Sinikallio Sanna, Aalto Timo, Airaksinen Olavi, Herno Arto, Kröger Heikki, Savolainen Sakari, Turunen Veli, Viinamäki Heimo
Department of Rehabilitation, Kuopio University Hospital, Kuopio, Finland.
Eur Spine J. 2007 Jul;16(7):857-64. doi: 10.1007/s00586-006-0080-5. Epub 2006 Mar 15.
The objective of the study was to examine self-reported life satisfaction and associated factors in patients (n=100) with lumbar spinal stenosis (LSS) in secondary care level, selected for surgical treatment. Life satisfaction was assessed with the four-item Life Satisfaction scale. Depression was assessed with a 21-item Beck Depression Inventory (BDI). Psychological well-being was assessed with Toronto Alexithymia Scale and Sense of Coherence Scale. LSS related physical functioning and pain were assessed with Oswestry disability index, Stucki questionnaire, Visual Analogue Scale and pain drawings. All questionnaires were administered before surgical treatment of LSS. Results showed that 25% of the patients with LSS were found to be dissatisfied with life. In a univariate analysis, smoking, elevated subjective disability scores and extensive markings in the pain drawings were more common in the dissatisfied patients. The dissatisfied patients also showed lower coping resources, elevated alexithymia and depression scores, and were more often depressed. In multiple logistic regression analyses, only younger age and somatic comorbidity were associated with life dissatisfaction. This association remained significant even when the BDI score was added into the model. No other significant associations emerged. In conclusion, life dissatisfaction was rather common among preoperative LSS patients. Pain and constraints on everyday functioning were important correlates of life dissatisfaction. However, only younger age and somatic comorbidity were independently associated with life dissatisfaction. These results emphasize the importance of recognizing and assessing the effect of coexisting medical conditions and they need to be addressed in any treatment program.
本研究的目的是调查在二级医疗水平下被选作手术治疗的100例腰椎管狭窄症（LSS）患者自我报告的生活满意度及相关因素。采用四项生活满意度量表评估生活满意度。用21项贝克抑郁量表（BDI）评估抑郁状况。用多伦多述情障碍量表和连贯感量表评估心理健康状况。用Oswestry功能障碍指数、Stucki问卷、视觉模拟量表和疼痛图评估与LSS相关的身体功能和疼痛。所有问卷均在LSS手术治疗前进行。结果显示，25%的LSS患者对生活不满意。在单因素分析中，吸烟、主观残疾评分升高和疼痛图中有广泛标记在不满意患者中更为常见。不满意的患者还表现出较低的应对资源、较高的述情障碍和抑郁评分，且更常处于抑郁状态。在多元逻辑回归分析中，只有年龄较小和躯体合并症与生活不满意相关。即使将BDI评分纳入模型，这种关联仍然显著。未出现其他显著关联。总之，术前LSS患者中生活不满意相当普遍。疼痛和日常功能受限是生活不满意的重要相关因素。然而，只有年龄较小和躯体合并症与生活不满意独立相关。这些结果强调了认识和评估共存疾病影响的重要性，并且在任何治疗方案中都需要解决这些问题。
