• Title/Summary/Keyword: rheumatoid factors

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A Study on Burden of Middle Aged Spouses of Rheumatoid Arthritic Patients (류마티스 관절염 환자 배우자의 부담감)

  • Choi, Kyung-Sook;Eun, Young;Ham, Mee-Young
    • Journal of muscle and joint health
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    • v.7 no.2
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    • pp.241-257
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    • 2000
  • Rheumatoid arthritis as one of the chronic illness requiring management in long period of time puts great burden to patients, their family and society. For patients with chronic illnesses, providing a social support is important and the most important source comes from spouses. Therefore we assessed burden of husbands of female rheumatoid arthritic patients and also found out the factors affecting burden. The sample of study was 107 female rheumatoid arthritic patients and their spouses. The tool of assessing spouses' burden was the revised version of subjective and objective parameters developed by Montgomery et al.(1985). The results are as follows: 1. General characteristics of patients and spouses: The mean age of the patients was 48 years. Educational level of patients was high school 41.1%. The mean age of the spouses was 51years. Educational level of spouses was mostly high school(40.2%) and college(29.9%) graduate. The mean marital period was 23.4years. Average income per month was 1,609,000 won. The average duration since diagnosis was 9.4years. As a therapy, 67.3% chose standard drug therapy. Average rating of discomfort by patient was 3.05(range 1-5) and that of severity was 3.48 and that of dependency was 2.58. The husband's rating of their spouses disease severity was 3.68. 2. Husbands' burden: The average burden in subjective items was 21.61(range 6-36) and objective items was 35.24(range 10-60). The average of total burden was 56.59(range 16-96). 3. Husband's total burden correlated with patient's age, educational level of patients, therapy method, patient's level of discomfort, patient's severity, patient's level of dependence, husband's recognition of level of severity in statistical level. Husband's objective burden correlated with patient's age, educational level of patient, patient's level of discomfort, husband's recognition of level of severity. Husband's subjective burden correlated with patient's age, educational level of patients, therapy method, patient's severity, patient's level of dependence, husband's recognition of level of severity. 4. Linear correlation analysis on burden: The husbands' total burden is explained in 37 7% by husband's recognition of level of severity and husband's age. The husbands' objective burden is explained in 31.2% by patient's level of dependence, husband's age, husband's recognition of level of severity. The husbands' subjective burden is explained in 26.7% by husband's recognition of level of severity and patient's age. In conclusion, husbands' level of burden is affected by many factors and therefore nursing strategy for relieving burden of middle aged husbands should be individualized taking these factors into consideration.

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Determinants of Reduced Bone Mass in Postmenopausal Women with Rheumatoid Arthritis (폐경 후 류마티스 관절염 여성의 골량감소 판별요인)

