Skip to main content

Advertisement

SpringerLink
Log in

Loneliness among women with rheumatoid arthritis: a cross-cultural study in the Netherlands and Egypt

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

The objective of this study was to explain loneliness as experienced by women with rheumatoid arthritis (RA) in a cross-cultural context. We studied 36 Egyptian female RA patients and 140 female Dutch RA patients.. Self-report data were collected about loneliness, physical and psychological health status, social support and social network, needs for help, attitudes and feelings of guilt. Loneliness was significantly higher among Egyptian (44.2 ± 32.3) than Dutch (12.9 ± 18.9) female RA patients (F = 54.3, p < 0.001). In Egypt, 36% of the variance of loneliness could be explained by worse affect (anxiety and depression; β = 0.51), fewer children (β = 0.31), and higher negative social support for the patients (β = 0.28) in multiple regression analysis. In the Netherlands, 35% of feeling lonely could be explained by worse affect scores (β = 0.52), less positive social support for the patients (β = 0.24), and a higher degree of disability (β = 0.21). Age of the patients and disease duration only explained 4% and 3% of the loneliness of RA patients in Egypt and the Netherlands, respectively. Female Egyptian RA patients experienced more loneliness than Dutch patients. Affect is the most important and constant variable in explaining loneliness in both countries. The role of the family in perceived loneliness is greater in Egypt than the Netherlands. Low social support received by patients is important in explaining loneliness in the Netherlands but not in Egypt.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Rokach A (2000) Terminal illness and coping with loneliness. J Psychol 134:283–296

    PubMed  CAS  Google Scholar 

  2. Rokach A (2000) Loneliness and the life cycle. Psychol Rep 86:629–642

    Article  PubMed  CAS  Google Scholar 

  3. Penninx BW, van Tilburg T, Kriegsman DM, Boeke AJ, Deeg DJ, van Eijk JT (1999) Social network, social support, and loneliness in older persons with different chronic diseases. J Aging Health 11:151–168

    Article  PubMed  CAS  Google Scholar 

  4. West DA, Kellner R, Moore-West M (1986) The effects of loneliness: a review of the literature. Compr Psychiatry 27:351–363

    Article  PubMed  CAS  Google Scholar 

  5. Kiecolt-Glaser JK, Ricker D, George J, Messick G, Speicher CE, Garner W et al (1984) Urinary cortisol levels, cellular immunocompetency, and loneliness in psychiatric inpatients. Psychosom Med 46:15–23

    PubMed  CAS  Google Scholar 

  6. Rook KS (1987) Social support versus companionship. Effects on life stress, loneliness, and evaluations by others. J Pers Soc Psychol 52:1132–1147

    Article  PubMed  CAS  Google Scholar 

  7. Michela JL, Peplau LA, Weeks DG (1982) Perceived dimensions of attributions for loneliness. J Pers Soc Psychol 43:929–936

    Article  PubMed  CAS  Google Scholar 

  8. Marangoni C, Ickes W (1989) Loneliness—a theoretical review with implications for measurement. J Soc Pers Relat 6:93–128

    Article  Google Scholar 

  9. Weiss R (1973) Loneliness: the experience of emotional and social isolation. MIT, Cambridge, Ma

    Google Scholar 

  10. Rokach A (1999) Cultural background and coping with loneliness. J Psychol 133:217–229

    PubMed  CAS  Google Scholar 

  11. Kalliopuska M, Laitinen M (1987) Testing loneliness on the differential Loneliness Scale. Psychol Rep 60:15–18

    PubMed  CAS  Google Scholar 

  12. Lynch JJ, Convey WH (1979) Loneliness, disease, and death: alternative approaches. Psychosomatics 20:702–708

    PubMed  CAS  Google Scholar 

  13. Valente S, Aoyama DL (1992) Helping your patient overcome loneliness. Nursing 22:70–1 73

    PubMed  CAS  Google Scholar 

  14. Kessler RC, Kendler KS, Heath A, Neale MC, Eaves LJ (1992) Social support, depressed mood, and adjustment to stress: a genetic epidemiologic investigation. J Pers Soc Psychol 62:257–272

    Article  PubMed  CAS  Google Scholar 

  15. Stansfeld SA, Gallacher JE, Sharp DS, Yarnell JW (1991) Social factors and minor psychiatric disorder in middle-aged men: a validation study and a population survey. Psychol Med 21:157–167

    Article  PubMed  CAS  Google Scholar 

  16. Case RB, Moss AJ, Case N, McDermott M, Eberly S (1992) Living alone after myocardial infarction. Impact on prognosis. JAMA 267:515–519

