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Emotional Adjustment and Scleroderma
janey Hello, I am Janey Willis, ISN Guide to Emotional Adjustment. I know from experience that scleroderma can place unique demands on patients and caregivers alike. I have systemic scleroderma (SSc). It is common to suffer reactive depression with scleroderma. If you or someone you care about is having a difficult or suicidal time right now, call your nearest suicide hotline, or a doctor, or hospital. This is a medical emergency and it is okay to go to the emergency room or to call for help from your local police or fire department. The important thing is to make a call—any call—until you find help.
Emotional Adjustment and Scleroderma (MAIN MENU)
Overview
Living with a Chronic Illness
Anxiety and Attitude
Coping with Scleroderma
Depression and Scleroderma
Marriage and Health
Fear of Progression
Pain Management

Quality of Life with Scleroderma
Sexuality and Scleroderma
Sleep Disorders and Scleroderma
Suicide Prevention
Quality of LIfe (QOL) with Scleroderma
Overview of Quality of Life (QOL)
Quality of Life with Scleroderma
Symptoms and QOL
Assessing QOL
Improving on the QOL
Personal Stories
Overview of Quality of Life (QOL)
The quality of life (QOL) is affected any time something prevents us from maintaining our normal routine or from doing something that we enjoy. A broken arm will affect your QOL on a temporary basis, but a chronic illness may it affect it indefinitely.
A chronic illness such as scleroderma affects our lives in so many ways. Going to lunch with friends or simply taking a walk around the neighborhood become a chore. The secret is to find alternatives. What have you not done in your life that could make you just as happy as before, but with less effort? For example, rather than going out to lunch, have your friends bring you lunch. Have a picnic in the yard so you don't have to clean up the house. Go for a stroll rather than a walk. Stop and smell the roses or watch the hummingbirds pick bugs out of the air. It's amazing how some of the simpliest things can add a sense of quality to your life.
Working ability in relation to disease severity, everyday occupations and well-being in women with limited systemic sclerosis. Fifty per cent of the women were restricted in their working ability; the lower the working ability, the lower their perceived well-being. G. Sandqvist. Rheumatology 2008 47(11):1708-1711.
Quality of Life with Scleroderma
Quality of Life (QOL) in Patients with Systemic Sclerosis (SSc)Compared to the General Population and Patients with Other Chronic Conditions. Health-related QOL of patients with SSc is significantly impaired compared to that of the general population and is comparable to or worse than that of patients with other common chronic conditions: namely heart disease, lung disease, hypertension, diabetes, and depression. M. Hudson. Journal of Rheumatology. April 1, 2009 vol. 36 no. 4 768-772.
Quality of Life and Functional Status in Systemic Sclerosis Compared to Other Rheumatic Diseases. Joint involvement in SSc is more disabling than joint involvement in psoriatic arthritis, and patients with SSc experience more severe pain than patients with rheumatoid arthritis. J Rheumatol 2006 June;33:1117–22.
Symptoms and QOL
The Relative Contributions Of Pulmonary Artery Systolic Pressure (PASP) And Forced Vital Capacity (FVC) To Function And Health Related Quality Of Life (HRQOL) In Systemic Sclerosis (SSc). Although it is obvious from clinical practice that for patients with either severe PAH or ILD, lung disease may be an important cause of morbidity, in the average patient the degree of pulmonary involvement is not severe enough to interfere significantly with function or HRQoL. Disease severity outside the lung appears to be more important. M. Baron. AB0495 EULAR 2007. (Also see: Pulmonary Involvement)
Gastrointestinal Symptoms, Perceived Functioning and Quality of Life Issues Correlate with Gastric Myoelectrical Activity in Systemic Sclerosis (SSc) Patients. GI symptoms, quality of life issues and perceived functioning significantly correlated with gastric myoelectrical activity, which has been shown to reflect gastric dysmotility in SSc patients. Terry A. McNearney. 1137/396 ACR 2006. (Also see: Gastrointestinal Involvement)
Scleroderma Care and Research Journal, Vol. 3, No. 2
SCAR Journal Scleroderma Care and Research Journal: Spring 2006. This free online PDF medical journal issue includes articles on Health Related Quality of Life: A Primer with a Focus on Scleroderma, and Pulmonary Arterial Hypertension in Systemic Sclerosis: Risk Factors and Diagnosis. SCTC Spring 2006. (Also see: SCAR Journals and Pulmonary Hypertension) Posted 07-20-06.
