Centre for Palliative Medicine, Medical Ethics and Communication Skills, Medical School, University of Zagreb, Croatia.
Health Qual Life Outcomes. 2011 Jul 29;9:56. doi: 10.1186/1477-7525-9-56.
The aim of this study was to investigate the quality of life in Croatian homeland war veterans who suffer from post-traumatic stress disorder and chronic low back pain (LBP).
A total of 369 participants were included, classified in four study groups: those with post-traumatic stress disorder (PTSD; N = 59), those with both PTSD and lower back pain (PTSD+LBP; N = 80), those with isolated LBP (N = 95) and controls (N = 135). WHOQOL-BREF survey was used in the estimation of quality of life. The data were analysed using statistical methods and hierarchical clustering.
The results indicated a general pattern of lowering quality of life in participants with both psychological (PTSD) and physical (LBP) burden. The average overall quality of life was 2.82 ± 1.14 for the PTSD+LBP group, 3.29 ± 1.28 for the PTSD group, 4.04 ± 1.25 for the LBP group and 4.48 ± 0.80 for the controls (notably, all the pair-wise comparisons were significantly different at the level of P < 0.001, except for the pair LBP-controls, which was insignificant). This result indicated that quality of life was reduced for 9.9% in patients with LBP, 26.6% in patients with PTSD and 37.1% in PTSD+LBP, suggesting strong synergistic effect of PTSD and LBP. The analysis also identified several clusters of participants with different pattern of quality of life related outcomes, reflecting the complex nature of this indicator.
The results of this study reiterate strong impact of PTSD on quality of life, which is additionally reduced if the patient also suffers from LBP. PTSD remains a substantial problem in Croatia, nearly two decades after the beginning of the 1991-1996 Homeland war.
本研究旨在探讨患有创伤后应激障碍和慢性下腰痛（LBP）的克罗地亚本土战争退伍军人的生活质量。
共纳入 369 名参与者，分为四个研究组：创伤后应激障碍组（PTSD；N=59）、PTSD 合并下腰痛组（PTSD+LBP；N=80）、单纯下腰痛组（N=95）和对照组（N=135）。使用 WHOQOL-BREF 量表评估生活质量。采用统计方法和层次聚类分析对数据进行分析。
结果表明，患有心理（PTSD）和身体（LBP）负担的参与者的生活质量普遍下降。PTSD+LBP 组的平均总体生活质量为 2.82±1.14，PTSD 组为 3.29±1.28，LBP 组为 4.04±1.25，对照组为 4.48±0.80（值得注意的是，除 LBP-对照组外，所有组间比较均具有统计学意义，P<0.001，而 LBP-对照组无统计学意义）。这表明，LBP 患者的生活质量下降了 9.9%，PTSD 患者的生活质量下降了 26.6%，PTSD+LBP 患者的生活质量下降了 37.1%，提示 PTSD 和 LBP 具有很强的协同作用。分析还确定了几个生活质量相关结果的不同模式的参与者聚类，反映了该指标的复杂性。
本研究结果再次强调了 PTSD 对生活质量的强烈影响，如果患者还患有 LBP，则生活质量进一步降低。PTSD 仍然是克罗地亚的一个重大问题，距离 1991-1996 年家园战争开始近二十年。
