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Cited by 111Rheumatoid Arthritis Research and TherapiesHealth disparities and outcomesMusculoskeletal pain and rehabilitation

Formal education and five‐year mortality in rheumatoid arthritis: Mediation by helplessness scale scores

Callahan, Leigh F., Cordray, David S., Wells, George, Pincus, Theodore·1996·Arthritis & Rheumatism
DOI 10.1002/art.1790090608
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Abstract

Objective To analyze scores on a scale designed to measure helplessness, a cognitive variable, as a possible mediator of the association between formal education level and mortality over 5 years in patients with rheumatoid arthritis (RA). Methods A cohort of 1,416 patients with RA from 15 private practices in 6 states and Washington, DC was monitored for over 5 years. Demographic, socioeconomic, therapy, functional status, and psychological variables were analyzed as possible predictors of mortality in invariable and multivariable Cox Proportional Hazards models. Results In a 5-year followup, 1,384 patients were accounted for (97.3%), including 174 who died versus 111 expected (standardized mortality ratio = 1.54). Higher mortality was associated significantly with low formal education, high age, poor scores for activities of daily living (ADL) on a modified health assessment questionnaire (MHAQ), and poor scores on a helplessness scale (all P Conclusion Scores on a helplessness scale appear to mediate a component of the association between formal education level and 5-year mortality in these patients with RA. Health professionals and policy makers might consider interventions directed at modification of helplessness as adjunctive to standard interventions to improve outcomes in RA.

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Crossref · 10.1002/art.1790090608

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  • Interventions designed to reduce helplessness might be useful in reducing early death in patients with rheumatoid arthritis.

    “They also suggest that interventions designed to reduce helplessness might be useful in reducing early death in patients with rheumatoid arthritis.”

    From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [16]

  • In a 5-year study of 1416 patients with rheumatoid arthritis, individuals with low formal education and higher levels of disease activity had a significantly higher risk for early death.

    “As expected, the results revealed that individuals with low formal education and higher levels of disease activity had a significantly higher risk for early death.”

    From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [16]

  • These results suggest that helplessness might explain why persons with limited formal education and rheumatoid arthritis die earlier.

    “These results suggest that helplessness might actually explain why persons with limited formal education and rheumatoid arthritis die earlier”

    From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [16]

  • To date, interventions to decrease helplessness have not been reimbursed and thus are not being widely used in the medical management of rheumatic pain conditions.

    “However, to date, interventions to decrease helplessness have not been reimbursed and thus are not being widely used in the medical management of rheumatic pain conditions.16”

    From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [16]

  • The link between helplessness and early death has been reported in only one study.

    “To our knowledge, this result has been reported in only one study,16”

    From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [16]

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Authors
Callahan, L. F., Cordray, D. S., Wells, G., & Pincus, T.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • Vanderbilt University (US)
  • University of Ottawa (CA)
Corresponding author
Callahan, Leigh F.
ORCID
Venue
Arthritis & Rheumatism
Publisher
Wiley
Published
1996-12
Volume
9
Issue
6
Pages
463-472
ISSN
  • 0004-3591 (ISSN-L)
  • 1529-0131
DOI
10.1002/art.1790090608
OpenAlex
W2067851921
Cited by
111
References
91
Citations by year
2022: 1 · 2021: 1 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 3 · 2016: 1 · 2015: 2 · 2014: 2 · 2013: 4 · 2012: 4
FWCI
3.64
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 3300 d)
Locations
  • Arthritis & Rheumatism (publishedVersion)
  • PubMed (publishedVersion)
Funders
U.S. Public Health Service (21393)
Topics
  • Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
rheumatoid arthritis, mortality, helplessness, formal education, mediation, activities of daily living, modified Health Assessment Questionnaire, age, sex differences, socioeconomic factors, psychological factors
MeSH terms
Adult, Aged, Arthritis, Rheumatoid, Educational Status, Female, Health Status, Helplessness, Learned, Humans, Longitudinal Studies, Male, Middle Aged, Patient Education as Topic, Surveys and Questionnaires, Proportional Hazards Models

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