PO12 - Stress and Self-Efficacy as Key Drivers of Symptoms in Sarcoidosis — A Cross-Sectional Survey Study
Logan J Harper MD, MS (United States)1; Maeve MacMurdo MBChB, MPH (United States)1; Elise Hoover MPH (United States)2; Xiaofeng Wang PhD (United States)3; Manuel Lessa Ribeiro Neto MD (United States)1; J. Daryl Thornton MD, MPH (United States)4; Daniel A Culver DO (United States)1;
1 - Cleveland Clinic - Pulmonary Medicine; 2 - Foundation for Sarcoidosis Research; 3 - Cleveland Clinic - Quantitative Health Sciences; 4 - MetroHealth;
Keywords: Self efficacy; Patient reported outcomes; Quality of care;
Select the theme: Special Topics in Extrathoracic Sarcoidosis
Type: Original Papers
Presentation: Poster Presentation

Introduction: Sarcoidosis is associated with substantial fatigue, depression, and impaired quality of life poorly correlated with disease activity. The relative contributions of perceived stress, self-efficacy, and quality of care to these outcomes remain incompletely understood.

Objectives: To evaluate associations between perceived stress, self-efficacy, and perceived quality of care with sarcoidosis-related quality of life, fatigue, and depression.

Materials and Methods: Cross-sectional survey of 476 individuals with sarcoidosis recruited from the Foundation for Sarcoidosis Research registry, Cleveland Clinic, and MetroHealth. Participants completed validated measures of perceived stress (PSS), self-efficacy (PROMIS), quality of care (PACIC), quality of life (SHQ), fatigue (SAT-Fatigue), and depression (PHQ-8). Regression models adjusted for age, sex, race, and medication use were fit for each predictor individually, then simultaneously.

Results: Mean age 59 years (SD 11); 70% female, 18% Black. Mean depression score 9.1 (SD 6.4), fatigue T-score 61 (SD 11), SHQ-Physical 3.8 (SD 1.4). In multivariate models, all three predictors were significantly associated with outcomes: higher stress predicted worse quality of life (ΔSHQ 0.7/SD, 95% CI 0.5–0.8), greater fatigue (ΔSAT 6.7, 95% CI 5.6–7.7), and more severe depression (ΔPHQ 4.6, 95% CI 4.1–5.1); greater self-efficacy likewise was associated with improved quality of life (ΔSHQ −0.6, 95% CI −0.8 to −0.5), reduced fatigue (ΔSAT-fatigue −6.4, 95% CI −7.4 to −5.4), and lower depression scores (ΔPHQ −4.2, 95% CI −4.7 to −3.7), as was better perceived quality of care. When modeled simultaneously, perceived quality of care lost independent associations with all outcomes while stress and self-efficacy retained them. Given correlations among predictors, perceived quality of care may influence outcomes in part through its effects on stress and self-efficacy. No race interactions were observed.

Conclusions: Stress and self-efficacy are key proximal determinants of fatigue, depression, and quality of life in sarcoidosis. Quality of care appears to operate through these pathways, highlighting stress reduction and self-efficacy enhancement as intervention targets.

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