University of North Carolina (UNC) Thurston Arthritis Research Center, Chapel Hill, North Carolina, USA.
J Rheumatol. 2011 Apr;38(4):709-15. doi: 10.3899/jrheum.100808. Epub 2011 Feb 1.
Few studies have investigated whether the utility of social support for patients with a relapsing, remitting illness varies by activity level of the disease. Our goal was to determine whether disease status (relapse vs remission) moderates the effect of medication-related support from physicians and partners on the health-related quality of life (HRQOL) of patients with vasculitis.
Patients with vasculitis (n = 228) completed baseline measures of disease status and medication-related support and a 3-month followup measure of HRQOL (RAND 36-item health survey 1.0). We calculated 8 HRQOL dimensions: physical functioning, physical role limitations, bodily pain, general health, vitality, social functioning, emotional role limitations, and mental health. Bonferroni-corrected t tests compared the HRQOL of patients in relapse to patients in remission, and multivariate analysis of covariance determined whether disease status moderated the effect of medication-related support from physicians and partners on patient HRQOL. Wilks' lambda assessed whether the support-by-disease status interaction terms were significant.
Relapsing patients reported significantly worse quality of life compared with nonrelapsing patients for every HRQOL dimension except physical role limitations. Disease status did not moderate the effect of physician (lambda = 0.48; p = 0.86) or partner (lambda = 1.51; p = 0.16) medication-related support on HRQOL, although greater physician and partner support predicted better HRQOL for all dimensions except bodily pain and vitality.
Vasculitis patients experience compromised HRQOL but the magnitude of the compromise is greater for patients experiencing a relapse. Medication-related support from physicians and partners is beneficial for patients' HRQOL regardless of disease status.
很少有研究调查复发缓解性疾病患者的社会支持效用是否因疾病活动水平而异。我们的目标是确定疾病状态(复发与缓解)是否调节了医生和伴侣提供的与药物相关的支持对血管炎患者健康相关生活质量(HRQOL)的影响。
血管炎患者(n=228)完成了疾病状态和与药物相关的支持的基线测量以及 3 个月的 HRQOL 随访(RAND 36 项健康调查 1.0)。我们计算了 8 个 HRQOL 维度:身体机能、身体角色限制、身体疼痛、总体健康、活力、社会功能、情感角色限制和心理健康。Bonferroni 校正的 t 检验比较了复发患者和缓解患者的 HRQOL,多元协方差分析确定了疾病状态是否调节了医生和伴侣提供的与药物相关的支持对患者 HRQOL 的影响。Wilks' lambda 评估了支持与疾病状态交互项是否显著。
与非复发患者相比,复发患者在除身体角色限制外的每个 HRQOL 维度上报告的生活质量都明显更差。尽管医生和伴侣提供的更多支持可以预测除身体疼痛和活力外的所有维度的 HRQOL,但疾病状态并没有调节医生(lambda=0.48;p=0.86)或伴侣(lambda=1.51;p=0.16)提供的与药物相关的支持对 HRQOL 的影响。
血管炎患者的 HRQOL 受损,但复发患者的受损程度更大。医生和伴侣提供的与药物相关的支持对患者的 HRQOL 有益,无论疾病状态如何。