The role of anxiety, depression, and illness perception in quality of life of patients with rheumatoid arthritis: A structural equation model approach.

This study aimed to construct and test a structural model of self-regulation for the relationship between health-related quality of life (HRQoL) and related factors in patients with rheumatoid arthritis. In this cross-sectional correlational study, 250 patients with rheumatoid arthritis who visited the outpatient clinic of a general hospital in Korea were selected through convenience sampling. Sociodemographic characteristics, clinical characteristics, HRQoL, awareness of disease outcomes, anxiety, depression, and stress coping strategies were evaluated using a questionnaire. Structural equation modeling was used to examine the proposed model. The final model for predicting HRQoL of patients had an explanatory power of 70.3% and demonstrated a good fit with the data. Anxiety, depression, and illness perception had direct negative effects on HRQoL. Self-efficacy and self-esteem showed indirect effects on HRQoL, fully mediated by illness perception. Social support, which was fully mediated by anxiety and depression, indirectly affected HRQoL. The self-regulation model tested in this study may serve as a framework for future intervention studies on improving HRQoL among patients.