  • Lee, Eun-Nam
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.2
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    • pp.193-205
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    • 1999
  • This study was carried out to identify the important risk factors for reduced bone mass of postmenopausal RA patients and to develop discriminant function which can classify postmenopausal RA patients with either reduced or normal bone mass. Through the literature review, individual characteristics such as age, body weight, height, age of menarche, duration of menopause, gravity, parity, and breast feeding period and factors of life style such as milk consumption exercise habit, alcohol intake, cigarette smoking, coffee consumpt ion , disease activity, corticosteroid therapy were identified as influencing factors of reduced bone mass in RA patients Sixty eight postmenopausal women with rheumatoid arthritis aged between 42 and 76 were selected among those who checked bone mineral density in lumbar spine and femur from october, 1998 to Apr il, 1999 at Dong-a university hospital in Pusan. Assessment of disease activity, duration of disease and corticosteroid therapy were made by the same rheumatologist and included Ritchie articular index, erythrocyte sedimentation rate, and C-reactive protein on measuring bone mineral density. Cumulative steroid dosage was calculated from the daily dosage multiplied by t h e number of days received. The information of other risk factor including health assessment score, individual characteristics and life style factors were collected by questionnaire. Bone mineral density(BMD) was measured using DXA at lumbar spine and femoral Ward's triangle. Discriminant function(regression equation) was developed for estimating the likelihood of the presence or absence of reduced bone mass. The results are as follows: Among the subjects, thirteen(19.1%) exhibited osteoporosis in lumbar spine and twenty four(35.3%) exhibited osteoporosis in femoral Ward's triangle. For lumbar spine, the variables significant were age, body weight, health assessment score, while for femoral Ward's triangle, age, body weight, duration of disease. But disease activity and corticosteroid therapy were not signigicant to distinguish reduced bone mass from normal bone mass. When the discriminant function was evaluated by comparing the observed out come with predicted out come, the discriminant function correctly classified 85.4% of patients with reduce bone mass and 63.0% of patients with normal bone mass in the lumbar spine and 100% of patients with reduced bone mass and 9.1% of patients with normal bone mass in the femoral Ward's triangle. In summary, we found that osteoporosis in postmenopausal women with RA is more evident at the femur than the lumbar spine. Also the important discriminant factors of reduced bone mass postmenopausal women with RA were age, body weight , duration of disease and health disability. In nursing situation, the efforts to improve of functional capacity of postmenopausal women with rheumatoid arthritis should be considered to prevent osteoporosis and fractures. Also we recommend those postmenopausal women with RA who are classified as a group of the reduced bone mass in the discriminant function should examine the bone mineral density to further examine the usefulness of this discriminant function.

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Comparison of the Usefulness of Diagnostic Tests for Rheumatoid Arthritis (류마티스 관절염 진단을 위한 검사의 유용성 비교)

  • Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.4
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    • pp.168-174
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    • 2015
  • Rheumatoid arthritis (RA) is a chronic inflammatory disease, which is mainly characterized by disease of joints affected with synovial hyperplasia, pathological immune response, and progressive destruction; all of which represent an important social health problem. These provide new insights in its pathogenesis of rheumatoid arthritis diagnosis and disease progression in molecular changes. This review focuses on new serological and immunological markers which seem to be useful in early diagnosis and prognosis of rheumatoid arthritis. Therefore, such tests are widely conducted for serological biomarkers and the developments with such immunological factors to identify patients who are at risk for disease progression. This evidence of the disease based on laboratory medicine could provide the best outcome for patients. Finally, data from recent studies will help to refine the ultimate usefulness of this novel approach for early diagnosis, treatment, and helping clinicians to optimize therapy by using this approach.

A Study on the Impact of Mastery on Appraisal of Uncertainty in Women Patients with Rheumatoid Arthritis (극복력(Mastery)이 여성 류마티스 관절염 환자가 자각하는 불확실성 인지에 미치는 효과)

  • Yoo, Kyung-Hee
    • Research in Community and Public Health Nursing
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    • v.13 no.2
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    • pp.249-259
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    • 2002
  • Objectives: This study was conducted to investigate the effects of mastery on appraisal of uncertainty in women patients with rheumatoid arthritis. Methods : The study subjects consisted of 168 patients who were recruited from the outpatient clinic of a rheumatic center in Seoul. Self report questionnaires were used to measure the study variables that included uncertainty, mastery, danger appraisal of uncertainty, and opportunity appraisal of uncertainty. Cronbach's alpha reliabilities of these instruments ranged from .72 to .93. For data analysis. the SPSSWIN 10.0 program was utilized to exam descriptive statistics. Pearson's correlation. and regression analysis. Results: The results were as follows.: 1) The uncertainty scores of the subjects ranged from 33 to 87 with the mean score of 63.27. 2) The mastery scores of the subjects ranged from 10 to 27 with a mean score of 18.70. 3) The danger appraisal of uncertainty scores of the subjects ranged from 8 to 32 with a mean score of 20.22. 4) The opportunity appraisal of uncertainty scores of the subjects ranged from 7 to 28 with a mean score of 17.80. 5) Significant factors that explained the danger appraisal of uncertainty were mastery (=-.444. p<.001), and education level (=-.184. p<.05). 6) Significant factor that explained the opportunity appraisal of uncertainty was level of uncertainty (=-.328. p<.001). Conclusion: Among the independent variables. the most significant factor that explained the danger appraisal of uncertainty in the women patients with rheumatoid arthritis was mastery. Therefore, a nursing intervention with strategies to improve sense of mastery should be developed for women patients with rheumatoid arthritis.

