Darjani Abbas, Heidarzadeh Abtin, Golchai Javad, Sadr-Eshkevari Shahrivar, Alizadeh Narges, Arami Maryam, Nichhah Nahid
Department of Dermatology, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Department of Community Medicine, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Int J Prev Med. 2014 Sep;5(9):1146-52.
Quality of life (QOL) is increasingly recognized as an important outcome measure in dermatology. Psoriasis has a great impact on QOL of patients, and has a strong effect on social relations, psychological status, and daily activities. This study describe and compare the impact of different grades of severity of psoriasis on QOL of patients in north of Iran.
This cross-sectional study was performed on 55 patients diagnosed with psoriasis and 55 healthy controls. The patients were selected by consecutive sampling from April to December 2006. The controls were recruited by simple random sampling among patient escorts. After obtaining written informed consent, all the members were included into the study. The Psoriasis Area and Severity Index (PASI) standard questionnaire was used to determine the severity of the disease. In addition, the short-form-36 questionnaire, which is validated for use in Iran, was employed. The gathered data were analyzed using the Stata (V 8.0, SE) (Copyright 1984-2003, Stata Corporation, 4905 Lakeway Drive Special Edition, College Station, Texas 77845 USA) and analyses of covariance (ANCOVA) test.
Overall, The mean PASI scores was 5.4 ± 6.7, total QOL scores had a significant difference between patients and controls (61.1 ± 17.0 vs. 71.9 ± 22.4) (P < 0.05), especially in three domains: Role-physical (58.5 ± 23.3 vs. 70.8 ± 26.2), general health (43.8 ± 21.6 vs. 61.5 ± 27.3), and social functioning (62.7 ± 26.7 vs. 79.5 ± 27.5) (P < 0.01). Physical activities were affected in >50% of the cases. This figure significantly increased with the increasing severity of psoriasis. In addition, social relationships were disrupted in more than half of the patients, but with no significant difference between different grades of severity (P > 0.05). There is no significant difference between adjusted score of multiple domains of QOL in psoriatic patients according to PASI levels (ANCOVA, P > 0.05).
The physicians' awareness of the importance of patients' QOL in both physical and emotional aspects could improve and enhance the psychological evaluation of the psoriatic patient, which will promote his/her positive outcome. And, PASI score can't to predict the QOL really.
生活质量(QOL)在皮肤病学中日益被视为一项重要的结局指标。银屑病对患者的生活质量有重大影响,对社会关系、心理状态和日常活动均有显著作用。本研究描述并比较了伊朗北部不同严重程度的银屑病对患者生活质量的影响。
本横断面研究对55例诊断为银屑病的患者和55例健康对照者进行。患者通过2006年4月至12月的连续抽样选取。对照者通过在患者陪同人员中简单随机抽样招募。在获得书面知情同意后,所有成员纳入研究。采用银屑病面积和严重程度指数(PASI)标准问卷确定疾病严重程度。此外,还使用了在伊朗经验证有效的简明健康调查问卷(Short-Form-36)。收集的数据使用Stata(V 8.0,SE)(版权所有1984 - 2003,Stata公司,美国得克萨斯州大学城莱克韦大道4905号特别版,邮编77845)和协方差分析(ANCOVA)检验进行分析。
总体而言,PASI平均得分为5.4±6.7,患者与对照者的总生活质量得分有显著差异(61.1±17.0对71.9±22.4)(P<0.05),尤其是在三个领域:生理功能(58.5±23.3对70.8±26.2)、总体健康状况(43.8±21.6对61.5±27.3)和社会功能(62.7±26.7对79.5±27.5)(P<0.01)。超过50%的病例身体活动受到影响。这一比例随银屑病严重程度的增加而显著上升。此外,超过一半的患者社会关系受到干扰,但不同严重程度等级之间无显著差异(P>0.05)。根据PASI水平,银屑病患者生活质量多个领域的调整得分无显著差异(ANCOVA,P>0.05)。
医生对患者生活质量在生理和情感方面重要性的认识可改善并加强对银屑病患者的心理评估,这将促进其积极预后。而且,PASI评分并不能真正预测生活质量。