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Cultural and quality-of-life considerations when administering corticosteroids as a therapeutic strategy for African American women living with systemic lupus erythematosus

Authors Applyrs DL, Williams EM, Faith TD, Kamen DL, Vazquez E, Jurkowski JM

Received 8 November 2017

Accepted for publication 23 March 2018

Published 12 June 2018 Volume 2018:12 Pages 1007—1014

DOI https://doi.org/10.2147/PPA.S156457

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen


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

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