We identified three studies that analyzed the prevalence and correlates of lupus nephritis (LN) in a total of 428 patients [46-48] (Table 1). The follow-up period varied from less than 1 year up to 10 years. End-stage renal disease requiring dialysis (ESRD) was the most common complication reported (Table 1). Kidney biopsy was the most frequent method applied for diagnosis [46, 48]. However, some studies also analyzed clinical, serological, and immunological data [46] or employed genotyping [47]. Risk factors for LN development or progression of diagnosed instabilities identified were: hypertension, higher creatinine, proliferative nephritis, and decreased GFR [46, 48], as well as genetic, environmental, and socioeconomic …show more content…
The follow-up reported varied from 6 weeks to 6 months. The Chronic Disease Self-Management Program (CDSMP) was the mode of self management education/ implementation reported by each study, however some studies also utilized electronic administrative records and disease activity data from medical histories, physical examination, phlebotomy, and urine collection to assess changes [74, 76, 78]. Effects on the following risk factors were examined: gender, age, insurance status, highest year of education completed, current and past employment status, health status, self-efficacy, health care utilization, depression, social/role activities limitations, health distress, fatigue, pain, hospital visits, illness intrusiveness, communication with health care providers, perceived racism, neuroendocrine responses to stress (Cortisol and DHEA), and self-management behaviors …show more content…
also piloted the validated “Better Choices, Better Health” CDSMP in 30 African American lupus patients participating in the SLE Clinic Database Project at the Medical University of South Carolina (MUSC) to examine the relationship between psychosocial stress and underlying biological mechanisms that influence disease activity and pathology in this high risk group [75]. As part of the Balancing Lupus Experiences with Stress Strategies (BLESS) study, measures of psychosocial and biological indicators of stress were collected in all of the patients in each of the study conditions (15 intervention and 15 control) before and after intervention activities (from baseline to 6 weeks after the start of the intervention), as well as four months post-intervention, to assess the effectiveness of the program in reducing perceived and biological indicators of stress. Psychosocial indicators of stress were assessed by five validated measures: the State-Trait Anxiety Inventory (STAI), the Arthritis Self-Efficacy Scale pain and other symptoms sub-scale, the Perceptions of Racism Scale, a modified version of the Medical Outcomes Study (MOS) health distress scale, adapted by the Stanford Patient Education Research Center, and the Beck Depression Inventory. Quality of life was assessed using two instruments that describe a spectrum of quality of life outcomes; The LUP-QOL, which incorporates the MOS SF-36 Health Survey and the Functional Assessment of Chronic Illness