TAP CHI NGHIEN CUU Y HOC •
NGHIEN c u u AP DUNG BQ CAU HOI SF - 36 TRONG DANH GIA C H A T LUONG CUQC SONG BENH NHAN
VIEM KHdP DANG THAR
Pham Hoai Thu, D6 Thj Thuy, Nguyin Van Hiing Tru&ng Bai hqc Y Ha Nqi Diinh gia sw thay doi chit iwang cudc sdng & benh nhan viem khap dang thip la mpt viqc quan trpng, c6 y nghTa trong theo doi va diiu th benh Nghien cwu nham danh gia kha nang sir dqng bo eau hoi SF - 36 va danh gia chit iwqng cudc sdng cua benh nhan viem khap dang thip bang bo eau hoi SF - 36 Kit qua cho thiy he so tin cSy cua thang diem SF - 36 la chip nhan dwac (a = 0,67) Chit Iwang cudc sdng cua benh nhan viem kh&p dang thip theo SF - 36 chu yiu a miec dd tmng binh (83,34%) va thip (13,33%) Diim chat luang cudc sdng trung binh la 33,29 ± 2,37 Cd mdi tuang quan tuyin tinh nghich bidn giwa sue khde the chit, sire khoe tinh thin va chit iwang cudc sdng theo SP - 36 vai mwc do hoat ddng benh v&i r iin iwpt la - 0,53, -0,46 va -0,87 Tu' dd cd thi kit luan benh nhan viem kh&p dang thip bi anh hwang n^ng ni vi sue khde thi chat ian swc khoe tinh than Thang diem SP - 36 phan anh tinh trang sire khoe thi chit tot han sue khde tmh thin
TLT khda: Viem khdp dang thap, chat lucrng cupc song, SF- 36 I. O A T V A N D E
Viem khdp dang thlp la mot bgnh tu miln, diln biln man tinh, chu y l u ggy tdn thuang vigm tai cac khdp vdi cac bilu hien lam sang nhu sung, dau, han e h l van ddng, J i n d i n tinh trang huy hoai khdp, cirng khdp, biln dgng khdp va cudi ciing lam mat chirc nang cua khdp [1] Benh vigm khdp dang t h l p cung cd the gay ton thugng eae eg quan khae ngoai khdp nhu tim maeh (viem mang ngoai tim, vigm ndi tam mac, viem eg tim, r l i loan nhjp tim . ), hd h i p (tran dieh mang phoi, xg hoa phoi .), thin kmh (hpi chirng I n g co tay, Chen gp tuy do trat C l - C2), . [2]. Nhilu bgnh nhan cd tinh trang met mdi, giam chit lugng gilc ngu, tram cam va giam nang suit iam vige. Chit luang eude sdng (Heaith-
Dia Chilian he Pham Horn Thu - Bo mdn N6i Tong hop, Truong Dai hoc Y Ha Ndi
Email drthu23@gmail com Ngaynhan 16/11/2016 Ngay duac chap Ihuan 26/2/2017
related quality of life (HRQL)) la mdt hign tugng da chilu dugc sCr dung d l mieu ta nhan thirc, su hai long ca nhan va phan anh cac khia canh khae nhau cua cudc sing nhu kha nang hoat ddng, tam ly, cam xiic cOng nhu cac m l i quan he xa hdi [3; 4] Su phde tap va tinh c h i t chu quan eua khai mem nay da trd thanh mdt thach thuc eho ra ddi nhilu cdng cu luang gia va giai thich nd D l danh gia c h i t lugng eude' sdng eua benh nhan, ngudi ta sir dung cae bd eau hdi nhu EQ5D, SF - 36, SF12, HAQ, AIMS [4 - 6] Bd eau hoi Short form -36 (SF - 36) da duac phat triln bdi nhdm nghien cuu y t l (Medical Outcomes Study - MOS) thudc tap doan RAND Tren T h i gidi, ehc d i n nay da cd r l t nhilu nghign ciru sir dung bd eau hdi SF - 36 trong danh gia ehlt lugng cudc s i n g benh nhan vigm khdp dang t h l p K i t qua nghign cuu d l u eho thly benh nhan viem khdp dang t h l p cd diem chit lugng cudc s i n g thee SF36 thap va cd mdi tugng quan tuyin tinh vdi mire dd hoat ddng
" TAP CHI NGHIEN CU'U Y HOC bgnh [ 7 - 9 ] O Vigt Nam, sd dyng eae cdng
cu danh gia chat luang cudc sing ndi chung trong qua trinh theo doi va dieu tri bgnh vigm khdp dang t h l p edn r l t han ehl. Do dd, nghien ciru nay duge t i l n hanh vdi mue tidu'