    Article  PubMed  CAS  Google Scholar 

  17. Spiegel D, Kraemer HC, Bloom JR, Gottheil E (1989) Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet 334:888–891

    Article  Google Scholar 

  18. Fawzy FI, Fawzy NW, Hyun CS, Elashoff R, Guthrie D, Fahey JL et al (1993) Malignant melanoma. Effects of an early structured psychiatric intervention, coping, and affective state on recurrence and survival 6 years later. Arch Gen Psychiatry 50:681–689

    PubMed  CAS  Google Scholar 

  19. Bartrop RW, Luckhurst E, Lazarus L, Kiloh LG, Penny R (1977) Depressed lymphocyte function after bereavement. Lancet 309:834–836

    Article  Google Scholar 

  20. Kiecolt-Glaser JK, Fisher LD, Ogrocki P, Stout JC, Speicher CE, Glaser R (1987) Marital quality, marital disruption, and immune function. Psychosom Med 49:13–34

    PubMed  CAS  Google Scholar 

  21. Kiecolt-Glaser JK, Kennedy S, Malkoff S, Fisher L, Speicher CE, Glaser R (1988) Marital discord and immunity in males. Psychosom Med 50:213–229

    PubMed  CAS  Google Scholar 

  22. Ouellet R, Joshi P (1986) Loneliness in relation to depression and self-esteem. Psychol Rep 58:821–822

    PubMed  CAS  Google Scholar 

  23. Booth R (1983) An examination of college GPA, composite act scores, IQs, and gender in relation to loneliness of college students. Psychol Rep 53:347–352

    PubMed  CAS  Google Scholar 

  24. Triandis HC (1996) The psychological measurement of cultural syndromes. Am Psychol 51:407–415

    Article  Google Scholar 

  25. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324

    Article  PubMed  CAS  Google Scholar 

  26. Riemsma RP, Klein G, Taal E, Rasker JJ, Houtman PM, Van Paassen HC et al (1998) The supply of and demand for informal and professional care for patients with rheumatoid arthritis. Scand J Rheumatol 27:7–15

    Article  PubMed  CAS  Google Scholar 

  27. Meenan RF, Mason JH, Anderson JJ (1992) The content and properties of a revised and expanded arthritis impact measurement scales health status. Arthritis Rheum 35:1–10

    Article  PubMed  CAS  Google Scholar 

  28. Riemsma RP, Taal E, Rasker JJ, Houtman PM, Van Paassen HC, Wiegman O (1996) Evaluation of a Dutch version of the AIMS2 for patients with rheumatoid arthritis. Br J Rheumatol 35:755–760

    Article  PubMed  CAS  Google Scholar 

  29. Pincus T, Summey JA, Soraci SA, Wallston KA, Hummon NP (1983) Assessment of patient satisfaction in activities of daily living using a modified Stanford Health Assessment Questionnaire. Arthritis Rheum 26:1346–1353

    Article  PubMed  CAS  Google Scholar 

  30. Ferraz MB, Quaresma MR, Aquino LR, Atra E, Tugwell P, Goldsmith CH (1990) Reliability of pain scales in the assessment of literate and illiterate patients with rheumatoid arthritis. J Rheumatol 17:1022–1024

    PubMed  CAS  Google Scholar 

  31. van Eijk LM, Kempen GI, van Sonderen FL (1994) Een korte schaal voor het meten van sociale steun bij ouderen: de SSL12-I. [A short scale to measure social support in the elderly: the SSL12-I]. Tijdschr Gerontol Geriatr 25:192–196

    PubMed  Google Scholar 

  32. Stevens J (1992) Applied multivariate statistics for the social siences (2nd ed). Lawrence Erlbaum, Hillsdale, NJ

    Google Scholar 

  33. Myers R (1990) Classical and modern regression with application (2nd ed). Duxubry, Boston, Ma

    Google Scholar 

  34. Wilson D, Sibanda J, Sibanda P, Wilson C (1989) Personality concomitants of loneliness among black and white male Zimbabwean adolescents. J Soc Psychol 129:577–578

    PubMed  CAS  Google Scholar 

  35. Ginter EJ, Glauser A, Richmond BO (1994) Loneliness, social support, and anxiety among two South Pacific cultures. Psychol Rep 74:875–879

    PubMed  CAS  Google Scholar 

  36. Hunt SM, Alonso J, Bucquet D, Niero M, Wiklund I, McKenna S (1991) Cross-cultural adaptation of health measures. European Group for Health Management and Quality of Life Assessment. Health Policy 19:33–44

