Sundaramurthy S, Bush T M, Neuwelt C M, Ward M M
Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Lupus. 2003;12(6):443-8. doi: 10.1191/0961203303lu410oa.
Patients whose perspective is oriented to the future more than to the present may have better long-term health outcomes. We examined if time perspective predicted future organ damage in patients with systemic lupus erythematosus (SLE). We assessed the time perspectives of 87 patients with SLE using a questionnaire at a baseline visit. Permanent organ damage was assessed by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index during the same visit, and reassessed after a median of 4.6 years. Patients who were oriented more to the future were less likely to have an increase in the Damage Index than those oriented more to the present. In a multivariate analysis, each 1-point increase in the degree of orientation to the future (on a scale of 1-6) was associated with a 22% decrease in the likelihood that the Damage Index would increase over time (odds ratio 0.78; 95% confidence interval 0.64-0.94; P = 0.009). Other measures that predicted an increase in the Damage Index were lower education levels, greater health locus of control attributed to chance and greater health locus of control attributed to powerful others. In conclusion, time perspective is a significant predictor of future organ damage in SLE. Patients who have a greater orientation to the future are less likely to develop permanent organ damage.
展望未来而非着眼当下的患者可能会有更好的长期健康结果。我们研究了时间观是否能预测系统性红斑狼疮（SLE）患者未来的器官损害。我们在基线访视时使用问卷对87例SLE患者的时间观进行了评估。在同一次访视中，通过系统性红斑狼疮国际协作临床组/美国风湿病学会（SLICC/ACR）损伤指数评估永久性器官损害，并在中位时间4.6年后重新评估。与更着眼当下的患者相比，更着眼未来的患者损伤指数增加的可能性更小。在多变量分析中，未来取向程度每增加1分（范围为1 - 6分），损伤指数随时间增加的可能性降低22%（比值比0.78；95%置信区间0.64 - 0.94；P = 0.009）。其他预测损伤指数增加的因素包括较低的教育水平、更多归因于机遇的健康控制点以及更多归因于有影响力他人的健康控制点。总之，时间观是SLE患者未来器官损害的重要预测指标。更着眼未来的患者发生永久性器官损害的可能性较小。
