Zutshi M, Hull T L, Hammel J
Department of Colorectal Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Desk A-30, Cleveland, OH 44195, USA.
Int J Colorectal Dis. 2007 Dec;22(12):1437-44. doi: 10.1007/s00384-007-0332-9. Epub 2007 Jul 31.
As healthcare providers for Crohn's disease, we assume that we have a good understanding of the disease progression and its symptoms. The aim of this study was to gather information about what patients with Crohn's disease think are relevant to their symptoms and what helps them cope with this lifelong benign disease.
A questionnaire was sent to all patients with a diagnosis of Crohn's disease seen in the Digestive Disease Center in the last 5 years. The returned forms were downloaded into a database and sent for analysis.
Sixty-two percent of respondents were female. One third were between the ages of 35 and 50 years. Seventy percent were married. Thirty-eight percent had a graduate degree, 19% were unemployed. Fifty percent still smoked, half of them less than one pack a day. Sixty-eight percent said that their symptoms affected work, and one fourth changed jobs due to this. Foods worsened symptoms in 60%, with a decrease in symptoms while on low fiber foods and white meats. Lifestyle change worsened symptoms in 66%. A change in the caregiver was not a significant stressor. More than half used Remicade, with one third stating that it was helpful. Eight percent had never used steroids. Alcohol increased symptoms in 40%. Factors that did not cause a significant change were children at any age, pregnancy, menopause, and hormone replacement therapy. Surgery caused half the patients to improve for many years, although one third felt a lowered self-esteem postoperatively.
Patients with Crohn's disease should be managed in a more comprehensive manner to provide optimal care. Thus, a team approach that includes a dietician and counselor should be considered as an integral part of this team. This will allow patients to have enhanced skills to cope with changes in their symptoms, whether they are due to the disease itself or the changes in their routine.
作为克罗恩病的医疗服务提供者，我们认为自己对该病的进展及其症状有很好的了解。本研究的目的是收集有关克罗恩病患者认为与其症状相关的信息，以及哪些因素有助于他们应对这种终身性良性疾病。
向过去5年在消化疾病中心就诊的所有诊断为克罗恩病的患者发送了一份问卷。回收的表格被下载到数据库中并送去进行分析。
62%的受访者为女性。三分之一的患者年龄在35至50岁之间。70%已婚。38%拥有研究生学位，19%失业。50%的患者仍在吸烟，其中一半每天吸烟量少于一包。68%的患者表示其症状影响工作，四分之一的患者因此更换了工作。60%的患者表示食物会使症状加重，食用低纤维食物和白肉时症状会减轻。66%的患者表示生活方式的改变会使症状加重。照顾者的更换不是一个显著的压力源。超过一半的患者使用类克，三分之一的患者表示该药有帮助。8%的患者从未使用过类固醇。40%的患者表示饮酒会使症状加重。任何年龄段的子女、怀孕、绝经和激素替代疗法等因素不会导致症状发生显著变化。手术使一半的患者多年来病情好转，尽管三分之一的患者术后感到自尊心下降。
应采用更全面的方式管理克罗恩病患者，以提供最佳护理。因此，应考虑将包括营养师和咨询师在内的团队方法作为该团队的一个组成部分。这将使患者有更强的能力应对症状变化，无论这些变化是由疾病本身还是日常习惯的改变引起的。
