Evaluation of coping with chronic rheumatic disease, in the context of socio-demographic factors and disease duration, based on the example of patients with ankylosing spondylitis

OBJECTIVES: Ankylosing spondylitis (AS) impairs patients’ functioning, reducing their quality of life. The author of salutogenesis, Antonovsky, claims that maintaining an inner balance in a chronic disease is possible through a high sense of coherence. The aim of the current study was to identify socio-demographic factors and disease duration related to the feeling of coherence of patients with AS, acceptance of disease and risk of depression. MATERIAL AND METHODS: The study was conducted on 82 patients with diagnosed AS. The research method was a diagnostic survey using the Life Orientation Questionnaire (SOC-29), Beck Depression Inventory (BDI) and Acceptance of Illness Scale (AIS). RESULTS: In the study, the majority of the patients were male (89%), aged 42 (±11.3). The average duration of AS is 13 (±7.8) years. It was reported that with age, illness acceptance got worse (r(p) = –0.567, p < 0.0001), and the risk of depressive disorders increased (r(p) = 0.648, p < 0.0001). The longer the patient suffered from AS, the weaker was their illness acceptance (r(p) = –0.446, p < 0.0001) and sense of coherence (r(p) = –0.448, p < 0.001) whereas the risk of depressive disorder increased (r(p) = 0.479, p < 0.0001). A high linear correlation between illness acceptance and sense of coherence (r(p) = 0.638, p < 0.0001) and a very high negative correlation between overall sense of coherence and risk of depression (r(p) = –0.857, p < 0.0001) were observed. CONCLUSIONS: Patients with low sense of coherence demonstrated poorer adaptation to the illness and a greater risk of depressive disorders. Factors lowering the sense of coherence and illness acceptance and increasing risk of depression in the studied patients with AS were progressing illness, older age and lower education level.