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肌强直性营养不良症:患者及其伴侣的负担。

Myotonic dystrophy: the burden for patients and their partners.

机构信息

Department of Medical Psychology and Psychotherapy, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands.

出版信息

J Rehabil Med. 2010 Oct;42(9):823-30. doi: 10.2340/16501977-0598.

Abstract

OBJECTIVE

Dystrophia myotonica is characterized by progressive muscular weakness, myotonia, mental slowness and lack of initiative, which causes problems in daily life both for patients and for their spouses. Some couples seem to deal with these problems satisfactorily, while for others they are quite burdensome. The aim of this study was to describe the relationship of severity of dystrophia myotonica and psychological wellbeing in patients and partners.

METHODS

Sixty-nine couples, in whom one partner had dystrophia myotonica, completed questionnaires on severity of dystrophia myotonica, marital satisfaction, anxiety and depression (Hospital Anxiety and Depression Scale), hopelessness (Beck Hopelessness Scale) and general psychological health (General Health Questionnaire-12).

RESULTS

For patients, a worse view of the future, worse general wellbeing, more anxiety and more depression was associated with a greater need for help. For partners, worse general wellbeing and more anxiety was associated with a lack of initiative of the patient and less marital satisfaction. It is noteworthy that 40% of patients and particularly female partners had Beck Hopelessness Scale scores suggestive of clinically relevant depression.

CONCLUSION

Dystrophia myotonica places a heavy burden on patients, and especially on female partners. The need for help and dependency has more influence on the wellbeing of patients than the symptoms of dystrophia myotonica themselves. Marital satisfaction is a strong predictor of better wellbeing, both for patients and, even more so, for partners.

摘要

目的

肌强直性营养不良的特征是进行性肌肉无力、肌强直、精神迟钝和缺乏主动性,这给患者及其配偶的日常生活都带来了问题。有些夫妇似乎能够很好地应对这些问题,而有些夫妇则感到相当沉重。本研究的目的是描述肌强直性营养不良患者及其配偶的疾病严重程度与心理健康之间的关系。

方法

69 对夫妇中,一方患有肌强直性营养不良,他们完成了关于肌强直性营养不良严重程度、婚姻满意度、焦虑和抑郁(医院焦虑和抑郁量表)、绝望(贝克绝望量表)和一般心理健康(一般健康问卷-12)的问卷。

结果

对于患者,对未来的看法越差、一般健康状况越差、焦虑越多和抑郁越多,对帮助的需求就越大。对于伴侣,一般健康状况越差和焦虑越多,与患者缺乏主动性和婚姻满意度较低有关。值得注意的是,40%的患者,特别是女性伴侣的贝克绝望量表得分表明存在临床相关的抑郁。

结论

肌强直性营养不良给患者,特别是女性伴侣带来了沉重的负担。对帮助的需求和依赖性对患者的幸福感的影响大于肌强直性营养不良本身的症状。婚姻满意度是患者及其配偶更好的幸福感的有力预测因素,尤其是对配偶的影响更为显著。

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