    Article  PubMed  CAS  Google Scholar 

  37. Whalley D, McKenna SP, de Jong Z, van der HD (1997) Quality of life in rheumatoid arthritis. Br J Rheumatol 36:884–888

    Article  PubMed  CAS  Google Scholar 

  38. Abdel-Nasser AM, Rasker JJ, Valkenburg HA (1997) Epidemiological and clinical aspects related to the variability of rheumatoid arthritis. Semin Arthritis Rheum 27:123–140

    Article  PubMed  CAS  Google Scholar 

  39. Malaviya AN, Kapoor SK, Singh RR, Kumar A, Pande I (1993) Prevalence of rheumatoid arthritis in the adult Indian population. Rheumatol Int 13:131–134

    Article  PubMed  CAS  Google Scholar 

  40. Abdel-Nasser AM, Rasker JJ, El Badawy SA, Taal E, Mahfouz R, Hassan SZ (1999) A comparison of the severity and impact of rheumatoid arthritis in Egyptian and Dutch patients. Rheumatology in Africa at the Turn of the Century, AFLAR Conference, 13–17 September, p. 57

  41. Abdel-Nasser AM, Abd El-Azim S, Taal E, El-Badawy SA, Rasker JJ, Valkenburg HA (1998) Depression and depressive symptoms in rheumatoid arthritis patients: an analysis of their occurrence and determinants. Br J Rheumatol 37:391–397

    Article  PubMed  CAS  Google Scholar 

  42. Larson JH, Medora N (1982) A cross-cultural comparison of Americans and Asian Indians. Int J Sociol Fam 22:55–66

    Google Scholar 

  43. Zhang Z, Hayward MD (2001) Childlessness and the psychological well-being of older persons. J Gerontol B Psychol Sci Soc Sci 56:S311–S320

    PubMed  CAS  Google Scholar 

  44. Hansson RO, Jones WH, Carpenter BN, Remondet I (1986) Loneliness and adjustment to old age. Int J Aging Hum Dev 24:41–53

    PubMed  Google Scholar 

  45. Neto F (2001) Personality predictors of happiness. Psychol Rep 88:817–824

    Article  PubMed  CAS  Google Scholar 

  46. Kim O (2001) Sex differences in social support, loneliness, and depression among Korean college students. Psychol Rep 88:521–526

    Article  PubMed  CAS  Google Scholar 

  47. Walker EA, Katon WJ, Russo J, Von Korff M, Lin E, Simon G, Bush T, Ludman E, Unutzer J (2000) Predictors of outcome in a primary care depression trial. J Gen Intern Med 15:859–867

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by grants from the Dutch Arthritis Association. We wish to thank all our respondents. We also gratefully acknowledge the cooperation of the rheumatologists H.J. Bernelot Moens, MD, G.A.W. Bruyn, MD, J.J.M. Festen, MD, E.N. Griep, MD, P.M. Houtman, MD, M.W.M. Kruijsen, MD, M.A.F.J. van de Laar, MD, J.C.M. Oostveen, MD, H.C. van Paassen, MD, and J. M.G.W. Wouters, MD from the Netherlands for their help in selecting the patients.

Conflict of interest statement

None disclosed.

Author information

Authors and Affiliations

  1. Dept. of Rheumatology and Rehabilitation, Minia University, El Minia, Egypt

    Tarek M. El-Mansoury, Ahmed M. Abdel-Nasser, Jehan A. Mahmoud & Samir A. El-Badawy

  2. Institute for Behavioral Research, University of Twente, Enschede, Netherlands

    Erik Taal & Johannes J. Rasker

  3. Kleijnen Systematic Reviews, York, United Kingdom

    Robert P. Riemsma

  4. Dept. of Psychiatry, Minia University, El Minia, Egypt

    Refaat Mahfouz

  5. Institute for Behavioral Research, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands

    Erik Taal

Authors
  1. Tarek M. El-Mansoury
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Erik Taal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ahmed M. Abdel-Nasser
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert P. Riemsma
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Refaat Mahfouz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jehan A. Mahmoud
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Samir A. El-Badawy
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Johannes J. Rasker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Erik Taal.

Rights and permissions

Reprints and permissions

About this article

Cite this article

El-Mansoury, T.M., Taal, E., Abdel-Nasser, A.M. et al. Loneliness among women with rheumatoid arthritis: a cross-cultural study in the Netherlands and Egypt. Clin Rheumatol 27, 1109–1118 (2008). https://doi.org/10.1007/s10067-008-0876-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-008-0876-2

Keywords

Search

Navigation