肌萎缩侧索硬化症患者心理因素与健康相关生活质量及总体生活质量的关联：一项系统评价
Associations between psychological factors and health-related quality of life and global quality of life in patients with ALS: a systematic review.
作者信息
van Groenestijn Annerieke C, Kruitwagen-van Reenen Esther T, Visser-Meily Johanna M A, van den Berg Leonard H, Schröder Carin D
机构信息
Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
Brain Center Rudolf Magnus, Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands.
出版信息
Health Qual Life Outcomes. 2016 Jul 20;14(1):107. doi: 10.1186/s12955-016-0507-6.
OBJECTIVE
To systematically identify and appraise evidence on associations between psychological factors (moods, beliefs, personality) and Health-related QoL (HRQoL) and/or global QoL in patients with Amyotrophic Lateral Sclerosis (ALS).
METHODS
A systematic review was conducted in several online databases (PsycINFO, EMBASE, PubMed and CINAHL) up to October 2015. Articles were included if they reported associations between psychological factors (moods, beliefs and personality) and HRQoL and/or global QoL in an ALS population. The search was limited to empirical studies, published in English, which provided quantitative data. The methodological quality of the included articles was assessed.
RESULTS
In total, 22 studies were included. Mood was investigated in 14 studies, beliefs in 11 studies and personality in one study. Fifteen different psychological factors were extracted and assessed using 24 different measures. Twelve different QoL measures were used in the selected studies, subdivided into seven different HRQoL measures and five different global QoL measures. Higher levels of anxiety and depression appeared to be related to a poorer HRQoL, whereas a higher level of religiosity seemed to be associated with better global QoL. No conclusive associations were found for confusion-bewilderment (mood), spirituality, mindfulness, coping styles, hopelessness, perception of burden, cognitive appraisal (beliefs), neuroticism, extraversion, openness, agreeableness and conscientiousness (personality), due to insufficient or inconsistent evidence. Religiosity and spirituality appeared to become more positively associated over time.
CONCLUSIONS
Our results suggest that higher levels of anxiety and depression are related to a poorer HRQoL, whereas higher levels of religiosity appeared to be related to better global QoL. Associations might change during the disease course. This review supports the importance of psychological factors with regard to ALS care. Further research is needed to supplement the available evidence and to investigate how psychological factors can be modified to improve QoL.
REVIEW REGISTRATION NUMBER
PROSPERO 2015:CRD42015027303.
目的
系统识别和评估关于心理因素（情绪、信念、人格）与肌萎缩侧索硬化症（ALS）患者健康相关生活质量（HRQoL）和/或总体生活质量之间关联的证据。
方法
截至2015年10月，在多个在线数据库（PsycINFO、EMBASE、PubMed和CINAHL）中进行了系统综述。如果文章报道了心理因素（情绪、信念和人格）与ALS患者群体的HRQoL和/或总体生活质量之间的关联，则纳入该文章。检索仅限于以英文发表的实证研究，这些研究提供了定量数据。对纳入文章的方法学质量进行了评估。
结果
总共纳入了22项研究。14项研究调查了情绪，11项研究调查了信念，1项研究调查了人格。提取了15种不同的心理因素，并使用24种不同的测量方法进行评估。所选研究中使用了12种不同的生活质量测量方法，细分为7种不同的HRQoL测量方法和5种不同的总体生活质量测量方法。较高水平的焦虑和抑郁似乎与较差的HRQoL相关，而较高水平的宗教信仰似乎与较好的总体生活质量相关。由于证据不足或不一致，未发现困惑（情绪）、灵性、正念、应对方式、绝望、负担感知、认知评估（信念）、神经质、外向性、开放性、宜人性和尽责性（人格）之间有确凿的关联。随着时间的推移，宗教信仰和灵性似乎呈现出更积极的关联。
结论
我们的结果表明，较高水平的焦虑和抑郁与较差的HRQoL相关，而较高水平的宗教信仰似乎与较好的总体生活质量相关。在疾病过程中，这些关联可能会发生变化。本综述支持心理因素在ALS护理中的重要性。需要进一步的研究来补充现有证据，并研究如何改变心理因素以改善生活质量。
综述注册号
PROSPERO 2015：CRD42015027303。
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