Introduction
Methods
Study design and subjects
Data collection
Questionnaire
Measures
Statistical analysis
Results
Socio-demographic factors
Men | Valid N | Women | Valid N | P-value | |
---|---|---|---|---|---|
Total number | 34% | 621 | 66% | 1194 | |
Socio-demographic variables | |||||
Average age (Mean ± SD) | 43.44 ± 13.59 | 621 | 39.82 ± 12.98 | 1194 | < 0.001 |
Educational level | 621 | 1194 | < 0.001 | ||
Elementary school or lower | 45 (7.25%) | 141 (11.81%) | |||
Junior high school | 172 (27.70%) | 322 (26.97%) | |||
Senior high school | 188 (30.27%) | 263 (22.03%) | |||
Junior college or above | 216 (34.78%) | 468 (39.20%) | |||
Employment status | 621 | 1194 | < 0.001 | ||
Employment | 287 (46.22%) | 408 (34.17%) | |||
Unemployment | 334 (53.78%) | 786 (65.83%) | |||
Not employed due to MG | 238 (71.26%) | 238 | 548 (69.72%) | 548 | 0.658 |
Annual household income (Mean ± SD)a | 50,598.95 ± 43,337.15 | 621 | 44,442.01 ± 36,557.39 | 1194 | < 0.001 |
Diagnosis and treatment history | |||||
Average onset age (Mean ± SD) | 34.36 ± 16.62 | 621 | 29.82 ± 14.87 | 548 | < 0.001 |
Disease duration (median (range)) | 4.75 (1.92–9.75) | 621 | 5.54 (2.50–11.40) | 548 | 0.002 |
Thymic hyperplasia | 105 (24.82%) | 423 | 261 (34.66%) | 753 | < 0.001 |
Thymic tumor | 203 (35.43%) | 573 | 254 (23.01%) | 1104 | < 0.001 |
Thymectomy | 272 (43.80%) | 621 | 446 (37.35%) | 1194 | 0.009 |
ICU admission | 218 (35.86%) | 608 | 404 (33.47%) | 1172 | 0.597 |
MG exacerbations | 192 (30.92%) | 560 | 421 (35.26%) | 1069 | =0.05 |
Prednisone treatment | 590 | 1151 | 0.989 | ||
Current prednisone | 295 (50.00%) | 572 (49.70%) | |||
Past prednisone | 141 (23.90%) | 275 (23.89%) | |||
Never had prednisone | 154 (26.10%) | 304 (26.41%) | |||
Number of comorbid conditions | 295 | 570 | 0.088 | ||
One | 72 (24.41%) | 124 (21.75%) | |||
Two | 37 (12.54%) | 56 (9.82%) | |||
Three or more | 41 (13.90%) | 60 (10.53%) | |||
Social support and active lifestyle | |||||
Social support (Mean ± SD) | 621 | 1194 | |||
Tangible support | 59.77 ± 28.03 | 58.61 ± 27.70 | 0.398 | ||
Affectionate support | 43.75 ± 25.37 | 47.19 ± 24.98 | < 0.01 | ||
Positive social interaction | 45.25 ± 24.78 | 45.59 ± 24.92 | 0.783 | ||
Emotional/information support | 43.04 ± 26.39 | 48.63 ± 25.56 | < 0.001 | ||
Active lifestyle | 42.42 ± 12.30 | 621 | 40.71 ± 11.93 | 1194 | < 0.01 |
MG-ADL (Mean ± SD)b | 6.15 ± 4.54 | 621 | 6.75 ± 4.47 | 1194 | < 0.01 |
Diagnosis and treatment history
