Opheim Randi, Fagermoen May Solveig, Bernklev Tomm, Jelsness-Jorgensen Lars-Petter, Moum Bjorn
Division of Medicine, Department of Gastroenterology, Oslo University Hospital, Nydalen, P.O. Box 4956, 0424, Oslo, Norway,
Qual Life Res. 2014 Mar;23(2):707-17. doi: 10.1007/s11136-013-0508-4. Epub 2013 Aug 23.
The purpose of the study was to examine fatigue interference with daily living in patients with inflammatory bowel disease (IBD) and to explore relationships between severe fatigue interference and socio-demographic and clinical variables, including use of complementary and alternative medicine (CAM).
Data were collected using self-report questionnaires from adult IBD outpatients. Fatigue interference was assessed with the 5-item Fatigue Severity Scale, and scores ≥ 5 were defined as severe fatigue interference. CAM use was assessed with the International CAM Questionnaire. Multivariate logistic regression analysis was used to examine associations between severe fatigue interference and socio-demographic factors, clinical factors, and CAM use.
In total, 428 patients had evaluable questionnaires (response rate 93 %). Severe fatigue interference was reported by 39 % of the total sample. Patients with Crohn's disease (CD) (n = 238) were more likely than patients with ulcerative colitis (UC) (n = 190) to report severe fatigue interference (43 and 33 %, respectively, p = 0.003). In addition, patients reporting severe fatigue interference were more likely to have active disease than patients without severe fatigue interference (p < 0.001 for both diagnoses). Patients with inactive disease had scores comparable to the general population. Factors independently associated with severe fatigue interference in UC included disease activity and CAM use, while in CD they included disease activity and current smoking.
Severe fatigue interference is common among IBD patients with active disease. Among patients with UC, but not CD, CAM use was associated with severe fatigue interference. The relationship between fatigue interference and personal factors should be considered further in subsequent studies.
本研究旨在调查炎症性肠病(IBD)患者疲劳对日常生活的干扰情况,并探讨严重疲劳干扰与社会人口学及临床变量之间的关系,包括补充和替代医学(CAM)的使用情况。
采用自填式问卷对成年IBD门诊患者进行数据收集。使用5项疲劳严重程度量表评估疲劳干扰情况,得分≥5分被定义为严重疲劳干扰。使用国际补充和替代医学问卷评估CAM的使用情况。采用多因素逻辑回归分析来研究严重疲劳干扰与社会人口学因素、临床因素及CAM使用之间的关联。
共有428例患者的问卷可用于评估(应答率93%)。总样本中有39%报告存在严重疲劳干扰。克罗恩病(CD)患者(n = 238)比溃疡性结肠炎(UC)患者(n = 190)更有可能报告严重疲劳干扰(分别为43%和33%,p = 0.003)。此外,报告有严重疲劳干扰的患者比无严重疲劳干扰的患者更有可能患有活动性疾病(两种诊断的p值均<0.001)。非活动性疾病患者的得分与一般人群相当。在UC中,与严重疲劳干扰独立相关的因素包括疾病活动度和CAM的使用,而在CD中则包括疾病活动度和当前吸烟情况。
严重疲劳干扰在患有活动性疾病的IBD患者中很常见。在UC患者中,而非CD患者中,CAM的使用与严重疲劳干扰有关。后续研究应进一步考虑疲劳干扰与个人因素之间的关系。