Lifestyle behavior change intervention in patients with systemic lupus erythematosus: effects on quality of life, fatigue, functional capacity, symptoms of anxiety and depression, and sleep quality - The randomized controlled trial Living Well with Lupus

Author(s)

Bruna Caruso Mazzolani

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD)
• Defense date: 2024-08-30

Examining board members

Bruno Gualano; Eduardo Ferreira Borba Neto; Danilo Reis Coimbra; Bárbara Hatzlhoffer Lourenço

• Advisor: Bruno Gualano

Abstract

Systemic lupus erythematosus (SLE) patients have a lower health-related quality of life when compared to the general population, populations with other rheumatic diseases or severe chronic diseases. Disease activity, pain, fatigue, treatment, comorbidities, demographic, social and emotional factors are predictors of a lower quality of life in these patients. In theory, interventions to promote physical activity and healthy eating could improve quality of life and other associated health outcomes. This randomized controlled trial aimed to assess the effects of a new intervention, aimed at promoting structured and unstructured physical activity and healthy eating, on quality of life, fatigue, functional capacity, symptoms of anxiety and depression and quality of sleep. The intervention lasted 6 months and was divided into two constructs: increasing physical activity levels, through the promotion of structured and unstructured physical activity, and improving eating aspects. Quantitative and qualitative methods were used before and after the intervention to assess the mentioned outcomes. Eighty patients were randomized (40 intervention group e 40 control group), of which 12 in the intervention group dropped out for personal reasons and 6 in the control group did not respond to multiple contact attempts for post-intervention assessments. The main finding of this study was the positive effect of the intervention on the physical aspects limitations domain of the SF-36 and on the fatigue score. Per protocol analyses also showed positive effects of the intervention on SF-36 total score and its domains functional capacity, physical aspects limitations, emotional aspects limitations and total physical, SLEQOL mood domain, fatigue score and handgrip strength. Furthermore, analyzing qualitative information obtained in focus groups we found that, in general, new behaviors and knowledge were achieved, which participants reported intending to maintain after the study; and the intervention had a positive impact on daily routine and physical capabilities, physical and mental health, and overall well-being. These findings should guide future research with larger sample sizes on the implementation of lifestyle change interventions in SLE care and their effects on quality of life, functional capacity, mental health, and sleep quality (AU)

• FAPESP's process: 19/14820-6 - Healthy lifestyle promotion in patients with Systemic Lupus Erythematosus: effects on life quality and psychological aspects
• Grantee: Bruna Caruso Mazzolani
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)