Patient Preference and Adherence (Jun 2018)
Cultural and quality-of-life considerations when administering corticosteroids as a therapeutic strategy for African American women living with systemic lupus erythematosus
Abstract
Dorcey L Applyrs,1 Edith M Williams,2 Trevor D Faith,2 Diane L Kamen,3 Elizabeth Vazques,4 Janine M Jurkowski5 1School of Health Sciences, Excelsior College, Albany, NY, USA; 2Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA; 3Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC, USA; 4Department of Epidemiology and Biostatistics, State University of New York at Albany, One University Place, Rensselaer, NY, USA; 5Department of Health Policy, Management, and Behavior, State University of New York at Albany, One University Place, Rensselaer, NY, USA Objective: This study investigated the association among corticosteroids, emotional health, physical health, and work/regular activities of daily living in an ethnically diverse sample of women with systemic lupus erythematosus.Methods: A secondary analysis of data from the Medical University of South Carolina Lupus Database was conducted between confirmed cases of lupus (n = 224) and controls (n = 60). The sample comprised 57 Caucasian Americans, 141 Gullah African Americans (a subpopulation of African Americans from the Sea Islands of South Carolina and Georgia), and 86 non-Gullah African Americans.Results: Emotional health outcomes were better for women with systemic lupus erythematosus compared with controls. High emotional health scores may be influenced by cultural factors such as masking emotion, disease-coping mechanisms, religion, and strong familial and social support. Although a significant association was not detected between emotional health and work/regular activities of daily living, relationships were significant after adjusting for corticosteroid use.Conclusion: These findings suggest corticosteroid use does influence the strength of the association between emotional health and work/regular activities of daily living. Keywords: systemic lupus erythematosus, emotional health, physical health, Gullah, corticosteroids, quality of life