Comorbid conditions
Social support, active lifestyle, and MG-ADL
HRQoL measured by MG-QOL15r
Men | Women | P-value | |
---|---|---|---|
MG-QOL15r | 49.32 ± 29.18 | 44.49 ± 29.10 | < 0.001 |
Sub-scales | |||
Physical QoL | 52.22 ± 29.32 | 47.01 ± 29.91 | < 0.001 |
Social QoL | 39.43 ± 33.39 | 35.93 ± 32.70 | < 0.05 |
Emotional QoL | 50.51 ± 34.58 | 45.48 ± 31.91 | < 0.01 |
Multivariable regression analyses
Overall QoL | Model 1 | Model 2 | Model 3 | |||
---|---|---|---|---|---|---|
β (95% CI) | P-value | β (95% CI) | P-value | β (95% CI) | P-value | |
Socio-demographic variables | ||||||
Age | 0.13 (0.02 to 0.24) | < 0.05 | 0.12 (0.01 to 0.23) | < 0.05 | 0.13 (0.02 to 0.24) | < 0.05 |
Education | 1.19 (− 0.27 to 2.66) | 0.111 | 1.19 (− 0.28 to 2.66) | 0.113 | 1.14 (− 0.33 to 2.61) | 0.127 |
Unemployment | − 4.99 (− 7.80 to − 2.18) | < 0.001 | − 4.87 (− 7.70 to − 2.03) | < 0.001 | − 4.78 (− 7.61 to − 1.96) | < 0.001 |
Annual household income | 0.00 (0.00 to 0.00) | < 0.01 | 0.00 (0.00 to 0.00) | < 0.05 | 0.00 (0.00 to 0.00) | < 0.01 |
Diagnosis and treatment history | ||||||
Thymectomy (0 = no; 1 = yes) | − 2.07 (− 4.66 to 0.52) | 0.118 | − 2.08 (− 4.68 to 0.51) | 0.115 | − 2.17 (− 4.75 to 0.42) | 0.100 |
MG exacerbations (0 = no; 1 = yes) | − 8.49 (− 11.43 to − 5.54) | < 0.001 | − 8.49 (− 11.44 to − 5.54) | < 0.001 | − 8.49 (− 11.43 to − 5.55) | < 0.001 |
Prednisone treatment (0 = never had prednisone) | ||||||
Current prednisone | −3.83 (− 6.55 to − 0.21) | < 0.05 | − 3.40 (− 6.57 to − 0.23) | < 0.05 | − 3.26 (− 6.43 to − 0.10) | < 0.05 |
Past prednisone | 1.33 (− 5.11 to 2.45) | 0.489 | − 1.32 (− 5.10 to 2.46) | 0.493 | − 1.22 (− 4.99 to 2.55) | 0.526 |
Number of comorbid conditions | 0.10 (− 0.63 to 0.82) | 0.795 | 0.08 (− 0.65 to 0.81) | 0.826 | 0.90 (− 0.08 to 1.88) | 0.071 |
Social support and Active lifestyle | ||||||
Tangible support | −0.03 (− 0.10 to 0.05) | 0.458 | − 0.03 (− 0.10 to 0.04) | 0.432 | − 0.03 (− 0.10 to 0.04) | 0.446 |
Affectionate support | 0.09 (− 0.03 to 0.22) | 0.134 | 0.10 (− 0.03 to 0.22) | 0.121 | 0.10 (− 0.02 to 0.23) | 0.099 |
Positive social interaction | 0.02 (− 0.09 to 0.14) | 0.675 | 0.02 (− 0.09 to 0.13) | 0.731 | 0.02 (− 0.09 to 0.13) | 0.739 |
Emotional/information support | 0.00 (−0.09 to 0.10) | 0.956 | 0.01 (−0.09 to 0.10) | 0.899 | 0.00 (−0.10 to 0.10) | 0.990 |
Active lifestyle | 0.28 (0.16 to 0.40) | < 0.001 | 0.28 (0.16 to 0.40) | < 0.001 | 0.28 (0.16 to 0.40) | < 0.001 |
