Tsutsumi Atsuro, Izutsu Takashi, Islam Akramul Md, Maksuda A N, Kato Hiroshi, Wakai Susumu
Hyogo Institute for Traumatic Stress, Kobe, Japan.
Soc Sci Med. 2007 Jun;64(12):2443-53. doi: 10.1016/j.socscimed.2007.02.014. Epub 2007 Mar 26.
The present study aims to determine the quality of life (QOL) and general mental health of leprosy patients compared with the general population, and evaluate contributing factors such as socio-economic characteristics and perceived stigma. A total of 189 patients (160 outpatients, 29 inpatients) and 200 controls without leprosy or other chronic diseases were selected from Dhaka district, Bangladesh, using stratified random sampling. A Bangladeshi version of a structured questionnaire including socio-demographic characteristics-the Bangla version of the World Health Organization Quality of Life Assessment BREF (WHOQOL-BREF)-was used to assess QOL; a Self-Reporting Questionnaire (SRQ) was used to evaluate general mental health; the Barthel Index to control activities of daily living (ADL); and the authors' Perceived Stigma Questionnaire was used to assess perceived stigma of patients with leprosy. Medical records were examined to evaluate disability grades and impairment. QOL and general mental health scores of leprosy patients were worse than those of the general population. Multiple regression analysis revealed that factors potentially contributing to the deteriorated QOL of leprosy patients were the presence of perceived stigma, fewer years of education, the presence of deformities, and a lower annual income. Perceived stigma showed the greatest association with adverse QOL. We conclude that there is an urgent need for interventions sensitive to the effects of perceived stigma, gender, and medical conditions to improve the QOL and mental health of Bangladeshi leprosy patients.
本研究旨在确定麻风病患者与普通人群相比的生活质量(QOL)和总体心理健康状况,并评估社会经济特征和感知耻辱等影响因素。采用分层随机抽样方法,从孟加拉国达卡地区选取了189例患者(160例门诊患者,29例住院患者)和200例无麻风病或其他慢性病的对照者。使用一份包括社会人口学特征的孟加拉语版结构化问卷——世界卫生组织生活质量评估简表(WHOQOL - BREF)的孟加拉语版——来评估生活质量;使用自评问卷(SRQ)来评估总体心理健康状况;使用巴氏指数来控制日常生活活动(ADL);并使用作者的感知耻辱问卷来评估麻风病患者的感知耻辱。检查病历以评估残疾等级和损伤情况。麻风病患者的生活质量和总体心理健康得分低于普通人群。多元回归分析显示,可能导致麻风病患者生活质量恶化的因素包括存在感知耻辱、受教育年限较少、存在畸形以及年收入较低。感知耻辱与不良生活质量的关联最为显著。我们得出结论,迫切需要采取对感知耻辱、性别和医疗状况影响敏感的干预措施,以改善孟加拉国麻风病患者的生活质量和心理健康。