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女性患者在烧伤后12个月的烧伤特异性生活质量较差。

Female patients display poorer burn-specific quality of life 12 months after a burn injury.

作者信息

Wasiak J, Lee S J, Paul E, Shen A, Tan H, Cleland H, Gabbe B

机构信息

Victorian Adult Burns Service, The Alfred, Melbourne, Australia; Epworth Hospital, Richmond, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School Monash University, Melbourne, Australia.

出版信息

Injury. 2017 Jan;48(1):87-93. doi: 10.1016/j.injury.2016.07.032. Epub 2016 Jul 21.

Abstract

INTRODUCTION

Although gender differences in morbidity and mortality have been measured in patients with moderate to severe burn injury, little attention has been directed at gender effects on health-related quality of life (HRQoL) following burn injury. The current study was therefore conducted to prospectively measure changes in HRQoL for males and females in a sample of burn patients.

METHODS

A total of 114 adults who received treatment at a statewide burns service for a sustained burns injury participated in this study. Instruments measuring generic health status (Short Form 36 Medical Outcomes Survey version 2), burn-specific HRQoL (Burns Specific Health Scale-Brief), psychological distress (Kessler Psychological Distress Scale) and alcohol use (Alcohol Use Disorders Identification Tool) were prospectively measured at 3, 6 and 12 months post-burn.

RESULTS

In the 12 months post-injury, female patients showed overall poorer physical (p=0.01) and mental health status (p<0.001), greater psychological distress (p<0.001), and greater difficulty with aspects of burn-specific HRQoL: body image (p<0.001), affect (p<0.001), interpersonal functioning (p=0.005), heat sensitivity (p=0.01) and treatment regime (p=0.01). While significant interaction effects suggested that female patients had more improvement in difficulties with treatment regime (p=0.007), female patients continued to report greater difficulty with multiple aspects of physical and psychosocial health status 12 months post-injury.

CONCLUSION

Even though demographic variables, injury characteristics and burn care interventions were similar across genders, following burn injury female patients reported greater impairments in generic and burn-specific HRQoL along with psychological morbidity, when compared to male patients. Urgent clinical and research attention utilising an evidence-based research framework, which incorporates the use of larger sample sizes, the use of validated instruments to measure appropriate outcomes, and a commitment to monitoring long-term care, can only improve burn-care.

摘要

引言

虽然已经对中重度烧伤患者的发病率和死亡率的性别差异进行了测定,但很少有人关注性别对烧伤后健康相关生活质量(HRQoL)的影响。因此,本研究旨在前瞻性地测量烧伤患者样本中男性和女性HRQoL的变化。

方法

共有114名在全州烧伤服务机构接受持续性烧伤治疗的成年人参与了本研究。在烧伤后3个月、6个月和12个月前瞻性地测量了评估一般健康状况的工具(简明健康状况调查简表第2版)、烧伤特异性HRQoL(烧伤特异性健康量表简表)、心理困扰(凯斯勒心理困扰量表)和酒精使用情况(酒精使用障碍识别工具)。

结果

在受伤后的12个月里,女性患者总体上身体(p=0.01)和心理健康状况较差(p<0.001),心理困扰更大(p<0.001)以及在烧伤特异性HRQoL的多个方面存在更大困难:身体形象(p<0.001)、情感(p<0.001)、人际功能(p=0.005)、热敏感性(p=0.01)和治疗方案(p=0.01)。虽然显著的交互作用表明女性患者在治疗方案方面的困难有更大改善(p=0.007),但女性患者在受伤12个月后在身体和心理社会健康状况的多个方面仍报告有更大困难。

结论

尽管不同性别之间的人口统计学变量、损伤特征和烧伤护理干预措施相似,但与男性患者相比,烧伤后女性患者在一般和烧伤特异性HRQoL以及心理发病率方面的损害更大。利用基于证据的研究框架,包括使用更大的样本量、使用经过验证的工具来测量适当的结果以及致力于监测长期护理,进行紧急的临床和研究关注,才能改善烧伤护理。

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