Muller Ashley E, Skurtveit Svetlana, Clausen Thomas
Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Postbox 1171 Blindern, 0318, Oslo, Norway.
Department of Pharmacoepidemiology, Division of Epidemiology, The Norwegian Institute of Public Health, Oslo, Norway.
Health Qual Life Outcomes. 2016 Mar 3;14:39. doi: 10.1186/s12955-016-0439-1.
Quality of life (QoL) is an important measure and outcome within chronic disease management and treatment, including substance use disorders (SUD). The aim of this paper was to investigate correlates of poorer QoL of individuals entering SUD treatment in Norway, in order to identify subgroups that may most benefit from different interventions.
Twenty-one treatment facilities invited all incoming patients to participate. Five hundred forty-nine patients who enrolled between December 2012 and April 2015 are analyzed. QoL, substance use, mental and physical comorbidities, and exercise behaviors were measured. Multinomial regression analysis was used to determine variables significantly associated with poorer QoL.
The majority of both genders (75 %) reported "poor" or "very poor" QoL at intake. Depression showed a strong association with poor QoL (relative risk ratio [RRR] 3.3, 95 % confidence interval [CI] 1.0-10.3) and very poor QoL (RRR 3.8, 1.2-11.8) among women. Physical inactivity among men was associated with very poor QoL (RRR 2.0, 1.1-3.7), as was reporting eating most meals alone (RRR 2.6, 1.4-4.8). Evaluating one's weight as too low was also associated with poor QoL (RRR 2.0, 1.0-3.9) and very poor QoL (RRR 2.0, 1.1-3.7) among men. Consuming methadone/buprenorphine was a protective factor for men reporting poor QoL (RRR 0.5, 0.3-0.9) and very poor QoL (RRR 0.4, 0.2-0.9), as well as for women reporting very poor QoL (RRR 0.2, 0.0-0.6).
Factors associated with poorer QoL among other healthy and clinical populations, such as impaired social and physical well-being and psychological distress, were also seen associated in this sample. Treatment should be targeted towards patients with these particular vulnerabilities in addition to focusing on substance-related factors, and interventions proven to improve the QoL of other populations with these vulnerabilities should be explored in a SUD context.
生活质量（QoL）是慢性病管理和治疗（包括物质使用障碍，SUD）中的一项重要衡量指标和结果。本文旨在调查挪威接受SUD治疗的个体生活质量较差的相关因素，以便确定可能从不同干预措施中获益最多的亚组。
21个治疗机构邀请所有入院患者参与。对2012年12月至2015年4月期间登记的549名患者进行分析。测量了生活质量、物质使用、精神和身体合并症以及运动行为。采用多项回归分析来确定与较差生活质量显著相关的变量。
大多数男性和女性（75%）在入院时报告生活质量为“差”或“非常差”。抑郁症与女性较差的生活质量（相对风险比[RRR]3.3，95%置信区间[CI]1.0 - 10.3）和非常差的生活质量（RRR 3.8，1.2 - 11.8）密切相关。男性缺乏体育活动与非常差的生活质量相关（RRR 2.0，1.1 - 3.7），独自用餐次数较多也与之相关（RRR 2.6，1.4 - 4.8）。男性将自己的体重评估为过低也与较差的生活质量（RRR 2.0，1.0 - 3.9）和非常差的生活质量（RRR 2.0，1.1 - 3.7）相关。服用美沙酮/丁丙诺啡是男性报告较差生活质量（RRR 0.5，0.3 - 0.9）和非常差生活质量（RRR 0.4，0.2 - 0.9）以及女性报告非常差生活质量（RRR 0.2，0.0 - 0.6）的保护因素。
在这个样本中，也发现了与其他健康和临床人群中较差生活质量相关的因素，如社会和身体健康受损以及心理困扰。除了关注与物质相关的因素外，治疗应针对具有这些特定脆弱性的患者，并且应在SUD背景下探索已被证明可改善具有这些脆弱性的其他人群生活质量的干预措施。
