Abstract
There have been few studies on the impact of rheumatoid arthritis (RA) on household work, and none has been done in a setting where female unemployment is normative. The typical Israeli Arab woman is nearly always unemployed, poorly educated, has low financial resources, and is fully responsible for maintenance of the household work. In this study, we attempted to determine whether social-economic factors or medical evaluation best predicts household work disability. Arab housewives with RA that are followed up regularly with disease duration >6 months were recruited consecutively from three outpatient clinics in northern Israel. These patients had to answer a questionnaire regarding demographic and social data, performance of typical household activities, patient–family relationship, and disease parameters. Information from the medical charts was also obtained on all the patients regarding erythrocyte sedimentation rate (ESR), C-reactive protein, tender joint count (28 joints), and swollen joint count (28 joints), all from the last visit. Information was obtained also on bone erosions, rheumatoid factor positivity, and disease duration. Those who could not perform at least one household activity were defined as being disabled and compared to those who have no such disability. Forty-eight patients completed the study, and 33 (68.8%) patients were disabled (unable to do at least one household activity). The disabilities in the 33 patients included total inability to clean the house in 30 (91%), inability to wash the floor in 28 (84.8%), inability to take care of the children or husband in 18 (54.5%), inability to wash the dishes in 15 (45.5%), and inability to cook in 10 (30.3%). There were three variables that significantly added to a logistic regression model predicting disability; husband’s salary, the number of kids in the family, and the ESR. This model was excellent with the area under the receiver-operator curve (ROC) of 93.1%. Substituting years of symptoms for ESR also resulted in an excellent model with the area under the ROC of 90.8%. None of the other variables including findings on physical examination significantly added to the model. We conclude that socio-economic factors are highly predictive of homemaking disability in Arab women with RA and more predictive than the clinical examination. Further studies in other cultures are needed to substantiate our results.
Similar content being viewed by others
References
Sokka T, Krishnan E, Hakkinen A, Hannonen P (2003) Functional disability in rheumatoid arthritis patients compared with a community population in Finland. Arthritis Rheum 48:59–63
Sokka T (2003) Work disability in early rheumatoid arthritis. Clin Exp Rheumatol 21(5 Suppl 31):S71–S74
Allaire SH, Meenan RF, Anderson JJ (1991) The impact of rheumatoid arthritis on the household work performance of women. Arthritis Rheum 34:669–678
Reisine ST, Goodenow C, Grady KE (1987) The impact of rheumatoid arthritis on the homemaker. Soc Sci Med 25:89–95
Yelin E, Lubeck D, Holman H, Epstein W (1987) The impact of rheumatoid arthritis and osteoarthritis: the activities of rheumatoid arthritis and osteoarthritis compared to controls. J Rheumatol 14:710–717
Fries JF, Spitz P, Kraines RG, Holman HR (1980) Measurement of patient outcome in arthritis. Arthritis Rheum 23:137–145
McDuffie FC (1985) Morbidity impact of rheumatoid arthritis on society. Am J Med 78(1A):1–5
Reisine ST, Fifield J, Winkelman DK (1998) Employment patterns and their effect on health outcomes among women with rheumatoid arthritis followed for 7 years. J Rheumatol 25:1908–1916
Minor MA, Hewett JE (1995) Physical fitness and work capacity in women with rheumatoid arthritis. Arthritis Care Res 8:146–154
Hochberg MC (1999) Early aggressive DMARD therapy: the key to slowing disease progression in rheumatoid arthritis. Scand J Rheumatol Supp 112:3–7
Leighh JP, Fries JF, Parikh M (1992) Severity of disability and duration of disease in rheumatoid arthritis. J Rheumatol 19:1906–1911
Leighh JP, Fries JF (1991) Education level and rheumatoid arthritis: evidence from five data centers. J Rheumatol 18:24–34
Bruce B, Fries J (2003) The Stanford health assessment questionnaire (HAQ): a review of its history, issues, progress and documentation. J Rheumatol 30:167–178
Sokka T, Kautiainen H, Hakkinen A, Hannonen P (2004) Radiographic progression is getting milder in patients with early rheumatoid arthritis. Results of 3 cohorts over 5 years. J Rheumatol 31:1073–1082
Amit M, Guedj D, Wysenbeek AJ (1996) Expression of rheumatoid arthritis in two ethnic Jewish Israeli groups. Ann Rheum Dis 55(1):69–72 (Jan)
Gorman JD, Lum RF, Chen JJ, Suarez-Almazor ME, Thomson G, Criswell LA (2004) Impact of shared epitope genotype and ethnicity on erosive disease: a meta-analysis of 3,240 rheumatoid arthritis patients. Arthritis Rheum 50:400–412
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Habib, G., Artul, S., Ratson, N. et al. Household work disability of Arab housewives with rheumatoid arthritis. Clin Rheumatol 26, 759–763 (2007). https://doi.org/10.1007/s10067-007-0554-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-007-0554-9