Aymerich Marta, Guillamón Imma, Jovell Albert J
Medical Sciences Department, University of Girona, Catalonia, Spain;
Patient Prefer Adherence. 2009 Nov 3;3:311-21. doi: 10.2147/ppa.s6217.
To measure the health-related quality of life (HRQoL) of multiple sclerosis (MS) patients and their caregivers, and to assess which factors can best describe HRQoL.
A cross-sectional multicenter study of nine hospitals enrolled MS patients and their caregivers who attended outpatient clinics consecutively. The instruments used were the SF-36 for patients and the SF-12 and GHQ-12 for caregivers. Classification and regression tree analysis was used to analyze the explanatory factors of HRQoL.
A total of 705 patients (mean age 40.4 years, median Expanded Disability Status Scale 2.5, 77.8% with relapsing-remitting MS) and 551 caregivers (mean age 45.4 years) participated in the study. MS patients had significantly lower HRQoL than in the general population (physical SF-36: 39.9; 95% confidence interval [CI]: 39.1-40.6; mental SF-36: 44.4; 95% CI: 43.5-45.3). Caregivers also presented lower HRQoL than general population, especially in its mental domain (mental SF-12: 46.4; 95% CI: 45.5-47.3). Moreover, according to GHQ-12, 27% of caregivers presented probable psychological distress. Disability and co-morbidity in patients, and co-morbidity and employment status in caregivers, were the most important explanatory factors of their HRQoL.
Not only the HRQoL of patients with MS, but also that of their caregivers, is indeed notably affected. Caregivers' HRQoL is close to population of chronic illness even that the patients sample has a mild clinical severity and that caregiving role is a usual task in the study context.
测量多发性硬化症(MS)患者及其照料者的健康相关生活质量(HRQoL),并评估哪些因素能最好地描述HRQoL。
一项在九家医院开展的横断面多中心研究,纳入连续就诊于门诊的MS患者及其照料者。患者使用SF-36量表,照料者使用SF-12和GHQ-12量表。采用分类与回归树分析来分析HRQoL的解释因素。
共有705例患者(平均年龄40.4岁,扩展残疾状态量表中位数为2.5,77.8%为复发缓解型MS)和551名照料者(平均年龄45.4岁)参与研究。MS患者的HRQoL显著低于一般人群(身体维度SF-36:39.9;95%置信区间[CI]:39.1 - 40.6;心理维度SF-36:44.4;95% CI:43.5 - 45.3)。照料者的HRQoL也低于一般人群,尤其是在心理领域(心理维度SF-12:46.4;95% CI:45.5 - 47.3)。此外,根据GHQ-12量表,27%的照料者存在可能的心理困扰。患者的残疾和合并症,以及照料者的合并症和就业状况,是其HRQoL最重要的解释因素。
不仅MS患者的HRQoL,而且其照料者的HRQoL确实受到显著影响。即使患者样本临床严重程度较轻且照料角色在研究背景中是一项常见任务,但照料者的HRQoL接近慢性病患者群体。