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[银屑病对健康相关生活质量的影响]

[Impact of psoriasis on health-related quality of life].

作者信息

Ferrándiz Foraster Carlos, García-Díez Amaro, Lizán Tudela Luis, Bermúdez-Rey Lina, Badia Llach Xavier

机构信息

Departamento de Dermatología, Hospital Germans Trias i Pujol, Universidad Autónoma de Barcelona, Badalona, Barcelona, Spain.

出版信息

Med Clin (Barc). 2007 Mar 10;128(9):325-9. doi: 10.1157/13099796.

Abstract

BACKGROUND AND OBJECTIVE

Different studies have reported of physical, social and psychological disadvantages in patients with psoriasis. Nevertheless, its impact on the health-related quality of life is not clarified sufficiently. Our objective is to know the repercussion of the moderate-severe psoriasis on the health-related quality of life with the Psoriasis Disability Index (PDI).

PATIENTS AND METHOD

An observational, cross-sectional, international study developed in dermatology practices in Spain and Portugal. During a period of 9 months, 332 participating dermatologist included a minimum of 10 consecutive patients with moderate to severe psoriasis. The date report form includes information about the health-related quality of life (PDI), as well as objective variables of severity as body surface area and PASI (Psoriasis Area and Severity Index), pruritus, costs and willingness to pay.

RESULTS

A total of 3,320 patients were assessed. The majority of cases were males (57%) and the mean age at study inclusion time was 47 years. The mean value of the PDI was 8.93 (95% confidence interval, 7.83-9.21), which represents a percentage of global disability lower than 20%. The floor effect varies between 8.3% and 61.2%, and the ceiling effect varies between 0% and 3%. The correlations between the PDI and objective variables of severity (PASI and body surface area) were weak though statistically significant (p < 0.001) They all indicate that to higher severity of the psoriasis, upper negative impact in the health-related quality of life.

CONCLUSIONS

Psoriasis causes a negative impact in the health-related quality of life, though the magnitudes are weak and suggest some problems with the questionnaire. Possibly, the PDI reflects more the disability that the form in which the patients perceive and react to their state of health, and, several items seem to have a scanty applicability in the Spanish and Portuguese population. The PDI doesn't seem the appropriate instrument for this type of patients in our environment.

摘要

背景与目的

不同研究报道了银屑病患者存在身体、社会和心理方面的不利因素。然而,其对健康相关生活质量的影响尚未得到充分阐明。我们的目的是通过银屑病残疾指数(PDI)了解中重度银屑病对健康相关生活质量的影响。

患者与方法

在西班牙和葡萄牙的皮肤科诊所开展的一项观察性、横断面国际研究。在9个月的时间里,332名参与研究的皮肤科医生纳入了至少10例连续的中重度银屑病患者。数据报告表包括有关健康相关生活质量(PDI)的信息,以及严重程度的客观变量,如体表面积和银屑病面积和严重程度指数(PASI)、瘙痒、费用和支付意愿。

结果

共评估了3320例患者。大多数病例为男性(57%),研究纳入时的平均年龄为47岁。PDI的平均值为8.93(95%置信区间,7.83 - 9.21),这代表全球残疾百分比低于20%。地板效应在8.3%至61.2%之间变化,天花板效应在0%至3%之间变化。PDI与严重程度的客观变量(PASI和体表面积)之间的相关性较弱,尽管具有统计学意义(p < 0.001),它们均表明银屑病严重程度越高,对健康相关生活质量的负面影响越大。

结论

银屑病对健康相关生活质量有负面影响,尽管程度较弱,且提示该问卷存在一些问题。可能,PDI更多地反映了残疾情况,而非患者对自身健康状况的感知和反应形式,并且几个项目在西班牙和葡萄牙人群中的适用性似乎不足。在我们的环境中,PDI似乎不是这类患者的合适工具。

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