Shawaryn M A, Schiaffino K M, LaRocca N G, Johnston M V
Kessler Medical Rehabilitation Research and Education Corporation, West Orange, New Jersey 07052, USA.
Mult Scler. 2002 Aug;8(4):310-8. doi: 10.1191/1352458502ms808oa.
The relationship between the cognitive and physical aspects of multiple sclerosis (MS) and health-related quality of life (HRQL) was examined with particular focus on illness intrusiveness as a mediator of this relationship. Disease severity, cognitive functioning HRQL, depression, and illness intrusiveness were assessed in 90 patients with MS. Disease severity (Expanded Disability Status Scale [EDSS]) predicted physical aspects of HRQL (SF-36 Physical Component Summary [PCS], fatigue, and bladder control). Information-processing speed (Paced Auditory Serial Addition Test [PASAT]) predicted mental and emotional aspects of HRQL (SF-36 Mental Component Summary [MCS]). However, both the EDSS and the PASAT predicted depression. Illness intrusiveness was significantly correlated with all indicators of HRQL Illness intrusiveness also mediated the manner in which disease severity predicted: physical health, fatigue, and depression. Results underscore the need to assess MS and its impact more broadly rather than relying on traditional mobility-centered assessments. While in most cases physical indices of disease predict physical quality of life and cognitive assessments predict mental and emotional quality of life, the individuals perception of MS is also a major factor contributing to quality of life. MS dearly affects multiple aspects of life and activity, as illustrated by the broad and powerful network of relationships between illness intrusiveness and all aspects of HRQL Perceptions of illness intrusiveness appear to be a central and essential measure of the impact of MS on HRQL.
研究了多发性硬化症（MS）的认知和身体方面与健康相关生活质量（HRQL）之间的关系，特别关注疾病侵扰作为这种关系的中介作用。对90例MS患者评估了疾病严重程度、认知功能、HRQL、抑郁和疾病侵扰情况。疾病严重程度（扩展残疾状态量表[EDSS]）可预测HRQL的身体方面（SF-36身体成分总结[PCS]、疲劳和膀胱控制）。信息处理速度（听觉连续加法测试[PASAT]）可预测HRQL的心理和情感方面（SF-36心理成分总结[MCS]）。然而，EDSS和PASAT均能预测抑郁。疾病侵扰与HRQL的所有指标均显著相关。疾病侵扰还介导了疾病严重程度对身体健康、疲劳和抑郁的预测方式。结果强调需要更广泛地评估MS及其影响，而不是依赖于传统的以活动能力为中心的评估。虽然在大多数情况下，疾病的身体指标可预测身体生活质量，认知评估可预测心理和情感生活质量，但个体对MS的认知也是影响生活质量的一个主要因素。MS明显影响生活和活动的多个方面，疾病侵扰与HRQL各方面之间广泛而强大的关系网络就说明了这一点。对疾病侵扰的认知似乎是MS对HRQL影响的核心且重要的衡量指标。