Health-related quality of life in patients with pulmonary arterial hypertension. Health-related quality of life is severely impaired in patients with pulmonary arterial hypertension and is associated with measures of functional status. Specific associations with impaired health-related quality of life suggest potential areas for targeted intervention. PubMed. Respir Res. 2005 Aug 10;6(1):92. (Also see: Pulmonary Hypertension)
Gastrointestinal Manifestations and Health Related Quality of Life in Systemic Sclerosis (SSc). Patients with SSc report poor health-related quality of life, both on a physical and psychological level. GI symptoms are common in SSc and are associated with significantly poorer mental health. S. S. Taillefer. FRI0125 EULAR 2005. (Also see: Gastrointestinal Involvement)
Assessing QOL
Disease and Symptom Burden in Systemic Sclerosis: A Patient Perspective. Patients with SSc report significant symptomatic and emotional burdens, which, in turn, affect their Quality Of Life (QOL) and psychological well-being. J Rheumatol 2007;34:1718-26.
The Scleroderma Assessment Questionnaire. A new self-assessment questionnaire for evaluation of disease status in patients with systemic sclerosis. The Scleroderma Assessment Questionnaire (SAQ) is a sensitive measurement of disease status and level of impairment of different organ systems in patients with systemic sclerosis. PubMed. Z Rheumatol. 2006 Mar 3.
Responsiveness of the SF-36 and the Health Assessment Questionnaire Disability Index in a Systemic Sclerosis Clinical Trial. These data support inclusion of both the SF-36 and HAQ-DI as outcome measures in future clinical trials of diffuse SSc. J Rheumatol 2005 May;32:832-40.
Validation of French version of the Scleroderma Health Assessment Questionnaire (SSc HAQ). This study showed the value of the SSc HAQ, which is a simple, discriminant, reproducible self-administered questionnaire to evaluate French-speaking SSc patients. In addition, we suggest the use of a new outcome measure, the SSc HAQ score, to assess this systemic disease more accurately. PubMed. Clin Rheumatol. 2005 Feb;24(1):3-10.
Improving on the QOL
Rare autoimmune rheumatic illnesses during pregnancy: systemic sclerosis, polymyositis/dermatomyositis and vasculitis. Autoimmune rheumatic diseases (ARD) affect young females durrng childbearing age. Over the last decades, improvements in survival as well as quality of life in patients affected with ARD have led to an increased number of pregnancies observed during the course of such diseases. PubMed. Z Rheumatol. 2006 May 3. (Also see: Pregnancy and Scleroderma, Dermatomyositis, and Vasculitis)
Weight Training Gives MS Patients Physical, Emotional Benefits. Lifting weights can improve muscle strength and quality of life for people afflicted with the degenerative disease multiple sclerosis, a new University of Florida study finds. The study, published in the December issue of the journal Multiple Sclerosis, showed that after eight weeks of supervised resistance training on conventional gym equipment, eight MS patients had stronger muscles, could walk better, and reported less overall fatigue and disability. Newswise. 01/13/05. (Also see: Multiple Sclerosis)
Weather conditions can influence rheumatic diseases. These data suggest that in the future it may be possible to modulate pharmacological and non-pharmacological treatments for some osteoarthritic patients depending on the predictable weather conditions in order to avoid, as much as possible, the disease-associated joint pain and functional incapacity, thus improving patients' quality of life. PubMed. Proc West Pharmacol Soc. 2004;47:134-6.
Intravenous Immunoglobulins (IVIg) in the Treatment of Joint Involvement in Patients Affected by Systemic Sclerosis. In SSc quality of life may be significantly impaired by articular involvement. IVIg have already shown a benefit in SSc, leading to a rapid decrease of skin score. Preliminary results show that IVIg treatment may improve skin and articular involvement by reducing pain and ameliorating quality of life in SSc pts. F. Nacci. FRI0112 EULAR 2003 (Also see: Treatments and Skeletal Involvement)
Personal Stories
Caregiving by Dee Dee Hunt When living with a chronic illness, we encounter "angels." They take different forms: Doctors, nurses, family, friends and caregivers.
Cindy Fuchs-Morrissey: Mother of a Progressive Systemic Sclerosis Child Some days she feels like a very stiff old lady.
Marina: Diffuse Scleroderma At forty-five, I am single, have three well-adjusted adult children, as well as a conviction that despite the low quality of life SD gives me, it has also brought me closer to my faith...
Patty S.: Localized Scleroderma, Pulmonary Hypertension and Sjögren's There's no more putting off for tomorrow in my world.
 
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