Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands.
J Crohns Colitis. 2013 Sep;7(8):e292-301. doi: 10.1016/j.crohns.2012.11.002. Epub 2012 Dec 4.
Crohn's disease (CD) negatively impact patients' health-related quality of life (HRQOL). We used the common sense model to examine the contribution of illness perceptions and coping to HRQOL, in addition to clinical and socio-demographic characteristics. This provides insight into potential targets for psychological interventions aimed at improving HRQOL.
Consecutive CD patients undergoing colonoscopy were included. Disease activity was assessed by a clinical and an endoscopic index. Patients completed questionnaires assessing illness perceptions (IPQ-R), coping (Utrecht Coping List), self-perceived health, neuroticism, and HRQOL. Hierarchical multiple regression analyses were performed to assess the contribution of illness perceptions and coping to HRQOL. Illness perceptions were compared to patients with rheumatoid arthritis, myocardial infarction (MI), and head and neck cancer (HNC).
Of 82 CD patients, mean age was 42±14years. Clinical and endoscopic active disease was present in 42 (52%) and 49 (60%) patients, respectively. HRQOL was strongly impaired by clinical active disease (r=-0.79), self-perceived health (r=-0.60), and perceived consequences of CD (r=-0.54), but correlated poorly with endoscopic disease activity (r=-0.29). Illness perceptions significantly contributed 3-27% to HRQOL. Coping had no contributory role. CD patients perceived similarly strong consequences of their illness as patients with MI and HNC and had the strongest thoughts about the chronic nature of their illness.
CD has a similar impact on patients' daily lives as was observed in patients with MI and HNC. Illness perceptions contribute to HRQOL and should therefore be incorporated in clinical practice, thereby improving HRQOL.
克罗恩病（CD）会对患者的健康相关生活质量（HRQOL）产生负面影响。我们使用常识模型来检验疾病认知和应对方式对 HRQOL 的贡献，以及临床和社会人口统计学特征。这为潜在的针对改善 HRQOL 的心理干预目标提供了深入了解。
纳入接受结肠镜检查的连续 CD 患者。通过临床和内镜指数评估疾病活动度。患者完成了评估疾病认知（IPQ-R）、应对方式（乌得勒支应对清单）、自我感知健康、神经质和 HRQOL 的问卷。进行分层多元回归分析，以评估疾病认知和应对方式对 HRQOL 的贡献。将疾病认知与类风湿关节炎、心肌梗死（MI）和头颈部癌症（HNC）患者进行比较。
82 例 CD 患者中，平均年龄为 42±14 岁。42 例（52%）和 49 例（60%）患者存在临床和内镜活动期疾病。临床活动期疾病（r=-0.79）、自我感知健康（r=-0.60）和 CD 的感知后果（r=-0.54）强烈损害了 HRQOL，但与内镜疾病活动度相关性差（r=-0.29）。疾病认知对 HRQOL 的贡献为 3-27%。应对方式没有贡献。CD 患者对疾病的后果与 MI 和 HNC 患者的感知相似强烈，对疾病的慢性性质有强烈的想法。
CD 对患者日常生活的影响与 MI 和 HNC 患者相似。疾病认知对 HRQOL 有贡献，因此应纳入临床实践，从而改善 HRQOL。
