{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:30:06Z","timestamp":1792092606543,"version":"4.4.0"},"reference-count":49,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:00:00Z","timestamp":1777766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:00:00Z","timestamp":1777766400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U01DP006698"],"award-info":[{"award-number":["U01DP006698"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U01DP06701"],"award-info":[{"award-number":["U01DP06701"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG061179"],"award-info":[{"award-number":["R01AG061179"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate how modifiable psychosocial factors and fatigue relate to physical functioning in patients with systemic lupus erythematosus (SLE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross\u2010sectional study of two demographically distinct cohorts (Approaches to Positive, Patient\u2010Centered Experiences of Aging with Lupus [APPEAL] and California Lupus Epidemiology Study [CLUES]), perceived physical function was assessed using Patient\u2010Reported Outcomes Measurement Information System Physical Function Short Forms 12a (APPEAL) and 10a (CLUES). Fatigue, depression, and stress; coping efficacy and learned helplessness (APPEAL); and resilience and self\u2010efficacy (CLUES) were all assessed with validated questionnaires. We used multivariable linear regression analyses to assess associations between perceived physical function and outcomes, adjusting for age, sex, and race, then further for disease damage and activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      APPEAL participants (N\u00a0=\u00a0451) were primarily Black (82.5%); CLUES participants (N\u00a0=\u00a0580) were predominantly Asian (29.3%), Hispanic (22.9%), and White (27.4%). Mean physical function T scores were lower in APPEAL (43.6) versus CLUES (47.2;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). In both cohorts, higher fatigue, depression, and perceived stress were strongly associated with poorer physical function. Greater resilience (per +1 SD: \u03b2\u00a0=\u00a02.04, 95% confidence interval [CI] 0.57\u20133.50) and self\u2010efficacy (high vs low: \u03b2\u00a0=\u00a013.53, 95% CI 8.69\u201318.37) (both in CLUES) and better coping (per +1 SD: \u03b2\u00a0=\u00a03.15, 95% CI 2.39\u20133.91; in APPEAL) were associated with better physical function. In APPEAL, greater learned helplessness was associated with worse physical function (per +1SD: \u03b2\u00a0=\u00a0\u22123.88, 95% CI \u22124.62 to \u22123.14). Although adjusting further for disease damage and activity attenuated these associations, they remained statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results demonstrate associations of fatigue and psychosocial factors with physical functioning, reinforcing their relationship with overall health in SLE.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/acr80065-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80065","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T17:23:01Z","timestamp":1776100981000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Association of Physical Function With Psychosocial Patient\u2010Reported Outcomes in People With Systemic Lupus Erythematosus"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6858-4338","authenticated-orcid":false,"given":"Mrinalini","family":"Dey","sequence":"first","affiliation":[{"name":"Kings\u2019 College London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2686-7628","authenticated-orcid":false,"given":"Jessica","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"University of California  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7439-2316","authenticated-orcid":false,"given":"Maria","family":"Dall'Era","sequence":"additional","affiliation":[{"name":"University of California  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5770-1583","authenticated-orcid":false,"given":"Charmayne","family":"Dunlop\u2010Thomas","sequence":"additional","affiliation":[{"name":"Emory University  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5500-3709","authenticated-orcid":false,"given":"Courtney","family":"Hoge","sequence":"additional","affiliation":[{"name":"Emory University  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2361-0787","authenticated-orcid":false,"given":"S. Sam","family":"Lim","sequence":"additional","affiliation":[{"name":"Emory University  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8146-2519","authenticated-orcid":false,"given":"Patricia P.","family":"Katz","sequence":"additional","affiliation":[{"name":"University of California  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3508-4094","authenticated-orcid":false,"given":"Jinoos","family":"Yazdany","sequence":"additional","affiliation":[{"name":"University of California  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0809-8981","authenticated-orcid":false,"given":"Laura C.","family":"Plantinga","sequence":"additional","affiliation":[{"name":"University of California  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23536"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12962-015-0034-z"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25266"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2025.152709"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25446"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.2025-0314.POD05"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2019.02.004"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2023-001060"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2025-005661"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2024.103609"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2024-004171"},{"issue":"9","key":"e_1_2_6_13_1","article-title":"Physical function and performance in SLE: a comparison of two population\u2010based cohorts [abstract]","volume":"77","author":"Fitzpatrick J","year":"2025","journal-title":"Arthritis Rheumatol"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400928"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2020.07.002"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204053"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23238"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/PR9.0000000000001170"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2008.06.026"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200412000-00006"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1348\/135910705X53155"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-016-0534-3"},{"key":"e_1_2_6_24_1","unstructured":"HealthMeasures.General self\u2010efficacy and self\u2010efficacy for managing chronic conditions scoring manual.https:\/\/www.healthmeasures.net\/images\/PROMIS\/manuals\/Scoring_Manuals_\/PROMIS_Self_Efficacy_Managing_Chronic_Conditions_Scoring_Manual.pdf"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000258615.42478.55"},{"issue":"5","key":"e_1_2_6_26_1","first-page":"866","article-title":"A brief measure of helplessness in rheumatic disease: the helplessness subscale of the Rheumatology Attitudes Index","volume":"20","author":"DeVellis RF","year":"1993","journal-title":"J Rheumatol"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1191\/0961203303lu332oa"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20503"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2025.105902"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2023.101894"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2019.06.017"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24398"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/key398"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyp147"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr2.11590"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0000000000002204"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2018-000279"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25301"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2021-000566"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.2024-0961"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25076"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/41.2.184"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25321"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2025-001876"},{"issue":"3","key":"e_1_2_6_45_1","first-page":"525","article-title":"The relationship between health related quality of life and disease activity and damage in systemic lupus erythematosus","volume":"28","author":"Wang C","year":"2001","journal-title":"J Rheumatol"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24213"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24555"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.55563\/clinexprheumatol\/az3pkn"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21686"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41927-021-00191-6"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.80065","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acr.80065","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.80065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:45:19Z","timestamp":1777877119000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.80065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,3]]},"references-count":49,"alternative-id":["10.1002\/acr.80065"],"URL":"https:\/\/doi.org\/10.1002\/acr.80065","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,3]]},"assertion":[{"value":"2025-12-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"acr.80065"}}