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Relationship of Health Status, Self-Efficacy, Hardiness, Family Support and Pain in Patients with Rheumatoid Arthritis (류마티스 관절염환자의 건강상태와 자기효능, 강인성, 가족지지 및 통증과의 관련성)

  • Paik, Kwang-Mi;Shim, Seung-Cheol;Kim, Jong-Im
    • Journal of muscle and joint health
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    • v.7 no.2
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    • pp.309-322
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    • 2000
  • This study was conducted to find out the relationship among several variables such as health status, self-efficacy, health related hardiness, family support and pain in patients with rheumatoid arthritis. The subjects were 108 patients with rheumatoid arthritis who visited the out patient department of Rheumatism at E university hospital in Teajon. Data were collected by questionnaire from November 26, 1999 to January 14, 2000. The instrument used in this study were health status developed by Bae et al(1998), self-efficacy scale developed by KRHPS, health related hardiness modified by Suh(1988), family support scale developed by Kang(1984), Pain with graphic rating scale. Data were analyzed by descriptive statistics, one-way ANOVA, Pearson Correlation Coefficient, multiple regression using the SPSS Win program. The results were as follows; 1. There were no statistically significant differences between general characteristics and variables such as health status, self-efficacy, health related hardiness and family support respectively. 2. Statistically significant differences were not found between clinical characteristic and variables such as health status, self-efficacy, health related hardiness and family support respectively. 3. Significant correlations were found between health status and self-efficacy, self-efficacy and hardiness, hardiness and family support, health status and pain, self-efficacy and pain respectively(p<0.01), and health status and hardiness, self-efficacy and family support, hardiness and pain respectively(p<0.05). 4. Self-efficacy and pain were significant affecting factors of a health status. In these results, it is suggested that nursing intervention to increase self-efficacy and to reduce pain was very important for patients with rheumatoid arthritis.

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Comparison of Bone Mineral Density and Risk Factors of Osteoporosis between Normal and Rheumatoid Arthritis in Postmenopausal women (폐경 후 정상여성과 폐경 후 류마티스 관절염환자의 골밀도 및 골다공증 위험요인 비교)

  • Lee, Eun-Nam
    • Journal of muscle and joint health
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    • v.7 no.1
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    • pp.89-101
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    • 2000
  • This study was carried out to compare the bone mineral density and risk factors of osteoporosis between normal and rheumatoid arthritis in postmenopausal women. Sixty-eight postmenopausal patients with rheumatoid arthritis(RA) were compared with 124 postmenopausal normal women. Data were collected from october, 1998 to April, 1999 at Dong-a university hospital in Pusan. From all subjects, individual characteristics such as age, body weight, height, age of menarche, duration of menopause, gravity, parity, and breast feeding period and factors of life style such as milk consumption, exercise, alcohol intake, cigarette smoking, coffee consumption were identified as influencing factors of osteoporosis by questionnaire. From RA patients, health assessment score, Ritchie articular index, erythrocyte sedimentation rate, C-reactive protein and steroid dosage were measured by rheumatologist on measuring bone mineral density. Bone mineral density was measured at the Lumbar spine, femoral neck, femur Ward's triangle, and femur trochanter using dual x-ray absorptiometry. The data was analyzed by using a frequency, t-test, Chi-square, ANCOVA with SPSS PC program. The results could be summarized as follows : 1) There was a significant difference in age and breast feeding period between RA patients and normal women. 2) RA patients took less calcium in the past and practiced less regular exercise in past and present than normal women. 3) There was no difference in lumbar bone mineral density between RA patients and normal women. 4) There was a significant difference in femur Ward's triangle and femur trochanter between RA patients and normal women after adjustment for age and breast feeding period. 5) The prevalence of osteoporosis of all subjects was the highest in femur Ward's triangle. In summary, our findings suggest that the bone mineral densities of femur Ward's triangle and trochanter in postmenopausal women with RA is significantly lower than normal women. Also the exercise participation rate of postmenopausal women with RA is lower than normal women. For the further study, we recommend to develop exercise program that improve the bone mineral density in femur Ward's triangle and trochanter and to test the effect of that exercise program.

