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生活满意度低与腰椎管狭窄症患者手术效果较差及抑郁相关:一项为期2年的前瞻性研究。

Life dissatisfaction is associated with a poorer surgery outcome and depression among lumbar spinal stenosis patients: a 2-year prospective study.

作者信息

Sinikallio Sanna, Aalto Timo, Koivumaa-Honkanen Heli, Airaksinen Olavi, Herno Arto, Kröger Heikki, Viinamäki Heimo

机构信息

Department of Rehabilitation, Kuopio University Hospital, Tarinan sairaala, Siilinjärvi, 71800, Kuopio, Finland.

出版信息

Eur Spine J. 2009 Aug;18(8):1187-93. doi: 10.1007/s00586-009-0955-3. Epub 2009 Apr 3.

Abstract

The aim of this study was to examine the life satisfaction of lumbar spinal stenosis (LSS) patients up to the 2-year postoperative phase. Patients (N = 102, mean age, 62 years) with symptomatic LSS underwent decompressive surgery. Data collection took place with the same set of questionnaires before surgery and 3 months, 6 months, 1 year and 2 years postoperatively. Life satisfaction was assessed with the four-item Life Satisfaction scale and depression symptoms with the 21-item Beck Depression Inventory (BDI). In addition, a depression burden variable was included, comprising the sum of preoperative, 3- and 6-month BDI scores. Physical functioning and pain were assessed with the Oswestry disability index, Stucki questionnaire, self-reported walking ability, visual analogy scale and pain drawing. Two years postoperatively, 18% of the LSS patients was dissatisfied with their lives. As a whole, the life satisfaction of the LSS patients improved during the postoperative follow-up, reaching the level of the healthy adult Finnish population. However, 2 years postoperatively, dissatisfied patients reported significantly more pain, a poorer functional ability and more depressive symptoms and depression than the patients who were satisfied with life. This difference was seen throughout the postoperative follow up. In regression analyses, the only significant associations were between the depression burden and postoperative life dissatisfaction. Thus, subjective well-being as well as depression among LSS patients should be assessed pre- and postoperatively in order to enable early intervention for those at risk of poorer life satisfaction.

摘要

本研究的目的是调查腰椎管狭窄症(LSS)患者术后长达2年的生活满意度。有症状的LSS患者(N = 102,平均年龄62岁)接受了减压手术。在手术前以及术后3个月、6个月、1年和2年,使用同一组问卷进行数据收集。使用四项生活满意度量表评估生活满意度,使用21项贝克抑郁量表(BDI)评估抑郁症状。此外,纳入了一个抑郁负担变量,包括术前、3个月和6个月的BDI得分总和。使用奥斯威斯残疾指数、斯图基问卷、自我报告的步行能力、视觉模拟量表和疼痛图评估身体功能和疼痛。术后两年,18%的LSS患者对自己的生活不满意。总体而言,LSS患者的生活满意度在术后随访期间有所提高,达到了芬兰健康成年人群的水平。然而,术后2年,不满意的患者报告的疼痛明显更多,功能能力更差,抑郁症状和抑郁程度比生活满意的患者更严重。这种差异在整个术后随访期间都存在。在回归分析中,唯一显著的关联是抑郁负担与术后生活不满意之间的关联。因此,应在术前和术后评估LSS患者的主观幸福感以及抑郁情况,以便对生活满意度可能较低的风险人群进行早期干预。

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