MG-ADL | − 4.02 (− 4.37 to − 3.67) | < 0.001 | − 4.02 (− 4.36 to − 3.67) | < 0.001 | − 3.99 (− 4.34 to − 3.64) | < 0.001 |
Gender (0 = male; 1 = female) | − 0.89 (− 3.74 to 1.97) | 0.542 | 0.90 (− 2.29 to 4.09) | 0.579 | ||
Gender × Comorbiditiesa | −1.71 (− 3.08 to − 0.34) | < 0.05 | ||||
Adjusted R-squared | 0.6155 | 0.6152 | 0.6177 |
Physical QoL | Model 1 | Model 2 | Model 3 | |||
---|---|---|---|---|---|---|
β (95% CI) | P-value | β (95% CI) | P-value | β (95% CI) | P-value | |
Socio-demographic variables | ||||||
Age | 0.04 (− 0.06 to 0.15) | 0.419 | 0.03 (− 0.07 to 0.14) | 0.522 | 0.04 (− 0.07 to 0.15) | 0.451 |
Education | 1.12 (− 0.32 to 2.56) | 0.127 | 1.11 (− 0.33 to 2.55) | 0.130 | 1.07 (− 0.37 to 2.50) | 0.146 |
Unemployment | − 4.82 (− 7.58 to − 2.07) | < 0.001 | − 4.70 (− 7.48 to − 1.92) | < 0.001 | − 4.61 (− 7.38 to − 1.84) | < 0.01 |
Annual household income | 0.00 (0.00 to 0.00) | < 0.05 | 0.00 (0.00 to 0.00) | < 0.05 | 0.00 (0.00 to 0.00) | < 0.05 |
Diagnosis and treatment history | ||||||
Thymectomy (0 = no; 1 = yes) | −2.70 (− 5.24 to − 0.16) | < 0.05 | − 2.72 (− 5.26 to − 0.18) | < 0.05 | − 2.81 (− 5.34 to − 0.27) | < 0.05 |
MG exacerbations (0 = no; 1 = yes) | −7.71 (− 10.60 to − 4.82) | < 0.001 | − 7.71 (− 10.60 to − 4.82) | < 0.001 | − 7.71 (− 10.59 to − 4.83) | < 0.001 |
Prednisone treatment (0 = never had prednisone) | ||||||
Current prednisone | −3.12 (− 6.22 to − 0.01) | < 0.05 | − 3.14 (− 6.25 to − 0.03) | < 0.05 | −2.99 (− 6.09 to 0.11) | 0.059 |
Past prednisone | −0.98 (− 4.69 to 2.72) | 0.603 | − 0.971 (− 4.68 to 2.74) | 0.607 | −0.86 (− 4.56 to 2.83) | 0.646 |
Number of comorbid conditions | 0.41 (−0.30 to 1.13) | 0.252 | 0.40 (− 0.31 to 1.11) | 0.272 | 1.25 (0.30 to 2.21) | < 0.05 |
Social support and Active lifestyle | ||||||
Tangible support | −0.00 (− 0.07 to 0.07) | 0.972 | − 0.00 (− 0.07 to 0.07) | 0.990 | −0.00 (− 0.07 to 0.07) | 0.989 |
Affectionate support | 0.06 (−0.07 to 0.18) | 0.364 | 0.06 (−0.06 to 0.18) | 0.333 | 0.07 (−0.06 to 0.19) | 0.284 |
Positive social interaction | −0.03 (− 0.14 to 0.08) | 0.609 | − 0.03 (− 0.15 to 0.08) | 0.559 | −0.03 (− 0.15 to 0.08) | 0.549 |
Emotional/information support | 0.02 (−0.08 to 0.11) | 0.718 | 0.02 (−0.07 to 0.11) | 0.664 | 0.02 (−0.08 to 0.11) | 0.753 |
Active lifestyle | 0.27 (0.16 to 0.39) | < 0.001 | 0.27 (0.16 to 0.39) | < 0.001 | 0.27 (0.16 to 0.39) | < 0.001 |
MG-ADL | −4.39 (− 4.73 to − 4.05) | < 0.001 | −4.38 (− 4.73 to − 4.04) | < 0.001 | −4.36 (− 4.70 to − 4.02) | < 0.001 |