1 Danh gia kha nang sii' dung bd eau hdi SF - 36 tai Viet Nam
2 Danh gia e h l t luang cudc sdng eCia benh nhan viem khdp dang t h l p bang bd eau hoi SF - 36.
IL D 6 | TU'O'NG VA PHU'aNG PHAP
1. Ooi t u a n g
Gom 60 bgnh nhan duae ehln doan viem khdp dang t h l p theo tieu chuin ACR 1987 dilu tn ndi trii tai Khoa Ca xuang khap Bgnh vign Bach Mai tir thang 4/2014 d i n thang 8/2014 Benh nhan d i n g y tham gia nghidn ciru
Logi khdi nghien ciru cac benh nhan cd t i l n sw hoSe hien tai m l c cac bgnh vigm khdp man tinh khac (bgnh giit, viem khdp v l y nln.,), benh hg thdng, r l i logn tam t h i n kmh Bgnh nhgn khong d i n g 'y tham gia nghidn eiru
2. PhU'O'ng phap
- Thilt k l nghign ciru. nghien ciru tiln ciru, md ta e l f ngang
- C d m l u Chgn c d mau thuan tien vdi n = 60 benh nhan
- Ndi dung nghien cuu
+ Tat ca cac benh nhan duac khai thae eac tneu chdng lam sang theo met m l u benh an thing nhlt va khao sat cac chi sd ve huylt hgc, smh hda (duac thuc hign tgi cac khoa chuyen trach Benh vien Bach Mai vdi eac thdng sd tham chilu do cac khoa nay edng bd).
+ Cdng thirc tinh DAS 28 (danh gia mice dd hoat ddng bgnh)
DAS28 - ESR = [0,56 ^ ' s l khdp dau v ' ^ o khdp sung . + 0,28 + 0,7 x ln(mau ling Igid)]
C h i s d DAS 28 < 2,6 2,6 £ DAS 28 < 3,2 3,2 < DAS 28 < 5,1 • DAS 28 > 5,1
WILFC do hoat ddng Benh khdng hoat ddng
Bgnh hoat ddng nhe Bgnh hoat ddng muc trung binh
Benh hoat ddng nang
+ Danh gia ehlt luong cudc sdng eiia benh nhan bang bd eau hdi SF - 36 tai thdi diem phong v l n
Bd eau hoi SF - 36 (phien ban 1.0): cd 36 eau hdi
cac/7 cho diSm ci^a bd cBu hdi SF - 36: D i l m cang cao thi xac dinh tinh trang sire khde cang t i t Mdi eau tra Idi deu cd diem s l thay d l i tir 0 d i n 100 Sau dd tinh d i l m trung binh cua 8 y l u t l sau'
TAP CHI NGHIEN CU'U Y HOC - YlutS Hoat dong t h i I y c CtiLVc nang ttie Iyc Cam giac dau Hoat dong sCfc khoe chung Su'c s6ng
Hoat dong xa hpi ChLfc nang cam xiic Si>c khoe tam ly
sa
lu'O'ng 104 2 5 4 2 3 5'
Cau hoi 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10, 11, 12
13, 14, 15, 16 21,22 1, 33,34, 35, 36
23, 27, 29, 31 20,32 17, 18,19 24, 25, 26, 28, 30 (Ngudn: The RAND 36 - Item Health Survey, Version 1 0)
Danh gia dp tin cay cua thang diem SF-36
Dd tin eay cua SF - 36 duoc tinh theo he so tin cay hlng dinh ndi bd Cronbach's a (Cronbaeh's a internal consistency reliability Coefficients) [8].
Danh gia ehlt luang cudc sing a bgnh nhan viem khdp dang t h l p theo SF - 36 va khao sat m l i tugng quan gida diem chit lugng cudc song, diem sue khde t h i chit, diem sdc khde tinh t h i n theo SF - 36 vdi DAS 28
3, Xie ly va phan tich sd lieu: Phln m l m SPSS 22 0
4. Dao dire nghien cii'u
Nghien ciru duac su d i n g y cua Khoa Co xugng khdp, Benh vien Baeh Mai, Bd mdn Ndi tong hgp va Phdng Dao tao sau Dai hoe Trudng Dai hoc Y Ha Ndi Benh nhan t u nguyen tham gia nghien cuu Cac thdng tin v l benh nhan duoc gitr bi mat Du lieu thu thap ehi phuc vu cho nghign eiru va ehan doan, giiip cho vigc dilu tri benh duoc t i t hgn
III.
