Mental, emotional and social dimensions of quality of life and their relationship with physical and functional status in adults with haemophilia

Abstract

Introduction: A comprehensive treatment for patients with haemophilia (PwH) should focus on how the disease interferes with their mental, emotional and social environment to analyse if all the therapeutic efforts invested in their physical status have positive impact on a life worth living.

Aim: To analyse the correlation between the physical status of a cohort of adults with haemophilia and their mental, emotional and social states regarding their treatment modality; Also, to investigate which variables are most related to quality of life (QoL), joint health and emotional, mental and social states.

Methods: In this cross-sectional, 102 adults with haemophilia divided into a prophylactic group (G1, n = 77) and on-demand group (G2, n = 25) were included. Demographic and clinical characteristics, health joint (HJHS), presence of synovitis with ultrasound, self-perceived functionality (HAL) and QoL (A36-HaemoQoL), were analysed.

Results: In G1 all the variables that defined the physical status correlated (rho: 0.33 to 0.72) to the mental and social spheres. The emotional state correlated with the self-perceived ones. In G2 physical status did not correlate with the three states. According to the regression models, HAL was the variable that most influenced the QoL (together with the bleedings in the last year, R² = 0.61), emotional (R² = 0.16), mental (together with HJHS, R² = 0.41) and social states (R² = 0.39). In addition, the HJHS was influenced by synovitis, HAL, mental health, age and the bleeding history (R² = 0.83).

Conclusion: Emotional, mental and social states of PwH in prophylaxis are correlated to their physical status, being the self-perceived functionality the variable that most influenced in their QoL.

Keywords: Assessment patient outcome; Blood coagulation factor; Haemophilia; Health status; Hemarthrosis; Quality of life; Ultrasound.