Gender (0 = male; 1 = female) | − 0.93 (− 3.73 to 1.87) | 0.516 | 0.93 (−2.19 to 4.06) | 0.557 | ||
Gender × Comorbiditiesa | −1.78 (−3.12 to −0.44) | < 0.01 | ||||
Adjusted R-squared | 0.6364 | 0.6362 | 0.6389 |
Social QoL | Model 1 | Model 2 | Model 3 | |||
---|---|---|---|---|---|---|
β (95% CI) | P-Value | β (95% CI) | P-Value | β (95% CI) | P-Value | |
Socio-demographic variables | ||||||
Age | 0.21 (0.07 to 0.36) | < 0.01 | 0.22 (0.07 to 0.37) | < 0.01 | 0.23 (0.08 to 0.38) | < 0.01 |
Education | 1.17 (− 0.86 to 3.21) | 0.258 | 1.18 (− 0.86 to 3.22) | 0.256 | 1.13 (− 0.91 to 3.16) | 0.277 |
Unemployment | − 5.68 (− 9.57 to − 1.79) | < 0.05 | −5.78 (− 9.70 to − 1.85) | < 0.01 | −5.68 (− 9.60 to − 1.76) | < 0.01 |
Annual household income | 0.00 (0.00 to 0.00) | 0.070 | 0.00 (0.00 to 0.00) | 0.067 | 0.00 (0.00 to 0.00) | 0.058 |
Diagnosis and treatment history | ||||||
Thymectomy (0 = no; 1 = yes) | −0.788 (−4.38 to 2.80) | 0.667 | −0.77 (− 4.37 to 2.82) | 0.672 | − 0.87 (− 4.46 to 2.72) | 0.633 |
MG exacerbations (0 = no; 1 = yes) | −9.23 (− 13.31 to −5.15) | < 0.001 | − 9.23 (− 13.31 to − 5.14) | < 0.001 | − 9.22 (− 13.30 to − 5.15) | < 0.001 |
Prednisone treatment (0 = never had prednisone) | ||||||
Current prednisone | −3.79 (− 8.18 to 0.61) | 0.091 | − 3.77 (− 8.16 to 0.62) | 0.093 | − 3.61 (− 8.00 to 0.78) | 0.107 |
Past prednisone | −0.13 (− 5.37 to 5.10) | 0.960 | −0.14 (− 5.38 to 5.10) | 0.958 | − 0.022 (− 5.25 to 5.21) | 0.993 |
Number of comorbid conditions | − 0.31 (− 1.31 to 0.70) | 0.550 | − 0.29 (− 1.30 to 0.71) | 0.566 | 0.65 (− 0.71 to 2.01) | 0.347 |
Social support and Active lifestyle | ||||||
Tangible support | − 0.13 (− 0.23 to − 0.03) | < 0.05 | − 0.13 (− 0.23 to − 0.03) | < 0.05 | −0.13 (− 0.23 to − 0.03) | < 0.05 |
Affectionate support | 0.13 (− 0.04 to 0.30) | 0.146 | 0.12 (− 0.05 to 0.30) | 0.159 | 0.13 (− 0.04 to 0.30) | 0.136 |
Positive social interaction | 0.14 (0.02 to 0.30) | 0.082 | 0.14 (0.02 to 0.30) | 0.077 | 0.14 (−0.02 to 0.30) | 0.078 |
Emotional/information support | −0.04 (− 0.17 to 0.10) | 0.599 | − 0.04 (− 0.17 to 0.09) | 0.575 | −0.04 (− 0.18 to 0.09) | 0.511 |
Active lifestyle | 0.33 (0.16 to 0.49) | < 0.001 | 0.33 (0.17 to 0.49) | < 0.001 | 0.33 (0.17 to 0.49) | < 0.001 |
MG-ADL | −3.61 (− 4.09 to − 3.12) | < 0.001 | −3.61 (− 4.10 to − 3.13) | < 0.001 | −3.58 (− 4.07 to − 3.10) | < 0.001 |
Gender (0 = male; 1 = female) | 0.67 (− 3.28 to 4.63) | 0.738 | 2.73 (−1.69 to 7.15) | 0.226 | ||
