The roles of sex, Perceived Pain and illness Perceptions on Disease Activity in Rheumatoid Arthritis

Background: In the “treating to target” strategy to rheumatoid arthritis (RA) management, “cognitive” beyond “physical” measures allow a more comprehensive assessment. This study reports a predictive analysis of patient properties on Disease Activity, and the degree to which these predictions could be uniquely attributable to Illness perception (IP), pain, and sex differences. Methods: This cross-sectional study was conducted in 108 patients with Rheumatoid Arthritis aged 18 to 65 years old, selected via convenience sampling. Measurements were collected using Disease Activity Score in 28 Joints (DAS28), patient's illness perception (IPQ-R), and numerical rating scale (NRS) for perceived pain. Data were analyzed applying Spearman and Pearson correlation coefficients and multiple stepwise regression (MSR) analyzes. Results: In correlation analysis, sex- Disease Activity association (.40**, P<0.01), Pain-Disease Activity association (.54**, P<0.01) were found. Additionally, we observed stronger and significant associations between IPQ-R subscales and Disease Activity [Identity (r =.53**, P<0.01) Personal control (r = -.40**, P<0.01) and Emotional representation (r =.36**, P<0.01)]. Regression analysis showed sex differences was a not significant predictor and perceived pain and three IPQ-R items (Identity, Personal control and Emotional representation) emerged as the strongest predictors (P<0.001). Conclusion: Disease Activity predicted by pain and three Illness perception items. By identifying the components affecting Disease Activity, the therapist can adjust complementary treatment according to patients' needs.