Impacts of Violence on Nurses: Stress and Productivity Effects

Abstract

Background: Psoriatic arthritis (PsA) and rheumatoid arthritis (RA) are chronic inflammatory disorders with overlapping clinical consequences but distinct pathophysiological mechanisms. Both impair health-related quality of life (HRQoL), yet direct comparative evidence is scarce, particularly in low-resource settings. Objective: To compare HRQoL outcomes in patients with PsA and RA, focusing on physical functioning, disability, and mental health. Methods: We conducted a cross-sectional study of 256 outpatients with clinically confirmed PsA (n=128) or RA (n=128) recruited through stratified random sampling. HRQoL was assessed using the Short Form-36 (SF-36) and Health Assessment Questionnaire (HAQ), alongside clinical measures of grip strength, effusion count, and erythrocyte sedimentation rate. Multivariable linear regression adjusted for age, sex, and disease duration. Results: Compared with RA, PsA patients demonstrated significantly higher physical functioning (mean difference 21.7, 95% CI 14.7–28.7, p<0.001), fewer role limitations due to physical health (28.9, 95% CI 14.3–43.5, p<0.001), and greater vitality (13.5, 95% CI 5.0–22.0, p=0.002). Disability was lower in PsA (HAQ difference –0.53, 95% CI –0.73 to –0.33, p<0.001). No differences were observed in mental health outcomes. Conclusion: PsA patients experience less disability and better physical performance compared with RA, although both groups share a comparable psychological burden. These findings highlight the need for targeted physical rehabilitation in RA and emphasize integrating psychosocial support into the care of both populations.