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16.05.2019 | Original Paper Open Access

Subjective well-being in patients with pemphigus: a path analysis

Zeitschrift:
The European Journal of Health Economics
Autoren:
Ariel Mitev, Fanni Rencz, Béla Tamási, Krisztina Hajdu, Márta Péntek, László Gulácsi, Andrea Szegedi, Zsuzsanna Bata-Csörgő, Ágnes Kinyó, Miklós Sárdy, Valentin Brodszky
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Abstract

Background

Pemphigus is a chronic autoimmune blistering disease of the skin and mucosa severely impairing patients’ health-related quality of life (HRQoL). To date, no studies have measured subjective well-being in terms of life satisfaction in pemphigus. Our main objective was to evaluate satisfaction with life in patients with pemphigus, and to analyse its relationship with clinical severity and HRQoL.

Methods

A cross-sectional survey was carried out enrolling 77 patients with pemphigus. Subjective well-being was measured using the Satisfaction with Life Scale (SWLS). HRQoL was assessed by the Dermatology Life Quality Index (DLQI) and EQ-5D-5L. Disease severity was measured by Autoimmune Bullous Skin Disorder Intensity Score (ABSIS).

Results

Mean ABSIS, DLQI, EQ-5D-5L and SWLS scores of patients were 11.7 (SD 17.3), 5.4 (6.8), 0.84 (0.22) and 4.76 (SD 1.52), respectively. The proportion of patients indicating extreme dissatisfaction, dissatisfaction, slightly below average in life satisfaction, average satisfaction, high satisfaction and very high satisfaction with life was 6 (7.8%), 5 (6.5%), 14 (18.2%), 16 (20.8%), 21 (27.3%) and 15 (19.5%), respectively. Life satisfaction was independent from age, gender, level of education and type of disease. A path analysis revealed that there was no direct relationship between ABSIS and SWLS (beta = − 0.09; p = 0.428); however, the following indirect path was confirmed: ABSIS → DLQI → EQ-5D-5L → SWLS.

Conclusions

Disease severity and HRQoL measures regularly used to assess patients’ health status may be complemented with a measure of subjective well-being, such as SWLS, to achieve a more holistic assessment of patients’ lives and optimise pemphigus care.

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