This project will describe disability in valued life activities (VLAs) among persons with rheumatoid arthritis (RA), as well as factors associated with maintenance of those activities and factors that may protect against negative psychological outcomes following VLA disability. The same physical manifestations of RA that may cause difficulty in mobility or in performing a self-care activity may also cause difficulty in more complex, discretionary activities such as hobbies or socializing with friends. The wide range of activities that individuals find meaningful or pleasurable, above and beyond activities necessary for survival or self-sufficiency, is what we term """"""""valued life activities"""""""". Performance of VLAs appears to be linked to psychological well-being and satisfaction with function. Although loss of VLAs has been found to be a risk factor for the onset of depressive symptoms, effects of difficulties in VLA performance are not known. Also, many individuals who lose the ability to perform VLAs do not develop depressive symptoms; factors that protect individuals from psychological distress after VLA disability have not been identified. This study will estimate VLA disability and identify factors associated with maintenance of VLAs, psychological outcomes of VLA disability, and factors associated with maintenance of psychological well-being after VLA disability, building on the Verbrugge and Jette disablement process model. Subjects will be queried about these topics in annual telephone interviews. Items to assess VLA disability and psychological outcomes will be included in the interview, as well as questions about potential risk and protective factors for VLA disability and psychological distress. These items will consist of existing scales and survey items when available, and items developed specifically for this study. Analyses based on the study model (Figure 1) will focus on 3 major areas: (1) description of VLA disability among individuals with RA over a 5-year period, (2) description of psychological outcomes of VLA disability, and (3) identification of factors associated with maintenance of VLAs and maintenance of psychological well-being after VLA disability. Mathematical models will be developed to describe these relationships in the context of the study model, using both cross-sectional and longitudinal analyses. The findings from this study will provide information that may help minimize VLA disability and the psychological distress that might result from VLA disability, thereby improving quality of life of persons with RA. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR050015-02
Application #
6795461
Study Section
Special Emphasis Panel (ZRG1-RPHB-3 (01))
Program Officer
Ader, Deborah N
Project Start
2003-09-01
Project End
2008-06-30
Budget Start
2004-07-01
Budget End
2005-06-30
Support Year
2
Fiscal Year
2004
Total Cost
$440,606
Indirect Cost
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Katz, Patricia P; Radvanski, Diane C; Allen, Diane et al. (2011) Development and validation of a short form of the valued life activities disability questionnaire for rheumatoid arthritis. Arthritis Care Res (Hoboken) 63:1664-71
Morris, Anne; Yelin, Edward H; Panopalis, Pantelis et al. (2011) Long-term patterns of depression and associations with health and function in a panel study of rheumatoid arthritis. J Health Psychol 16:667-77
Katz, Patricia; Morris, Anne; Gregorich, Steve et al. (2009) Valued life activity disability played a significant role in self-rated health among adults with chronic health conditions. J Clin Epidemiol 62:158-66
Katz, Patricia; Yelin, Edward; Patel, Vaishali et al. (2009) Patient-reported outcomes following biologic therapy in a sample of adults with rheumatoid arthritis recruited from community-based rheumatologists. Arthritis Rheum 61:593-9
Morris, Anne; Yelin, Edward H; Wong, Belinda et al. (2008) Patterns of psychosocial risk and long-term outcomes in rheumatoid arthritis. Psychol Health Med 13:529-44
Katz, Patricia; Morris, Anne; Yelin, Edward (2008) Subclinical disability in valued life activities among individuals with rheumatoid arthritis. Arthritis Rheum 59:1416-23
Katz, Patricia P; Morris, Anne (2007) Use of accommodations for valued life activities: prevalence and effects on disability scores. Arthritis Rheum 57:730-7
Katz, P; Morris, A (2007) Time use patterns among women with rheumatoid arthritis: association with functional limitations and psychological status. Rheumatology (Oxford) 46:490-5
Yelin, Edward H; Trupin, Laura S; Katz, Patricia P (2005) Impact of managed care on the use of biologic agents for rheumatoid arthritis. Arthritis Rheum 53:423-30
Katz, Patricia P (2005) Use of self-management behaviors to cope with rheumatoid arthritis stressors. Arthritis Rheum 53:939-49