Introduction:
Chronic urticaria (CU) is a skin disorder in which red, swollen, itchy, and sometimes painful hives (wheals), angioedema, or both, repeatedly occur for more than 6 weeks.1 Prevalence is estimated up to 1% in the general population2, with those aged between 30 and 50 years most affected, and females affected approximately twice as often as males.3-6 The current guidelines classify CU as spontaneous (chronic spontaneous urticaria [CSU], with no specified eliciting factor involved) or inducible (chronic inducible urticaria [CIndU], with a specific eliciting factor involved).1 Patients may concurrently experience CSU and CIndU in approximately 20% of cases.4
Existing evidence indicates that symptoms of CU have a deleterious effect on the quality of life (QoL).2,7-9 It impacts daily activities and emotional well-being; some patients‘ health status is comparable to that of coronary artery disease and severe asthma patients. It also causes inconvenience in family structures, compromising performance at work, school, and negatively impacting on leisure activities. It compromises patients’ QoL, mainly those with more severe disease or who are diagnosed with chronic spontaneous urticaria.7,10 Until now there are no reliable biomarkers to identify and measure disease activity in CSU. Consequently, use of patient reported outcomes (PROs) is crucial when evaluating and monitoring different aspects of chronic urticaria such as disease activity/severity, disease control, and QoL. Five different PROs that measure various aspects of disease severity/activity and QoL are used routinely in research and clinical practice of chronic urticaria. Four of these PROs are urticaria-specific: weekly Urticaria Activity Score (UAS7); Urticaria Control Test (UCT); and Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL); two are angioedema-specific: Angioedema Activity Score (AAS) and Angioedema Quality of Life Questionnaire (AE-QoL).11-15
Numerous other factors also may influence QoL. Among those likely to be important is spiritual well-being (SpWB). Viewed as a multifaceted construct, SpWB usually refers to a sense of meaning or purpose in life, inner peace and harmony, and the strength and comfort drawn from faith.16 SpWB has been measured over two dimensions (Meaning/Peace and Faith). Recent studies suggest a broad protective relationship between religious participation and population health.17 Although a positive effect of addressing spirituality in health care has been proved in several chronic diseases, spiritual well-being in patients with CU has never received attention.
The aim of this study was to evaluate spirituality and QoL in CU subjects with different control levels (subjects with controlled CU and those with not controlled CU).