Illness intrusiveness explains race-related quality-of-life differences among women with systemic lupus erythematosus

Our objective was to investigate whether quality of life in systemic lupus erythematosus (SLE) differs across ethnoracial groups and to identify facto rs that may explain race-related differences. Self-administered questionnaire data from 335 White, 40 Black, and 30 Asian women with SLE LL ere obtained from a multi-center database. Measures asse ssed illness intrusiveness, psychological well-being. depressive symptoms, musculoskeletal pain, and learned helplessness. Extent of SLE disease activ ity was indexed by self-reported functional-system involvement. Educational attainment was indicated by number of years in school. Principal-components analysts reduced the four psychosocial measures to a s ingle factor score. This represented psychosocial well-being in path analys is. Psychosocial well-being differed significantly across the three groups, with Whites reporting the highest, and Blacks the lowest, levels. Path ana lysis indicated that illness intrusiveness accounted for this race-related difference. Although disease activity was significantly associated with psy chosocial well-bring, it did not differ across ethnoracial groups. Illness intrusiveness and educational attainment emerged as independent mediators o f the race-related difference in psychosocial well-being. We conclude that race-related quality-of-life differences exist among women with SLE and are mediated independently by illness intrusiveness and educa tional attainment.