K £ T Q U A1. Dac d i l m chung benh nhan nghien CU'U
- T u l i trung binh cua benh nhan nghien ciru la; 58,40 + 12.11 Dp tudi thudng gap nhlt tir 56 - 65 tuoi, ehilm 46,67%,
- Bgnh gap chu y l u d nCr gidi, chilm 86.67% Ty lg nu/nam IS' 6,5/1
- Thdi gian m l e bgnh trung binh 6,09 ± 6,92 nam
-Diem VAS trung binh 6,23 ±2,71 Da s6 bgnh nhan cd bilu hien dau khdp d mire do nang (66,67%)
- D i l m DAS 28 trung binh 5,01 ± 0.98 diem (tir 1,63 - 6,77 diem) Ty le benh nhan cd mire do heat dong bgnh nang (DAS 28 ^ 5,1) la 55%,
' Tinh chi sd Cronbach's alpha du-a tren p h l n m l m SPSS
H$ s l Cronbach's a cOa thang d i l m SF-36 la; a = 0,67
• TAP CHI NGHIEN CU'U Y HOC Bang 1. Dp tin cay cua cac yeu to trong thang diem SF - 36
Khia canh Hoat dong the Ili'C Chi>c nSng the Iyc Cam giac dau Hoat dOng SCPC khoe Chung SCfC s6ng
Hoat dong xa hoi CtiLfc nang cam xuc Su'c khoe tam ly
S6 lu'O'ng 10 4 2 5 4 2 3 5
He sd Cronbach'a 0,69 0,73 0,67 0,71 0,75 0,76 0,63 0,68
He s6 tin cay cua thang d i l m SF - 36 g mii'c do chip nhan duoe (hd sd r nhgn gia tri tir 0,63 den 0,75).
3. Danh gia chit lu'gng cugc sdng benh nhan viem khdp dang thlp blng thang dilm S F - 3 6
3.1. Danh gia chat iwang cupc song benh nhan viem kh&p dang thap bang thang diem SF-36
Bang 2. D i l m chit lu'ong cuoc sdng cua benh nhan theo SF - 36 Thang dtim SF - 36
Hoat ddng the luc Chde nang van ddng Cam giac dau cCia ca t h i . Hoat ddng sdc khde chung Sire sing
Hoat ddng xa hdi Cam xuc Sire khde tam ly Tong diem SF - 36
X ± S D 31,90± 4,70 33,16 ±5,78 32,33 ±4,76 37,90 ±1,68 41,26 ±4,49 27,01 ±5,20 31,80 ±8,98 30,30 ±3,10 33,29 ±2,37
Diem SF - 36 trung binh la 33,29 ± 2,37-
TAP CHi NGHIEN CU'U Y HOC •
Bang 3. Chit lu'gng cuoc sdng cua benh nhan theo SF - 36 Dilm chit lu'O'ng cudc sdng theo SF
< 30 { Thap) 3 0 - 80 (Trung binh)
> 8 0 - 1 0 0 (Cao)
36 n
8 50 2
%
13,33 83,34 3,33 Chat luang cudc song eua benh nhan theo thang digm SF-36 ehu yeu d muc dd trung binh (chilm 83,34%) va t h l p (ehilm 13,33%).
