Dlova Ncoza C, Fabbrocini Gabriella, Lauro Carlo, Spano Maria, Tosti Antonella, Hift Richard H
Department of Dermatology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Section of Clinical, Allergological and Venereological Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
Int J Dermatol. 2016 Aug;55(8):875-81. doi: 10.1111/ijd.13042. Epub 2015 Nov 6.
Alopecia has been shown to have a significant impact on quality of life (QoL), particularly in women. However, there are no data for African populations. This study was conducted to pilot an original questionnaire and a model-based methodology to measure QoL and its determinants in a sample of South African Black women of African ancestry with alopecia.
Fifty participants aged 21-79 years were randomly chosen from patients presenting to dermatologists with alopecia. We used an original questionnaire consisting of 24 items grouped into those assessing the respective impacts of subjective symptoms, objective signs, and relationship issues, measured on a four-level scale. These were then combined using component-based structural equation modeling to return a QoL index (QLI) and to rank the factors contributing to this.
On a scale ranging from 0 (high QoL) to 100 (severely decreased QoL), we found a mean QLI of 67.7. The negative impact of alopecia on QoL was higher in younger patients than older patients. The factors with the highest impact were those relating to the subjective experience of alopecia and self-image (56.3%), followed by those relevant to relationships and interaction with other people (34.8%). The presence of objective symptoms and signs such as pruritus was of minor importance (8.9%).
Although not a life-threatening condition, alopecia may seriously impair QoL, particularly by inducing anxiety and reducing self-esteem among African women. Healthcare practitioners should be mindful of this and intervene appropriately to mitigate these effects.
脱发已被证明对生活质量（QoL）有重大影响，尤其是对女性。然而，目前尚无针对非洲人群的数据。本研究旨在试用一份原创问卷和一种基于模型的方法，以测量非洲血统的南非黑人脱发女性样本的生活质量及其决定因素。
从向皮肤科医生就诊的脱发患者中随机选取50名年龄在21 - 79岁之间的参与者。我们使用了一份由24个项目组成的原创问卷，这些项目分为评估主观症状、客观体征和人际关系问题各自影响的项目，采用四级量表进行测量。然后使用基于成分的结构方程模型将这些项目进行综合，得出生活质量指数（QLI）并对促成该指数的因素进行排名。
在从0（高生活质量）到100（生活质量严重下降）的量表上，我们发现平均QLI为67.7。脱发对生活质量的负面影响在年轻患者中高于老年患者。影响最大的因素是与脱发的主观体验和自我形象相关的因素（56.3%），其次是与人际关系和与他人互动相关的因素（34.8%）。诸如瘙痒等客观症状和体征的影响较小（8.9%）。
虽然脱发并非危及生命的疾病，但它可能严重损害生活质量，特别是通过引起焦虑和降低非洲女性的自尊。医疗从业者应注意到这一点，并进行适当干预以减轻这些影响。
