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伴侣负担:乳糜泻中的常见现象

Partner Burden: A Common Entity in Celiac Disease.

作者信息

Roy Abhik, Minaya Maria, Monegro Milka, Fleming Jude, Wong Reuben K, Lewis Suzanne, Lebwohl Benjamin, Green Peter H R

机构信息

Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, Columbia University Medical Center, Harkness Pavilion, 180 Fort Washington Ave, Room 936, New York, NY, 10032, USA.

Department of Medicine, National University of Singapore, Singapore, Singapore.

出版信息

Dig Dis Sci. 2016 Dec;61(12):3451-3459. doi: 10.1007/s10620-016-4175-5. Epub 2016 Apr 28.

Abstract

BACKGROUND

Caregiver burden is documented in several chronic diseases, but it has not been investigated in celiac disease (CD).

AIMS

We aim to quantify the burden to partners of CD patients and identify factors that affect the perceived burden.

METHODS

We surveyed patients with biopsy-proven CD and their partners. Patients completed CD-specific questions, including the validated Celiac Symptom Index (CSI) survey. Partners completed the validated Zarit Burden Interview (ZBI) and questions regarding sexual and relationship satisfaction. Univariable and multivariable analyses were used to assess the association between demographics, CD characteristics, and partner burden.

RESULTS

In total, 94 patient/partner pairs were studied. Fifteen patients (16 %) reported a CSI score associated with a poor quality of life, and 34 partners (37 %) reported a ZBI score corresponding to mild-to-moderate burden. Twenty-two partners (23 %) reported moderate-to-low overall relationship satisfaction, and 12 (14 %) reported moderate-to-low sexual satisfaction. The degree of partner burden was directly correlated with patient CSI score (r = 0.27; p = 0.008), and there were moderate-to-strong inverse relationships between partners' burden and relationship quality (r = -0.70; p < 0.001) and sexual satisfaction (r = -0.42; p < 0.001). On multivariable logistic regression, predictors of mild-to-moderate partner burden were low partner relationship satisfaction (OR 17.06, 95 % CI 2.88-101.09, p = 0.002) and relationship duration ≥10 years (OR 14.42, 95 % CI 1.69-123.84, p = 0.02).

CONCLUSIONS

Partner burden is common in CD, with more than one-third of partners experiencing mild-to-moderate burden. Partner burden is directly correlated with patient symptom severity, and it increases with poorer sexual and relationship satisfaction. Healthcare providers should address relationship factors in their care of patients with CD.

摘要

背景

照护者负担在多种慢性疾病中均有记载,但尚未在乳糜泻(CD)中进行研究。

目的

我们旨在量化CD患者伴侣的负担,并确定影响感知负担的因素。

方法

我们对经活检证实为CD的患者及其伴侣进行了调查。患者完成了CD特异性问题,包括经过验证的乳糜泻症状指数(CSI)调查。伴侣完成了经过验证的Zarit负担访谈(ZBI)以及有关性和关系满意度的问题。采用单变量和多变量分析来评估人口统计学、CD特征与伴侣负担之间的关联。

结果

总共研究了94对患者/伴侣。15名患者(16%)报告的CSI评分与生活质量差相关,34名伴侣(37%)报告的ZBI评分对应轻度至中度负担。22名伴侣(23%)报告总体关系满意度为中度至低度,12名(14%)报告性满意度为中度至低度。伴侣负担程度与患者CSI评分直接相关(r = 0.27;p = 0.008),伴侣负担与关系质量(r = -0.70;p < 0.001)和性满意度(r = -0.42;p < 0.001)之间存在中度至强的负相关关系。在多变量逻辑回归分析中,轻度至中度伴侣负担的预测因素是伴侣关系满意度低(比值比[OR] 17.06,95%置信区间[CI] 2.88 - 101.09,p = 0.002)和关系持续时间≥10年(OR 14.42,95% CI 1.69 - 123.84,p = 0.02)。

结论

伴侣负担在CD中很常见,超过三分之一的伴侣经历轻度至中度负担。伴侣负担与患者症状严重程度直接相关,并且随着性和关系满意度降低而增加。医疗保健提供者在对CD患者的护理中应关注关系因素。

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