3.2. Danh gia moi twang quan giu'a thang diem SF - 36 va DAS 28
Bieu dd 1. Mdi tu'ang quan giQ'a chat lu'O'ng cudc song theo thang diem SF-36 va DAS 28 Chat luang cudc sdng theo SF-36 va mire dd hoat ddng benh DAS 28 eo mdi tuang quan tuyin tinh nghich biln (r - - 0,87)
DAS 28
Bilu dd 2. IVIdi tu'ang quan gijj>a chit lu'gng hoat dong t h i lu>c va DAS 28 Cd mdi tuang quan tuyin tinh nghich biln gitra sire khde t h i ehlt (PCS) cua ngudi bgnh va DAS 28 (r = -0,53)
• TAP CHI NGHIEN CU'U Y HOC
p-0,0001974
DAS 28
B i l u dd 3. Mdi tu'gng quan giQ'a c h i t Iwang hoat dong tinh t h i n va DAS28 Cd m i l tuang quan tuyen tinh nghich biln giua sire khde tmh t h i n (MCS) cua ngudi benh va DAS 28 (r = -0,46)
IV. BAN LUAN
Bd cau hdi SF - 36 la mgt cdng eu pho biln de danh gia ehlt luang cudc s i n g Viec danh gia do tin cay ciJa mdt edng cu trude khi sCr dung d l khao sat trong nghign ciru la mpt vigc cln duge t i l n hanh Trong nghign euu nay, k i t qua khao sat eho thly do tin cay eua bd cau hdi SF - 36 dua trdn he s l Cronbach Alpha duae tinh toan b l n g phln m l m SPSS la 0 = 0,67 va dd tin cay cua 8 y l u to thanh phln cd gia tn tir 0,63 d i n 0,76 Theo mdt nghien ciru nam 2006, eac gia tn nay la c h i p nhan dwac, dae bigt neu dugc ap dung d cae nghien euu mdi [9]
Chit luang cudc sdng cua bdnh nhan vigm khdp dang thlp danh gia theo SF - 36 chu y l u d mdc do thlp do trung binh chilm 83,34%, Mdi tuang quan giua ehlt luong eude sdng cua bgnh nhan do b l n g thang diem SF - 36 va mire dd hogt ddng bdnh la nghjch biln vdi r =- 0,87. Dieu nay cho thly mue do hoat ddng eua benh la mdt y l u t l quan trong anh hudng d i n ehlt luong s i n g eua ngudi bgnh, benh cang ngng thi chat lugng eude sing cua ngudi bgnh eang t h l p .
SCrc khde thd chSt (Physical component summary -PCS) bao g I m Hoat ddng the luc, chirc nang van ddng, muc dp dau, tinh trang.
sire khde tong t h i Mdi tugng quan giua sue khde t h i ehlt eua benh nhan viem khdp dang thap va DAS 28 la tuang quan nghich bien vdi r = -0,53. K i t qua ngy cho thay mire do hoat ddng cua benh cang eao thi hoat dgng the ehlt ciia benh nhgn cang bi anh hudng va cang giam siit
Trong nghign euu nay, bgnh nhan viem khdp dang t h l p cd d i l m hoat ddng t h i luc trung binh la 31,90 ± 4,70, t h l p hen sg vdi mdt s6 nghign cuu khac, cd d i l m hoat dgng the luc trung binh l l n luot la 52,87 ± 23,51 va 44,06 ± 20,47 [10, 11] Chuc nang van ddng cLia bgnh nhan vigm khdp dang t h l p giam dan d i n tinh trang khd khan trcng thuc hien cac ddng tae van ddng, kha nang duy tri eac hoat ddng trong edng viec va smh hoat dan d i n hieu qua cdng viec va chat lugng cudc sdng giam sut K i t qua nghien cuu nay eho thly d i l m chirc nang van ddng trung binh eua bgnh nhan viem khdp dang t h l p la 33,16 ±
TjBkP CHI NQHIEN CLCU Y HOC - 5,78, tugng tu vdi nghien cdu eua nam 2009 vdi diem chuc nang vgn dgng d bgnh nhan viem khdp dang thap la 31,82 ± 16,83 nhung thlp han so vdi nghidn cuu nam 2013 la 43,19 ± 24,18 [11, 12] Chung tdi eung nhan thly trong nghign cdu nay, bgnh nhan ehij ye'u'ia viem khdp dang t h l p t i l n t n l n vdi muc t ^ h o g t ddng bgnh trung binh eao, khiln mire dd dau eua benh nhan nang n l hon, d i l m e l m giae dau trung binh cua benh nhan la 32,33 + 4,76 K i t qua nghien cuu nay eho thly cac y l u t l hoat ddng t h i lue, chuc nang van ddng va cam giac dau d l u cd m l i tuong quan nghich b i l n vdi DAS 28 vdi hg sd tugng quan (r) theo thu tu l l n luat la -0,49, -0,6 va - 0,46. D i l u nay ndi len n l u vige dieu tri benh dat hieu qua, kilm soat tot duac tinh trang tiln triln eua benh, giam muc dd hoat dgng cua bgnh se ed kha nang giup cai thien hoat ddng the luc, chde nang van dgng va cam giae dau eho benh nhan, qua dd cd the cai thien t i t hon ehlt lugng cudc sing cua bgnh nhan vigm khdp dang thlp.
