Department of Health Sciences, Buskerud University College, Drammen, Norway.
J Eur Acad Dermatol Venereol. 2012 Jan;26(1):29-35. doi: 10.1111/j.1468-3083.2011.04000.x. Epub 2011 Mar 8.
Patients with psoriasis commonly report severe sensory skin symptoms, sleep disturbance, psychological distress and impaired health related quality of life (HRQoL). However, the complex associations among these factors are poorly investigated in this patient group.
The purpose of this study was to investigate the association between skin pain or skin discomfort and HRQoL, and explore whether sleep disturbance and psychological distress were mediators of these associations.
A total of 139 psoriasis patients from a university hospital setting participated in this exploratory, cross-sectional study. Data were obtained through interviews and questionnaires (Dermatology Life Quality Index, General Sleep Disturbance Scale, Illness Perception Questionnaire) and analysed using a series of multiple regression analyses. HRQoL was the dependent variable. Independent variables and assumed mediators were entered into the model in a predefined order.
Skin pain, skin discomfort, sleep disturbance and psychological distress were significantly associated with HRQoL (all P < 0.05). Sleep disturbance was a partial mediator for the association between skin pain and HRQoL. No such mediation effect was found in terms of psychological distress. The total model explained 40% of the variance in HRQoL.
In this study, skin pain and skin discomfort were significantly related to HRQoL when controlling for demographic and clinical characteristics. In addition, sleep disturbance mediated the association between skin pain and HRQoL. An understanding of the complex association among physiological and psychological factors, and HRQoL is clinically important in order to provide proper treatment and care of patients with psoriasis.
银屑病患者常报告严重的皮肤感觉症状、睡眠障碍、心理困扰和健康相关生活质量(HRQoL)受损。然而,在这一患者群体中,这些因素之间的复杂关联尚未得到充分研究。
本研究旨在探讨皮肤疼痛或不适与 HRQoL 之间的关联,并探讨睡眠障碍和心理困扰是否是这些关联的中介因素。
本研究共纳入了来自大学医院的 139 名银屑病患者,采用探索性横断面研究设计。通过访谈和问卷调查(皮肤病生活质量指数、一般睡眠障碍量表、疾病感知问卷)获取数据,并采用一系列多元回归分析进行分析。HRQoL 为因变量。独立变量和假设的中介变量按照预定的顺序输入模型。
皮肤疼痛、皮肤不适、睡眠障碍和心理困扰均与 HRQoL 显著相关(均 P<0.05)。睡眠障碍是皮肤疼痛与 HRQoL 之间关联的部分中介因素。然而,在心理困扰方面,未发现这种中介效应。该模型总共解释了 HRQoL 变异的 40%。
在本研究中,控制人口统计学和临床特征后,皮肤疼痛和皮肤不适与 HRQoL 显著相关。此外,睡眠障碍介导了皮肤疼痛与 HRQoL 之间的关联。了解生理和心理因素与 HRQoL 之间的复杂关联在临床实践中非常重要,以便为银屑病患者提供适当的治疗和护理。