Over-reaching beyond disease activity: the influence of anxiety and medical economic burden on health-related quality of life in patients with inflammatory bowel disease.
Over-reaching beyond disease activity: the influence of anxiety and medical economic burden on health-related quality of life in patients with inflammatory bowel disease.
复制标题
超越疾病活动：焦虑和医疗经济负担对炎症性肠病患者健康相关生活质量的影响。
DOI：
10.2147/ppa.s118589
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发表时间：
2017
影响因子：
2.2
通讯作者：
Chen MH
中科院分区：
文献类型：
--
作者：
Luo XP;Mao R;Chen BL;Qiu Y;Zhang SH;He Y;Chen J;Zeng ZR;Ben-Horin S;Chen MH
许多炎症性肠病(IBD)患者的健康相关生活质量(HRQOL)受损。在IBD中，心理和经济因素对HRQOL的影响尚未完全阐明。因此，我们的目标是在IBD队列中确定HRQOL的预测因素。这是一项横断面队列研究，研究对象是我们三级IBD中心的患者。采用36项简式健康调查问卷(SF-36)和炎症性肠病问卷(IBDQ)测量患者的HRQOL。采用医院焦虑抑郁量表(HADS)评定焦虑、抑郁情绪。同时采用标准化量表对患者的压力感和社会支持感进行评估。人口学、社会经济学和临床数据来自预先指定的问卷和患者的医疗记录。采用单因素分析和多元回归分析确定影响HRQOL的预测因素。共调查242例IBD患者，问卷回收率为90.5%(219/242)。焦虑和抑郁的患病率分别为24.7%和17.4%。总体而言，30.6%的患者花费了超过一半的收入来支付医疗费用。多因素分析显示，焦虑症状(P<；0.001)、活动性疾病(P<；0.001)和较高的医疗费用(P=0.001)是高危人群生活质量下降的独立预测因素。心理因素和医疗费用对IBD患者的HRQOL有很大影响，且与疾病活动无关。应考虑将心理咨询和社会经济支持计划整合到IBD患者的管理中。
Many patients with inflammatory bowel disease (IBD) have impaired health-related quality of life (HRQOL). The influence of psychological and economic factors on HRQOL has not been fully elucidated in IBD. Therefore, we aimed to identify the predictors of HRQOL in an IBD cohort. This was a cross-sectional cohort study of patients presenting to our tertiary IBD center. HRQOL was measured using the 36-item Short Form Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ). Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Perceived stress and perceived social support were also assessed by standardized scales. Demographic, socioeconomic and clinical data were obtained from a prespecified questionnaire and patients’ medical records. Univariate analyses and multiple regression analysis were performed to identify predictors of HRQOL. A total of 242 IBD patients were recruited, and the questionnaire return rate was 90.5% (219/242). The prevalence rates of anxiety and depression were 24.7% and 17.4%, respectively. In all, 30.6% of the patients spent over half of their income to cover medical costs. Multivariate analysis revealed that anxiety symptoms (P<0.001), active disease (P<0.001) and higher medical expenditures (P=0.001) were strong and independent predictors of reduced HRQOL. Psychological factors and costs of medical care strongly impair HRQOL in IBD, independent of the disease activity. Psychological counseling and socioeconomic support programs should be considered for integration into the management of IBD patients.