Martin Offenbaecher1,2, Niko Kohls3, Thomas Ewert4, Claudia Sigl5, Robin Hieblinger5, Loren L Toussaint6, Fuschia Sirois7, Jameson Hirsch8, Miguel A Vallejo9, Sybille Kramer5, Javier Rivera10, Gerold Stucki11, Jörg Schelling12, Andreas Winkelmann5. 1. Department of Orthopedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Germany. martin.offenbaecher@gasteiner-heilstollen.com. 2. Gasteiner Heilstollen Clinic, Heilstollenstr. 19, 5645, Bad Gastein, Austria. martin.offenbaecher@gasteiner-heilstollen.com. 3. Division of Integrative Health Promotion, University of Applied Science and Arts, Coburg, Germany. 4. Bavarian Health and Food Safety Authority, Nuremberg, Germany. 5. Department of Orthopedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Germany. 6. Department of Psychology, Luther College, Decorah, IA, USA. 7. Department of Psychology, University of Sheffield, Sheffield, UK. 8. Department of Psychology, East Tennessee State University, Johnson City, USA. 9. Psychology Faculty, UNED, Madrid, Spain. 10. Rheumatology Unit, Rehabilitation Provincial Institute, "Gregorio Marañón" General Hospital, Madrid, Spain. 11. Department Health Sciences and Medicine, University of Luzern, Luzern, Switzerland. 12. Primary Care Center Martinsried, Munich, Germany.
Abstract
OBJECTIVE: To identify correlates of quality of life (QoL) measured with the Quality of Life Scale (QOLS) in participants of a multidisciplinary day hospital treatment program for fibromyalgia (FM). METHODS: In this cross-sectional, observational study, "real world" data from 480 FM patients including socio-demographics, pain variables and questionnaires such as the SF-36, Beck Depression Inventory (BDI), Multiphasic Pain Inventory (MPI), SCL-90-R and others were categorized according to the components (body structure and function, activities and participation, personal factors, environmental factors) of the International Classification of Functioning (ICF). For every ICF component, a linear regression analysis with QOLS as the dependent variable was computed. A final comprehensive model was calculated on the basis of the results of the five independent analyses. RESULTS: The following variables could be identified as main correlates for QoL in FM, explaining 56% of the variance of the QOLS (subscale/questionnaire and standardized beta in parenthesis): depression (- 0.22), pain-related interference with everyday life (- 0.19), general activity (0.13), general health perception (0.11), punishing response from others (- 0.11), work status (- 0.10), vitality (- 0.11) and cognitive difficulties (- 0.12). Pain intensity or frequency was not an independent correlate. CONCLUSIONS: More than 50% of QoL variance could be explained by distinct self-reported variables with neither pain intensity nor pain frequency playing a major role. Therefore, FM treatment should not primarily concentrate on pain but should address multiple factors within multidisciplinary therapy.
OBJECTIVE: To identify correlates of quality of life (QoL) measured with the Quality of Life Scale (QOLS) in participants of a multidisciplinary day hospital treatment program for fibromyalgia (FM). METHODS: In this cross-sectional, observational study, "real world" data from 480 FM patients including socio-demographics, pain variables and questionnaires such as the SF-36, Beck Depression Inventory (BDI), Multiphasic Pain Inventory (MPI), SCL-90-R and others were categorized according to the components (body structure and function, activities and participation, personal factors, environmental factors) of the International Classification of Functioning (ICF). For every ICF component, a linear regression analysis with QOLS as the dependent variable was computed. A final comprehensive model was calculated on the basis of the results of the five independent analyses. RESULTS: The following variables could be identified as main correlates for QoL in FM, explaining 56% of the variance of the QOLS (subscale/questionnaire and standardized beta in parenthesis): depression (- 0.22), pain-related interference with everyday life (- 0.19), general activity (0.13), general health perception (0.11), punishing response from others (- 0.11), work status (- 0.10), vitality (- 0.11) and cognitive difficulties (- 0.12). Pain intensity or frequency was not an independent correlate. CONCLUSIONS: More than 50% of QoL variance could be explained by distinct self-reported variables with neither pain intensity nor pain frequency playing a major role. Therefore, FM treatment should not primarily concentrate on pain but should address multiple factors within multidisciplinary therapy.
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