Physical, psychological, and social factors affect fibromyalgia patients’ health-related quality of life, according to a study that used an advanced statistical model to examine the interplay of the factors.
Patients with better physical capabilities and the confidence they can control situations related to their disease have better physical quality of life scores. Meanwhile, less physical capability, depression and anxiety impact their mental wellbeing.
The study, “Determinants of quality of life in patients with fibromyalgia: A structural equation modeling approach,“ also noted that better mental-health treatment can improve patients’ mental as well as physical quality of life. The research was reported in the journal PLOS ONE,
While many studies have examined quality of life among fibromyalgia patients, researchers at the Chonnam National University Hospital and Medical School in Korea noted that most of the research has examined the influence of one or a few factors at a time.
Quality of life in fibromyalgia patients is worse than in patients with other chronic diseases, including rheumatoid arthritis and chronic obstructive pulmonary disease (COPD), studies have shown.
Pain, depression, anxiety, lack of social support, and lack of self-efficacy — patients’ confidence that they can control situations that could influence the impact of their disease — all contribute to a lower sense of wellbeing, research has indicated. In studies addressing several factors, the choice of statistical method has prevented researchers from seeing the full picture, the authors argued.
The team used a method that can take into account several contributing factors at a time, as well as the relationships between them.
They assessed health-related quality of life, physical disability, depression, anxiety, social support, and self-efficacy in 336 patients, 89.6 percent of whom were women.
Their quality of life tool they used was able to distinguish between physical and mental factors impacting the patients. Poor fibromyalgia-related health status and low confidence in one’s ability to control the impact of the disease was linked to poor physical quality of life. But, importantly, depression and anxiety also impacted physical wellbeing.
On the other hand, mental quality of life was affected by all the factors that researchers investigated, including physical quality of life.
The study showed that the factors interacted with each other in a complex way. Depression was linked to all other factors, as was anxiety. Also, social support was linked to all other factors except the physical parameter of wellbeing.
“In conclusion, HRQOL [health-related quality of life] in FM patients was affected by physical, social, and psychological variables in our structural equation model. Higher physical function and higher self-efficacy may all improve the physical component of HRQOL, and better physical function and lower levels of depression and anxiety may directly improve the mental component of HRQOL.” the team concluded.
The findings underscore that fibromyalgia care needs to take into account more than just the obvious pain-related symptoms. Medical treatments, as well as non-medical interventions that improve mental health, may help improve physical measures of the disease as well.