Disabling foot pain and its impact on daily living among people with psoriatic arthritis in Singapore: a cross-sectional observational investigation.

IF 2.1 Q3 RHEUMATOLOGY BMC Rheumatology Pub Date : 2024-10-09 DOI:10.1186/s41927-024-00409-3
Vanessa H Y Teo, Kai Li Chia, Catherine Bowen, Manjari Lahiri, Peter P M Cheung, Deborah E Turner, Kate Carter
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Abstract

Background: Psoriatic Arthritis (PsA)-related foot involvement has been shown to have a profound impact on daily functioning, with most studies having focused on predominantly Caucasian populations. The aim was to describe disabling foot pain (DFP) and its impact on daily living in PsA in Singapore.

Methods: A cross-sectional, retrospective study was conducted using clinical data collected during a single-visit to a rheumatology clinic in Singapore. Records for adults with physician-diagnosed PsA were reviewed for sociodemographic information, disease characteristics, global disease activity and burden. Foot-specific measures included clinical assessment and the Manchester Foot Pain and Disability Index used to define DFP and evaluate between-group differences.

Results: Forty-two participants with PsA (83% female, 57% Chinese, 31% Malay, 9.5% Indian, mean (SD) age 54-years (16)) attended the rheumatology clinic over the study-period. The median (IQR) disease duration was 2-years (11) and all were taking current DMARDs. Global disease measures demonstrated mild-to-moderate global disease activity and mild functional impairment, and were significantly higher in those with DFP. Despite 90% reporting to be coping well with their condition, self-care and having emotional support (n = 38), this study sample demonstrated high levels of anxiety/depression (29%), sleep disturbance (34%) and fatigue (24%), and a lack of disease- and drug-specific knowledge (64%). Further management was indicated for medication adherence counselling (48%), occupational therapy (43%), physiotherapy (36%) and podiatry (30%). Nearly half had current foot pain with 40% reporting DFP (n = 17), which caused significantly greater difficulty walking 3 km than those without DFP (p < 0.05). Rearfoot enthesitis (plantar fasciitis, Achilles enthesitis) was the most common cause of DFP (67%) with pain lasting longer than 1-year. 72% were overweight or obese, with a high proportion not engaging in any cardiovascular exercise (70%). Three of 42 participants had previously seen a podiatrist.

Conclusions: People with DFP in PsA experience more severe global disease activity, reduced mobility and higher levels of negative impact on their daily lives in Singapore. In the absence of working in a multidisciplinary-team, there is value in comprehensive assessments that have potential to capture a holistic view of personal impact and improve person-centred care in PsA.

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新加坡银屑病关节炎患者致残性足部疼痛及其对日常生活的影响:一项横断面观察调查。
背景:与银屑病关节炎(PsA)相关的足部受累已被证明会对日常功能产生深远影响,而大多数研究主要集中在白种人群体中。本研究旨在描述新加坡 PsA 患者的致残性足部疼痛(DFP)及其对日常生活的影响:这项横断面回顾性研究使用了在新加坡一家风湿病诊所单次就诊时收集的临床数据。研究人员查阅了经医生确诊的成年 PsA 患者的病历,以了解其社会人口学信息、疾病特征、总体疾病活动度和负担。足部特异性测量包括临床评估和曼彻斯特足部疼痛和残疾指数,用于定义DFP和评估组间差异:42名PsA患者(83%为女性,57%为华人,31%为马来人,9.5%为印度人,平均(标清)年龄为54岁(16岁))在研究期间前往风湿病诊所就诊。病程中位数(IQR)为2年(11),所有患者目前都在服用DMARDs。总体疾病指标显示,总体疾病活动度为轻度至中度,功能障碍程度为轻度,DFP患者的这一指标明显高于其他患者。尽管90%的患者表示能够很好地应对病情、进行自我护理并获得情感支持(n = 38),但该研究样本显示,焦虑/抑郁(29%)、睡眠障碍(34%)和疲劳(24%)程度较高,且缺乏疾病和药物相关知识(64%)。需要进一步治疗的患者包括药物依从性咨询(48%)、职业治疗(43%)、物理治疗(36%)和足病治疗(30%)。近一半的人目前有足部疼痛,其中 40% 的人报告有 DFP(n = 17),与没有 DFP 的人相比,他们行走 3 公里的难度明显更大(p 结论:PsA 患者中,有 DFP 的人比无 DFP 的人更难行走 3 公里:在新加坡,患有 DFP 的 PsA 患者会经历更严重的全身疾病活动、更低的活动能力和更高程度的日常生活负面影响。在缺乏多学科团队合作的情况下,综合评估很有价值,有可能全面了解个人影响并改善以人为本的 PsA 护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Rheumatology
BMC Rheumatology Medicine-Rheumatology
CiteScore
3.80
自引率
0.00%
发文量
73
审稿时长
15 weeks
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