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

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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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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: Callahan, Leigh F.
Pincus, Theodore
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 › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › 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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Formal education and five‐year mortality in rheumatoid arthritis: Mediation by helplessness scale scores

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