Factors impacting on quality of life in Parkinson's disease: Results from an international survey
Factors impacting on quality of life in Parkinson's disease: Results from an international survey
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DOI：
10.1002/mds.10010
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发表时间：
2002
影响因子：
8.6
通讯作者：
L. Findley;T. Eichhorn;A. Janča;J. Kazenwadel;M. Baker;D. Currie-Gnjesda;K. Hughes;W. Koller;A. Liebermann;Y. Mizuno;A. Rajput;S. Roy;F. Stocchi;B. Tewarie;E. Tolosa
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文献类型：
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作者：
L. Findley;T. Eichhorn;A. Janča;J. Kazenwadel;M. Baker;D. Currie-Gnjesda;K. Hughes;W. Koller;A. Liebermann;Y. Mizuno;A. Rajput;S. Roy;F. Stocchi;B. Tewarie;E. Tolosa
由于缺乏对影响健康相关生活质量（HRQL）的因素的了解，目前帕金森病（PD）患者治疗的管理指南存在局限性。为了评估PD患者的HRQL，并系统地识别和评估这些因素（除了可能产生影响的疾病严重程度和药物），我们对PD患者、护理人员和临床医生进行了横断面、随机选择、多中心的国际调查。在六个国家进行了面对面的访谈。疾病严重程度、药物治疗和其他假设影响HRQL的因素采用特别开发的问卷和经过验证的工具进行评估，包括帕金森病问卷- 39 （HRQL）、Hoehn和Yahr分期（疾病严重程度）和Beck抑郁量表（BDI；抑郁）。使用多元线性回归模型来证明所调查的因素是否对HRQL有显著贡献。结果表明，Hoehn和Yahr分期和用药仅解释了PD患者HRQL变异的17.3%，但两者均具有显著性（R2 = 0.173, P < 0.05）。其他因素的解释能力均有提高，调整后的R2 = 0.597，其中BDI是HRQL变异性最显著的预测因子（调整后的R2 = 0.582, P < 0.001），其次是“对诊断时病情的解释满意度”和“当前乐观情绪”（P均< 0.05）。这些因素，加上疾病严重程度和药物治疗，解释了人群中HRQL差异的59.7%。总之，PD患者的抑郁程度（以BDI衡量）、“对诊断时病情解释的满意度”和“当前乐观情绪”对HRQL有显著影响。这项初步分析的完成是朝着制定真正影响PD患者HRQL的管理指南迈出的第一步。©2001运动障碍学会。
Current management guidelines for the treatment of patients with Parkinson's disease (PD) are limited due to the lack of knowledge of factors that influence health‐related quality of life (HRQL). To assess the HRQL of people with PD, and to systematically identify and evaluate those factors (other than disease severity and medication, which could have an impact), we undertook a cross‐sectional, randomized selection, multicenter international survey of patients with PD, caregivers, and clinicians. Face‐to‐face interviews were conducted with subjects in six countries. Disease severity, medication, and other factors hypothesized to influence HRQL were assessed using a combination of specially developed questionnaires and validated instruments including the Parkinson's Disease Questionnaire‐39 (HRQL), Hoehn and Yahr Stage (disease severity), and Beck's Depression Inventory (BDI; depression). Multiple linear regression models were used to demonstrate whether the factors investigated contribute significantly to HRQL. The results obtained indicated that Hoehn and Yahr stage and medication explained only 17.3% of the variability in HRQL of patients with PD, although both were significant (R2 = 0.173, P < 0.05). Other factors increased the explanatory power to adjusted R2 = 0.597, with BDI being the most significant predictor of variability in HRQL (adjusted R2 = 0.582; P < 0.001), followed by “Satisfaction with the explanation of the condition at diagnosis” and “Current feelings of optimism” (both P < 0.05). These factors, in addition to disease severity and medication, explain 59.7% of the variability in HRQL across the population. In conclusion, depression (as measured by the BDI) in PD, “satisfaction with the explanation of the condition at diagnosis” and “current feelings of optimism” have a significant impact on HRQL. The completion of this initial analysis is the first step towards developing management guidelines that truly influence the HRQL of patients with PD. © 2001 Movement Disorder Society.