Gender × Comorbiditiesa | −1.97 (−3.87 to −0.07) | < 0.05 | ||||
Adjusted R-squared | 0.4509 | 0.4503 | 0.4526 |
Emotional QoL | Model 1 | Model 2 | Model 3 | |||
---|---|---|---|---|---|---|
β (95% CI) | P-value | β (95% CI) | P-value | β (95% CI) | P-value | |
Socio-demographic variables | ||||||
Age | 0.31 (0.16 to 0.45) | < 0.001 | 0.29 (0.14 to 0.43) | < 0.001 | 0.29 (0.14 to 0.44) | < 0.001 |
Education | 1.43 (− 0.56 to 3.43) | 0.159 | 1.41 (− 0.58 to 3.41) | 0.164 | 1.38 (− 0.61 to 3.38) | 0.175 |
Unemployment | −4.79 (− 8.60 to − 0.98) | < 0.05 | − 4.47 (− 8.32 to − 0.63) | < 0.05 | − 4.41 (− 8.26 to − 0.57) | < 0.05 |
Annual household income | 0.00 (0.00 to 0.00) | < 0.05 | 0.00 (0.00 to 0.00) | < 0.05 | 0.00 (0.00 to 0.00) | < 0.05 |
Diagnosis and treatment history | ||||||
Thymectomy (0 = no; 1 = yes) | −1.45 (− 4.97 to 2.07) | 0.420 | − 1.49 (−5.01 to 2.02) | 0.405 | − 1.56 (− 5.07 to 1.96) | 0.386 |
MG exacerbations (0 = no; 1 = yes) | −10.08 (− 14.08 to − 6.07) | < 0.001 | − 10.08 (− 14.08 to − 6.08) | < 0.001 | − 10.08 (− 14.08 to − 6.08) | < 0.001 |
Prednisone treatment (0 = never had prednisone) | ||||||
Current prednisone | −3.78 (− 8.09 to 0.52) | 0.085 | − 3.84 (− 8.14 to 0.47) | 0.081 | − 3.73 (− 8.04 to 0.57) | 0.089 |
Past prednisone | −3.58 (− 8.71 to 1.55) | 0.171 | − 3.56 (− 8.69 to 1.58) | 0.174 | − 3.38 (− 8.61 to 1.65) | 0.183 |
Number of comorbid conditions | −0.46 (− 1.44 to 0.53) | 0.362 | − 0.50 (− 1.48 to 0.49) | 0.323 | 0.10 (−1.23 to 1.43) | 0.885 |
Social support and Active lifestyle | ||||||
Tangible support | −0.01 (− 0.11 to 0.09) | 0.795 | − 0.02 (− 0.12 to 0.08) | 0.730 | −0.02 (− 0.12 to 0.08) | 0.740 |
Affectionate support | 0.18 (0.01 to 0.35) | < 0.05 | 0.19 (0.02 to 0.36) | < 0.05 | 0.19 (0.02 to 0.36) | < 0.05 |
Positive social interaction | 0.07 (−0.09 to 0.22) | 0.384 | 0.06 (−0.10 to 0.21) | 0.467 | 0.06 (−0.10 to 0.21) | 0.471 |
Emotional/information support | 0.00 (−0.13 to 0.13) | 0.966 | 0.01 (−0.12 to 0.14) | 0.923 | 0.00 (−0.13 to 0.13) | 0.972 |
Active lifestyle | 0.25 (0.09 to 0.41) | < 0.01 | 0.25 (0.09 to 0.40) | < 0.01 | 0.25 (0.09 to 0.41) | < 0.01 |
MG-ADL | −3.32 (−3.80 to −2.85) | < 0.001 | − 3.31 (− 3.79 to − 2.84) | < 0.001 | −3.29 (− 3.77 to − 2.82) | < 0.001 |
Gender (0 = male; 1 = female) | − 2.33 (− 6.20 to 1.55) | 0.238 | −1.03 (− 5.37 to 3.30) | 0.640 | ||
Gender × Comorbiditiesa | −1.24 (−3.10 to 0.63) | 0.192 | ||||
Adjusted R-squared | 0.4497 | 0.45 | 0.4505 |