Department of General Internal Medicine, Bern University Hospital, Inselspital, and University of Bern, Switzerland.
Thromb Haemost. 2009 Dec;102(6):1219-26. doi: 10.1160/TH09-05-0316.
Health-related quality of life (QoL) has been associated with several social and medical conditions in patients with deep vein thrombosis (DVT) and pulmonary embolism (PE). To the best of our knowledge, there is no study investigating the relationship of QoL with psychological variables in this patient population. We assumed as a hypothesis an association between heightened levels of fatigue and psychological distress, as well as decreased QoL in patients with an objectively diagnosed venous thromboembolic event. Study participants were 205 consecutively enrolled out-patients (47.4 years, 54.6% men) with DVT and/or PE. Approximately 10 days before blood collection for thrombophilia work-up, QoL, fatigue, and psychological distress were assessed using the Short Form Health Survey (SF-12), the Multidimensional Fatigue Symptom Inventory Short Form (MFSI-SF) as well as the Hospitality Anxiety and Depression scale (HADS). After controlling for demographic and medical factors, fatigue (p < 0.01) but not psychological distress (p>0.05) was negatively associated with physical QoL, explaining 11.0% of the variance. Fatigue (p < 0.001) and psychological distress (p < 0.001) were significant predictors of mental QoL, explaining an additional 36.2% and 3.6% of the variance. Further analyses revealed that all subscales of the HADS (e.g. anxiety and depression) and of the MFSI-SF (e.g. general fatigue, physical fatigue, emotional fatigue, mental fatigue and vigor) were significant predictors of mental QoL. MFSI-SF subscales also predicted physical QoL. The findings suggest that fatigue and psychological distress substantially predict QoL in patients with a previous venous thromboembolic event above and beyond demographic factors.
健康相关生活质量（QoL）与深静脉血栓形成（DVT）和肺栓塞（PE）患者的多种社会和医疗状况有关。据我们所知，在这一患者群体中，尚无研究调查 QoL 与心理变量之间的关系。我们假设，患有客观诊断的静脉血栓栓塞事件的患者中，疲劳程度升高和心理困扰以及 QoL 降低之间存在关联。研究参与者为 205 名连续入组的门诊患者（47.4 岁，54.6%为男性），患有 DVT 和/或 PE。在进行血栓形成倾向检查的血液采集前约 10 天，使用简短健康调查（SF-12）、多维疲劳症状量表简表（MFSI-SF）和 Hospitality 焦虑和抑郁量表（HADS）评估 QoL、疲劳和心理困扰。在控制人口统计学和医学因素后，疲劳（p<0.01）但不是心理困扰（p>0.05）与身体 QoL 呈负相关，解释了 11.0%的方差。疲劳（p<0.001）和心理困扰（p<0.001）是心理 QoL 的重要预测因素，分别解释了另外 36.2%和 3.6%的方差。进一步分析表明，HADS 的所有子量表（例如焦虑和抑郁）和 MFSI-SF 的所有子量表（例如一般疲劳、身体疲劳、情绪疲劳、精神疲劳和活力）都是心理 QoL 的重要预测因素。MFSI-SF 子量表也预测了身体 QoL。这些发现表明，疲劳和心理困扰在患有先前静脉血栓栓塞事件的患者中，除了人口统计学因素外，还极大地预测了 QoL。
