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关于胃食管反流病的认知与信念:医生和患者意见不一。

Perceptions and beliefs concerning gastroesophageal reflux disease: physicians and patients disagree.

作者信息

Reimer Christina, Bytzer Peter

机构信息

Department of Medical Gastroenterology, Køge University Hospital, Køge, Denmark.

出版信息

Digestion. 2007;76(3-4):229-34. doi: 10.1159/000112650. Epub 2007 Dec 20.


DOI:10.1159/000112650
PMID:18097144
Abstract

BACKGROUND/AIM: There is insufficient evidence to support an association between lifestyle and gastroesophageal reflux disease (GERD). Furthermore, perceptions concerning the impact of GERD on lifestyle are largely unknown. We aimed at investigating physicians' perceptions about GERD and lifestyle and at evaluating physician-patient agreement concerning the impact of GERD on the quality of life. METHODS: A questionnaire was mailed to all Danish primary care physicians (n = 3,603, response rate 36%) and to all Danish gastroenterologists (n = 624, response rate 50%). Another questionnaire was completed by 176 GERD patients on medical therapy (84% on proton pump inhibitors). RESULTS: 35% of the physicians believe GERD is predominantly caused by lifestyle and 51% always recommend lifestyle modifications. According to the physicians, the three most frequently affected aspects of quality of life were sleep disturbances (24%), limitations in physical activities (22%) and tiredness (18%). However, according to the patients, the three most frequently reported aspects were dietary restrictions (63%), tiredness/lack of energy (49%) and health concerns (44%). 70% of the physicians considered complete absence of symptoms as a useful goal for therapy. 72% of the patients reported recent symptoms, despite therapy and self-imposed lifestyle restrictions. CONCLUSIONS: Physicians and GERD patients disagree on impairments of quality of life. Many patients reported frequent symptoms despite therapy and self-imposed lifestyle restrictions.

摘要

背景/目的:目前尚无充分证据支持生活方式与胃食管反流病(GERD)之间存在关联。此外,关于GERD对生活方式影响的认知情况在很大程度上尚不清楚。我们旨在调查医生对GERD与生活方式的看法,并评估医生与患者在GERD对生活质量影响方面的一致性。 方法:向所有丹麦初级保健医生(n = 3603,回复率36%)和所有丹麦胃肠病学家(n = 624,回复率50%)邮寄了一份问卷。另一份问卷由176名接受药物治疗的GERD患者填写(84%使用质子泵抑制剂)。 结果:35%的医生认为GERD主要由生活方式引起,51%的医生总是建议改变生活方式。据医生称,生活质量受影响最频繁的三个方面是睡眠障碍(24%)、身体活动受限(22%)和疲劳(18%)。然而,据患者称,报告最多的三个方面是饮食限制(63%)、疲劳/精力不足(49%)和健康担忧(44%)。70%的医生认为完全没有症状是治疗的一个有用目标。72%的患者报告尽管接受了治疗并自行实施了生活方式限制,但仍有近期症状。 结论:医生和GERD患者在生活质量受损方面存在分歧。许多患者报告尽管接受了治疗并自行实施了生活方式限制,但仍频繁出现症状。

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