Sire khoe tinh thin (Mental component summary - MCS) bao gdm Sue sdng, hoat ddng xa hdi, cam xue, sire khde tam thin, Mdi tugng quan giua sue khde tmh t h i n ciia bgnh nhan vigm khdp dang t h l p va DAS 28 la tuang quan nghich bien vdi r - - 0,46, nghTa la diem mire dd hoat ddng cua benh cang cao thi sue khde tmh t h i n cua benh nhan eang thlp
Sire sing phan anh thai do cua benh nhan vdl tinh trang bgnh tat, danh gia kha nang d l i mat vdi nhung khd khan eCia benh nhan D i l m sire sing trung binh d nhdm benh nhan nghien euu la 41,26 ± 4,49, eao han so vdi nghien cuu cua Esam Mohammed Abu Al- Fadl (2013) la 34,42 ± 18,18 [13] Hoat ddng
xa hdi t h i hign kha nang duy tri m l i quan h0 eCia bdnh nhan vdi nhung ngudi xung quanh Diem hgat ddng xa hdi trung binh trong nghign cuu eua ehiing tdi la 27,01 ± .'6,20, thlp hgn so vdl k i t qua eua Esam Mohammed Abu Al- Fadlva Klooster PM (2013) [1^0] K i t qua nay cho thly phln ddng benh ,nhan vigm khdp dang t h l p d Vigt Nam cd mu-c boat ddng xa hdi thlp. mdi trudng giao tilp han c h l hogc it tham gia cac eau lac bd Nghien ciru na cung chi ra cd mdi quan hg nghich biln giua mire do hoat ddng cua benh DAS28 vdi sue sing cua bgnh nhan (r = -0,55) va hoat ddng xa hdi (r = -0,36) Do do, viee d i l u tn lam giam muc dd hoat ddng cua benh se giiip cai thien cac hoat ddng xa hdi, tang cudng sire sing nhlm nang cao chit luong cudc sdng eua benh nhan viem khdp dang t h l p Doi vdi y l u t l cam xiic va sue khde tam ly, k i t qua nghien eiru nay la 31,80 ± 8,98 va 30,30 ± 3,10 diem, d l u thlp han so vdi k i t qua nghien cdu cua Esam Mohammed Abu Al-FadI (2013) la 52,56
± 42,35 va 49,23 ± 15,99 [13] Ben eanh dd, nghign cuu nay eung chi ra moi quan hg nghich biln giu'a muc do hoat ddng benh DAS 28 va hoat ddng chuc nang cam xiie eua bgnh nhan (r = -0,58), Do dd, cae can thiep lien tuc cd t h i giiip nang cao chuc nang cam xiie cho benh nhan, qua dd cd t h i cai thien kha nang lac ddng va iam vide cua bgnh nhan So vdi cac khia canh khac trong bd eau hoi SF - 36, sii'c khoe tam ly eua benh nhan bi I n h hudng it ban
Mac dii hgat ddng tinh t h i n cua benh nhan trong thang d i l m khdng tugng quan chat che vdl mire dd hoat ddng benh nhung ting diem ehlt luang cugc sdng cua bgnh nhan thu duae CO tuang quan chat che vdi tinh trang hoat ddng eua benh nhan D i l u nay cho thly
• TAP CHi NGHIEN CU'U Y HOC thang diem SF-36 trgn bgnh nhan viem khdp
dgng t h l p phan anh anh hudng d i n hogt ddng t h i luc cua bgnh nhan ban ia hoat ddng tinh t h i n
V. K^T LUAN
Bd cau hdi SF-36 dat duge dd tin cay v l ndi dung vdi he sd tin cay Cronbach' Alpha
> 0,6 hoan toan cd t h i ap dyng t i t tren lam sang tai Viet Nam
Chit lugng cudc sdng eua benh nhan viem khdp dang t h l p chu y l u d muc dd trung binh va thlp, va cd hen quan d i n mdc dd hoat ddng eua benh
Benh nhan vigm khdp dang t h l p bi anh hudng nang n l ea v l sue khoe t h i chit lln sire khde tmh t h i n Trong do thang d i l m SF - 36 phan anh tinh trang sire khoe thg chit nhilu hon ia sire khde tinh t h i n
Lo'i cam e n
D l hoan thanh nghien eiru nay chiing tdi xm chan thanh cam gn Ban lanh dao Bgnh vign Bach Mai, Khoa Ca xuong khdp Bgnh vign Bgch Mai
TAI LIEU THAM KHAO 1. Helmick CG, Felsgn DT, Lawrence RC et al (2008). Estimates of the prevalence of arthritis and other rheumatic conditions in the United States, part 1 Arthritis Rheum, 58, 15-25
2. Mclnnes IB, G.Schett (2011). The Pathogenesis of Rheumatoid Arthntis New England Journal of Medicine, 365(23), 2205 - 2219
3. Ferreira LN, Ferreira PL, Baleiro RR (2008). Health-related quality of life in patients with rheumatoid arthritis Acfa Reumatol Port.
