| PurposeTo understand the population baseline characteristics and disease-related factors of female patients with Systemic lupus erythematosus(SLE),and to compare the differences among different population baseline characteristics,disease status and quality of life;To understand the status quo of anxiety and depression and sleep quality in female patients with SLE.To explore the correlation between disease activity,anxiety and depression,sleep quality and quality of life,and compare the differences between anxiety and depression and sleep quality and quality of life.To explore the mediating effect of anxiety,depression and sleep quality on disease activity and quality of life.MethodPatients meeting the inclusion criteria were selected from the First Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital from June 2021 to December 2022 for a cross-sectional study.The Hospital Anxiety and Depression Scale,Pittsburgh S Quality Scale and Systemic Lupus Erythematosus Specific Quality of Life questionnaire were used to evaluate the patients’ anxiety and depression,sleep quality and quality of life.Pearson and Spearson correlation analysis were used to study the correlation between different variables and quality of life.t test,variance analysis and multiple linear regression analysis were used to analyze the influencing factors of quality of life in female patients with SLE.Finally,the mediating effect model was constructed to explore the mediating effect of anxiety,depression and sleep quality on disease activity and quality of life.ResultA total of 510 female SLE patients with an average age of 33.14±7.97 were included in this study.All patients were Han population.The duration of SLE patients ranges from6 months to 46 years.The disease activity of SLE patients ranged from 0 to 39,with basically no activity,mild,moderate and severe activity in 105,84,143 and 178 patients,respectively.The average score of anxiety in this study was(6.81±4.29),among which123 people(24.2%)had suspected anxiety and 92 people(18.0%)definitely had anxiety.The average score of depression was 7.36±4.05,of which 137(26.8%)were suspected to have depression and 106(20.8%)were sure to have depression.The average score of sleep quality was 8.42±3.62,of which 172(33.7%)had good sleep quality and 338(66.3%)had poor sleep quality.The total quality of life scores of 510 female SLE patients in this study ranged from40 to 256,with an average score of 96.86±41.90.Quality of life was divided into six dimensions,including the average score of physical function(9.03±4.08),activity(21.95±10.99),symptom(20.10±9.77),treatment(9.52±5.02)and emotional(11.19±6.24).Self-image score(25.07±12.40).Correlation analysis resultsThe scores of anxieties,depression,sleep quality and disease activity were positively correlated with the scores of six dimensions of life quality,with statistical significance(P< 0.05).Results of univariate analysisPatients with different incomes and different degrees of anxiety,depression,sleep quality and disease activity had significant differences in the scores of six dimensions(P< 0.05),and patients with different ages had significant differences in the scores of activity dimension(P < 0.05).There were significant differences in the scores of symptoms,activities,treatment and self-image among patients with different educational backgrounds(P < 0.05).There were significant differences in symptom,treatment and self-image scores among patients with different course of disease(P < 0.05).Multiple linear regression analysis resultsThe physical function dimension was affected by disease activity,anxiety and sleep quality in women with SLE.The influence factors of activity dimension were patient age,disease activity,anxiety and depression,and sleep quality.The influence factors of symptom dimension were family income,disease course,disease activity,anxiety and depression,and sleep quality.The factors influencing the treatment dimension were family income,disease course,disease activity,anxiety and depression,and sleep quality.The emotional dimension was affected by family income,disease activity,anxiety and depression,and sleep quality in female SLE patients.The self-image dimension was affected by family income,disease course,educational level,disease activity,anxiety and depression,and sleep quality of female SLE patients.Results of mediation effect analysisAccording to the results of mediating analysis,the indirect effect of anxiety(disease activity can indirectly affect patients’ quality of life through anxiety)was 0.170,and the mediating effect accounted for 33.60%.The indirect effect of depression(disease activity can indirectly affect patients’ quality of life through depression)was 0.161,and the intermediate effect accounted for 31.82%.The indirect effect of SLE(disease activity can indirectly affect patients’ quality of life through SLE)was 0.116,and the intermediate effect accounted for 22.92%.ConclusionAge,education,income,disease course,disease activity,anxiety,depression and SLE affect the quality of life in female patients with SLE.At the same time,anxiety,depression and sleep quality play a partial mediating effect in the direct influence of disease activity on quality of life.Relevant medical staff should pay attention to the influence of mediating variables when studying the influence of disease activity on quality of life. |