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Anti-nociceptive and Anti-inflammatory Effects of Gami-cheongyulsaseub-tang in Arthritic Model (관절염 모델에서 가미청열사습탕(加味淸熱瀉濕湯)의 진통 및 소염 효과에 관한 연구)

  • Kim, Il-Hyun;Lee, Ha-Il;Lee, Se-Won;Kwon, Young-Mi;Song, Yung-Sun
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.1
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    • pp.27-44
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    • 2015
  • Objectives This study was carried out to find the effects of Gami-cheongyulsaseub-tang (hereinafter referred to GCST) on the inhibition of zymosan-induced pain in rats and collagen II-induced arthritis (CIA) in DBA/1J mouse. Methods As an acute inflammatory pain model, peripheral inflammation was induced by intraplantar injection of zymosan into the right hind paw in rats and then the hyperalgesia and pain regulating factors in spinal cord were analyzed. As a chronic inflammation model, the mixture of collagen II and complete Freund's adjuvant was treated into mice to establish rheumatoid arthritis and then body weight, thickness of hind paw, pathological change of spleen, immunological rheumatoid factor (IgG1, IgG2a, IgG2b, IgM and anti-collagen II), pro-inflammatory cytokines, and bone injury were analyzed. Results In the acute inflammatory pain model, GCST significantly inhibited the thermal and mechanical hyperalgesia and the pain regulating factors, including Fos, CD11b, PKA and PKC, in the spinal cord with a dose-dependent manner. In the chronic rheumatoid arthritis model, GCST administration decreased arthritic index and paw edema as compared with CIA control group. In particular, GCST reduced significantly the serum levels of total IgG2a, IgG2b, IgM, and specific anti-collagen II, but not total IgG1. GCST also resulted in the attenuation of bone injury and spleen enlargement/adhesion in CIA mice. Moreover, the secretion of pro-inflammatory cytokines TNF-${\alpha}$ and IL-$1{\beta}$ in CIA mice was significantly reduced by GCST in a dose-dependent manner. Conclusions Comparison of the results in this study showed that GCST had anti-nociceptive and immunomodulatory effects. These data imply that GCST can be used as an effective drug for not only rheumatoid arthritic pain but also other auto-immune diseases.

Suppressive Effects of Haedongpi-san, a Traditional Herbal Medicine, on Collagen-induced Arthritis in Mice (해동피산(海桐皮散)의 콜라젠으로 유발된 류마티스관절염 억제 효과)

