and correlations were used to evaluate the relationship between coping strategies with the PtGA, HAQ-DI, and PhysGA, respectively.Of the 107 SSc patients enrolled to the RSS, there was sufficient data available for analysis of 91 participants. The mean (SD) PtGA was 40/100 (27) and the mean HAQ-DI was 0.87/3.0 (0.73). After controlling for clinical and patient demographics, pain catastrophizing and maladaptive coping skills were significantly associated with the PtGA and HAQ-DI scores (p<0.05 for both), but not the PhysGA.The impact of coping strategies on PtGA and HAQ-DI (but not the PhysGA in SSc) could influence the result of composite measures incorporating these outcome measures. Interventions to improve patient coping skills may support increased resilience and improve patient-perceived functional status and PtGA in SSc.

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Authors: Dana D DiRenzo, Theresa R Smith, Tracy M Frech, Ami A Shah, John D Pauling