Disease control can affect quality of life and happiness

The impact of rheumatoid arthritis is less in people with ’positive’ personality traits.

Rheumatoid arthritis is a chronic inflammatory disease that affects a person’s joints, causing pain and disability. It can also affect internal organs. Rheumatoid arthritis is more common in older people, but there is also a high prevalence in young adults, adolescents and even children, and it affects women more frequently than men. Chronic long-term diseases such as rheumatoid arthritis also affect a person’s ability to enjoy life as a whole, a concept similar to that of “happiness”. This call can be measured and scored using tools and questionnaires to get a picture of how much a person’s disease affects them. Together with improving physical symptoms, medical care aims to improve a person’s enjoyment of life.

What did the authors hope to find?
The authors hoped to find out the most important factors that affect happiness and quality of life in people with rheumatoid arthritis.

Who was studied?
The study looked at 213 people with rheumatoid arthritis at a single rheumatology outpatient department in Portugal. Everyone included was over the age of 18.

How was the study conducted?
Everyone taking part in the study completed four different questionnaires. These were 1) RAID (short for Rheumatoid Arthritis Impact of Disease score), which measures the impact of disease; 2) SHS (short for the Subjective Happiness Scale) to measure happiness; 3) the Ten-Item Personality Inventory to describe each person’s personality traits; and 4) the EuroQoL questionnaire to measure the health-related quality of life. The doctors running the study also measured each person’s disease activity and took blood samples to measure their levels of inflammation.

What were the main findings of the study?
The study found that levels of happiness were positively related to having a ‘positive’ personality and, negatively related to impact of disease. Impact of disease, in turn, was positively related to disease activity. The impact of disease was less in people with ’positive’ personality traits. Overall the impact of disease had a much stronger relationship with quality of life than with happiness. Happiness could lessen the negative effect of disease impact on quality of life. For these reasons, the authors suggest that to improve quality of life and happiness people need to have effective control of their disease.

Are these findings new?
To our knowledge, this is the first study to show the complex relationships between disease activity, impact of disease, personality traits, quality of life and happiness in people with rheumatoid arthritis.

What are the limitations of the study?
One limitation of the study is that, although the sample size and the diversity of characteristics were satisfactory, the study took place at a single clinic. This might mean that the results would not be the same in other populations. Also, the way the study was designed means it is not possible to say whether there is cause and effect. Another limitation is that all variables examined in this study could be influenced by other factors, such as material wealth, occupation and loneliness, and these were not accounted for.

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Date prepared: August 2018
Summary based on research article published on: 12 July 2018
From: Santos, EJF. et al. Determinants of happiness and quality of life in patients with rheumatoid
arthritis: a structural equation modeling approach. Ann Rheum Dis 2018;77:1118–1124. doi: 10.1136/

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