33(3), 4 2 - 3 3 1 .
4. Carr AJ, Higginson IJ, Robinson PG (2005) Quality of life Eur J Public Health. ^5 (6), 668
5. West E, Jonsson SW (2005). Health- related quality of life in rheumatoid arthritis in Northern Sweden a companson between pa- tients Vi'ith early RA, patients with medium- term disease and controls, using SF-36. Clin Rheumatol. 2 4 , 2 - 1 1 7 .
6. Pouchot J, Kherani RB, Brant R et al (2008) Determination of the minimal clinically important difference for seven fatigue meas- ures in rheumatoid arthritis. J Clin Epidemiol, 61(7), 1 3 - 7 0 5
7. Kosinski Wl, Kujawski SC, Martin R et al ( 2002) Health-related quality of life in early rheumatoid arthntis impact of disease and treatment response Am J Manag Care, 8(3), 231 - 240
8. J Talamo, A Frater, S Gaiiivan et al ( 1997) Use of the short form 36 (SF36) for health status measurement in rheumatoid ar- thritis British Journal of Rheumatology, 36, 463 - 469
9. Hair Jr., Joseph F., William C. Black et al. (2006). Multivariate Data Analysis, 6th ed , New Jersey. Pearson Education, Inc
10. Ten Ktooster PM, Vonkeman HE, Erik Taal E et al (2013). Performance of the Dutch SF36 as a measure of health related quality of life in patients with rheumatoid arthn- tis Health Quai Life Outcomes. 11, 1186 - 1477
11. Salaffi F, Sarzi Puttini, GIrolimetti R et al (2009). Health-related quality of life in fibromyalgia patients a companson w[h rheu- matoid arthntis patients and the general popu- lation using the SF-36 health sun/ey Clin Exp Rheumatol, 27(56), 67 - 74
12. Vonkeman HE, Ten Klooster PiVI, A.
van de Laar (2013). Health related quality of life in patients with chronic gout compared to
TAP CHI NGHIEN CU'U Y HOC •
patients with rheumatoid Ann Rheum Dis, 72 life, anxiety and depression in patients with (3), 361, early rheumatoid arthritis The Egyptian Rheu-
13. Esam Mohammed Abu Al-Fadia et al matoiogist, 36(2), 51 - 56 (2014). Assessment of health-related quality of
Summary
ADAPTATION OF SF - 36 SCALE FOR LIFE QUALITY ASSESSMENT OF RHEUMATOID ARTHRITIS PATIENTS
Evaluating the quality of life in rheumatoid arthritis patients is essentia! for follow up and treatment. The study was carried out to evaluate the applicable efficacy gf SF - 36 questiennaire and to assess the quality of life in rheumatoid arthntis patients by SF - 36 questionnaire The result showed that the reliability of SF - 36 questionnaire was acceptable (a = 0 67) The quality of life in rheumatoid arthritis patients was mainly moderate (83,34%) and low (13 33%) The mean quality of life score was 33,29 ± 2.37 There was a negative correlation between the physical component summary, the mental component summary and the quality of life was according to SF - 36 with disease activity score (DAS28) with r being -0 53, -0 46 and -0 87, respectively in conclusion, rheumatoid arthritis patients were affected significantly in both physical component summary and the mental component summary The SF - 36 questionnaire reflects the physical component summary was better than the mental component summary.
Keywords: Rheumatoid arthritis, quality of life, SF - 36
