Assessment of Psychosocial Dimensions of Systemic lupus Erythematosus (SLE): Implications for the Health Care Professionals

The aim of this chapter is to provide evidence-based recommendations for the SLE health care providers working with this cohort. This cross-sectional study evaluates 378 SLE patients to identify the psychosocial experiences and which ethnicities may be at risk for which psychosocial stressors. Depression and anxiety cause severe loss of quality of life for patients with systemic lupus erythematosus. The causes and factors that contribute to these psychological manifestations in lupus are difficult to disentangle.

In addition to sociodemographic variables, the instrument consisted of two scales: (A) the Systemic Lupus Erythematosus Needs Questionnaire (SLENQ) and the (B) Multidimensional Health Locus of Control Scale, as well as questions regarding the subjective perceptions of their SLE medication side effects.

The highest general cause of self-reported depressive and anxious feelings regarded: Over sixty percent (60.58%, n=228) of respondents indicated that their SLE was marked by a chronic set of symptoms. Another 16.23% (n= 61) had frequent flares while 19.13% (n=72) reported infrequent flares. Joint aches, fatigue and muscle pain were present for two-thirds or more of the respondents. Respondents reporting chronic symptoms or frequent flares had higher psychosocial needs as determined by their mean scores: depression 3.8 ±1.1, p = .000, anxiety 3.7 ± 1.1, p = .000 and SEC 3.3 ±1.2 (p = .043) as compared to those with infrequent flares. Compared to patients of other ethnicities, African-American and Hispanic SLE patients reported a higher degree of unmet psychological needs as a result of their disease. The most likely adverse effects of the medications, and the most likely causes of the anxiety and despair associated with SLE, were weight increase and hair loss. The medical staffs who are caring for this group of people need to be aware of the possible psychological effects of SLE, including anxiety and sadness. To address the emotional effects of having SLE, health care practitioners should, if feasible, conduct thorough biopsychosocial screening and assessment, make referrals when necessary, and offer complete treatment.