  • Kang, Sung-Youp;Jin, Mi-Rim;Choi, Jeong-June;Koo, Young-Sun;Roh, Seong-Soo;Kim, Dong-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.4
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    • pp.982-991
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    • 2007
  • The present study was done to assess the suppressive effects of Haedongpi-san(HDPS), a traditional herbal medicine, on collagen induced arthritis (CIA) in mice and to examined it's effects on immune system. Oral administration of HDPS (200 or 400 mg/Kg) significantly suppressed the progression of CIA, which extend is comparable to that of methotrexate (MTX, 30 mg/Kg), a positive control. Histological examinations reveled that HDPS inhibited infiltration of inflammatory cells into affected paw joint, and bone erosion and cartilage destruction were greatly reduced compared with control. In paw joint, the number of CD3+ cells and CD11b+/Gr-1+ cells were greatly reduced by HDPS. The levels of pathologic cytokines including TNF-a and IL-6 were significantly decreased in the serum by oral treatment with HDPS. The levels of $IFN-{\gamma}$ in the culture supernatant of splenocyte stimulated with CD3/CD28 or collagen were dramatically decreased, while those of IL-4 was increased. Rheumatoid factors including IgG, IgM and collagen specific antibody were present much lower in the serum of HDPS treated mice than control. In peripheral blood mononuclear cells of HDPS treated mice, the percentage of CD3+, CD3+/CD69+, CD4+, CD4+/CD25+ cells were significantly decreased, while CD19+ cells were slightly increased compared with control. The absolute number of CD19+, CD3+, CD3+/CD69+, CD4+/CD25+, CD49b+ cell in spleen from HDPS treated mice were significantly decreased. The absolute number of CD3+, CD3+/CD69+, CD4+, CD4+/CD25+ CD8+, CD49b+, CD3+/CD49b+ cells in draining lymph node were significantly increased compared with control. Taken together, HDPS has suppressive effects on rheumatoid arthritis by modulating immune system, and has potential to use as an therapeutic for rheumatoid arthritis.

Learned Helplessness to Predict Regular Physical Activity among Individuals with Rheumatoid Arthritis (학습된 무력감이 류마티스관절염 대상자의 규칙적 운동에 미치는 영향)

  • Boo, Sunjoo;Oh, Hyunjin
    • Journal of muscle and joint health
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    • v.24 no.2
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    • pp.150-158
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    • 2017
  • Purpose: Regular physical activity is beneficial in reducing disease activity and morbidity in patients with rheumatoid arthritis (RA). The purposes of this study were to examine the levels of regular physical activity and learned helplessness and to identify factors influencing in participation in regular physical activity in RA patients. Methods: This cross-sectional study was conducted with 210 RA patients in a university-affiliated hospital. Participants completed a questionnaire including demographic and disease-related characteristics, physical activity and learned helplessness. Data were analyzed with descriptive statistics, $x^2$ tests, t-tests, and multivariate logistic regression analyses. Results: About 23% of RA patients engaged in at least 30 minutes of regular physical activity per week. Patients with being older (OR=1.09, 95%CI=1.03~1.14), no employment status (OR=0.17, 95% CI=0.07~0.42), and lower levels of learned helplessness (OR=0.58, 95% CI=0.34~0.96) had significantly higher chance of engaging in regular physical activity. Conclusion: In developing nursing interventions to promote regular physical activity in RA patients, their learned helplessness should be considered.

An Exploration of the Life Experiences of Patients with Chronic Pain : Women with Rheumatoid Arthritis (만성통증환자의 생활경험에 관한 연구-여성 류마티스관절염 환자를 중심으로-)

  • 허혜경
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.13-25
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    • 1997
  • Rheumatoid Arthritis(RA), a chronic and systemic inflammatory disorder, is characterized by joint pain, swelling and stiffness. Patients with RA suffer from joint pain and overall pain. The painful and disabling consequences of RA are accompanied by a variety of affective, cognitive, and behavioral changes. The purpose of this paper was to explore and describe the life experiences of RA patients by eliciting verbal description of their experiences. Participants were nine persons who were diagnosed with RA, and had had it for more than six months. They were asked open ended and descriptive questions in order for them to talk about their experiences in their on terms. Interviews were tape recorded and transcribed verbatim. The transcripts were analyzed by Colaizzi method. From the protocols, 213 significant statements about life experience were organized into 83 formulating meanings which were then grouped into five theme clusters. The major themes that emgerged from the analysis were' Emotional Disturbances', 'Trying to Adapt to the Progress of Disease', 'Progress of Treatment'. 'Change of Role Performances', 'Experiences related to Family'. The result of this study showed that RA patients and families need nursing care based on a deep understanding of their lived experiences in everyday life. Nurses and other health workers must develop rehabilitation programs that focus on the pain control, functional independence and psychosocial factors.

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