Influence of juvenile idiopathic arthritis on the quality of life of young adults in the transition period to adult rheumatologic care in Ukraine.

Abstract

Background: Young adults with juvenile idiopathic arthritis (JIA) often have an active disease with significant functional impairment in adulthood that can affect their physical and mental functions. Objectives: The aim of the study was to determine the impact of JIA on quality of life, mental and physical health in young adults with JIA during the transition healthcare in Ukraine. Methods: The cross-sectional study of 89 young adults aged 16 to 22 years with a history of JIA and 25 age- and sex-matched controls (without rheumatic disease) were included. The study was performed at the Aleksandrivsky Central Clinical Hospital, Kyiv, Ukraine in the period between April 2015 and February 2017. There was performed an evaluation of the disease activity by JADAS, received therapy, quality of life by the SF36, the functional activity (HAQ), long-term JIA damage indices JADI-A and JADI-E,1 PHQ-9, Beck depression scale. Results: Patients with JIA had worse (p<0.001) physical health in comparison with the control group. Physical (p<0.001) and role (p<0.05) functioning and bodily pain (p<0.001) in JIA patients were decreased, compared with the controls. How- ever, the indicators responsible for psychological function in patients with JIA did not differ from the controls. The analysis of functional activity revealed a strong negative effect of the disease on physical role functioning (p<0.001), bodily pain (p<0.001), general health (p<0.001), vitality (p<0.001), social role functioning (p<0.001), and mental health (p<0.001), which are included in physical (p<0.001) and mental (p<0.05) health. HAQ had strong negative effects on physical function- ing (r=0.56, p<0.001), role function (r=0.33, p<0.001), bodily pain (r =-0,60, p<0.001), general health (r=-0,40, p=0.01), vitality (r=-0,46, p<0.001), social func- tioning (r=0.48, p<0.001) and mental health (r=0.42, p<0.001). Articular long- term damages (JADI-A) have a predominantly negative effect on the patient’s physical health (r=-0,27, p<0,05) and on the indices associated with it: physical functioning (r =-0,24, p<0.05), bodily pain (r=0.24, p<0.05), general health (r=0.24, p<0.05), vitality (r=0.19, p<0.05), social functioning (r=0.27,p<0.05), mental health (r=0.22, p<0.05). While the extra-articular long-term damages – JADI-E also have a predominantly negative effect on the patient‘s physical health (r=0.22, p<0.05) and on the indexes associated with it: physical functioning (r=- 0,28,p<0,05), bodily pain (r=-0,20, p<0,05), general health (r=-0,23, p<0,05), men- tal health (r=0.23, p<0.05), as well as a positive association with Beck depres- sion scale (r=0,28, p<0.05) and PHQ-9 (r=0.28, p<0.05).