The influence of psychosocial variables and disease severity in patients with chronic illness: A one-year follow-up

This study examined the extent to which psychosocial variables predict adjustment in patients with rheumatoid arthritis. Participants were recruited at an outpatient clinic. Data were available for 52 of the sample at one-year follow-up. Clinical disease status and psychological functioning were assessed at both timepoints. Findings from correlational and hierarchical regression analyses reveal a number of statistically significant relationships (p<0.01) between stress and emotional adjustment. Partial correlations showed that while social support did not mediate the relationship between psychological stress and adjustment, the use of venting emotions as a coping strategy was a mediator of the association between stress and negative affect. Results demonstrated that disease status predicted illness related functioning but did not predict emotional or social adjustment. Perceived stress was a better predictor than disease of concurrent positive and negative emotionality with explained variance ranging from 14 to 55%. Coping also predicted variance on these affective domains (10-19%). In longitudinal analyses, perceived stress accounted for variability in negative affect one year later and coping predicted positive affect over this time. Level of social support explained variance on social activity in cross-sectional and longitudinal analysis (10-14%). Results suggest that a cognitive behavioural intervention to facilitate patient adjustment could usefully include management of stress and its appraisal, the fostering of adaptive coping strategies and utilization of social support resources. It is concluded that improving patient adjustment to rheumatoid arthritis has implications for medical care seeking.