Determinants of happiness and quality of life in patients with rheumatoid arthritis: A structural equation modelling approach

Abstract

Objectives Besides increasing longevity, the ultimate goal of medical care is to improve patients’ enjoyment of life, a concept akin to happiness. This study examined the determinants of happiness and quality of life (QoL) in patients with rheumatoid arthritis (RA). Methods In this observational, cross-sectional study, patients were assessed on disease activity, disease impact, personality, QoL and happiness. Structural equation modelling estimation was used to analyse the associations between these dimensions, pursuing three hypotheses: H1—disease activity and perceived impact of disease are negatively associated with overall QoL and happiness in patients with RA; H2—‘positive’ personality traits are related to happiness both directly and indirectly through perceived disease impact; H3—happiness has a mediating effect in the relation between impact of disease and QoL. Results Data from 213 patients were analysed. Results supported all driving hypotheses. Happiness was positively related to ‘positive’ personality and, to a lesser extent, negatively related to impact of disease. Impact of disease, in turn, was positively related to disease activity and mitigated by ‘positive’ personality traits. Impact of disease had a much stronger relation with QoL than with happiness. Happiness mitigated the negative effect of disease impact on QoL. Conclusion Optimisation of QoL and happiness of people with RA requires effective control of the disease process and also improvement of the disease impact domains. Personality seems to play a pivotal mediating role in these relations.