Predicting functional status in patients with rheumatoid arthritis

Objective. To determine whether coping strategies and illness perceptions w ould be predictive of outcome in a longitudinal study of patients with rheu matoid arthritis (RA). Methods. A group of 71 patients with RA was examined on 2 occasions, one ye ar apart. Multiple regressions were used to examine which of the illness pe rceptions and coping strategies explained variance on the outcome variables : visits to the outpatient clinic, number of hospital admissions, Health As sessment Questionnaire, pain,tiredness, the Hospital Anxiety and Depression Scale. Results. Belief in adverse consequences of the disease was associated with more visits to the outpatient clinic, mon tiredness, and higher anxiety sco res. Less perceived control and less expression of emotion were associated with more hospital admissions. High scores on coping involving fostering re assuring thoughts were associated with more functional disability. More pas sive coping was associated with more functional disability and higher anxie ty scores, More perceived symptoms were associated with more pain, more tir edness, and more depression. More avoidant coping was associated with more tiredness. Belief that the illness will last a long time was associated wit h higher anxiety scores. Conclusion. Our longitudinal data show that, after statistically controllin g for the potential effects of intervening medical variables, coping strate gies and illness perceptions contribute to health outcome in patients with RA. Implications for patient management are discussed.