Kotecha Jalpa, Atkins Christopher, Wilson Andrew
Norfolk and Norwich University Hospital.
Sarcoidosis Vasc Diffuse Lung Dis. 2016 Dec 23;33(4):341-348.
Idiopathic pulmonary fibrosis (IPF) and sarcoidosis impact significantly on health-related quality of life (HRQOL). There are few studies on the impact of patient confidence on HRQOL in these conditions.
Study participants self-completed seven questionnaires: Hospital Anxiety and Depression Scale, EuroQol 5D (EQ5D), King's Brief Interstitial Lung Disease questionnaire, St George's Respiratory Questionnaire, MRC dyspnoea scale, Fatigue Assessment Scale and a non-validated questionnaire assessing patient confidence, symptom duration and access to community healthcare. Lung function and follow-up data were collected from hospital electronic databases. Spearman's rank correlation coefficients were calculated to assess for correlation between patient confidence, questionnaire variables and inpatient admissions. Chi-square tests were performed to assess for association between patient confidence, mortality and disease severity.
75 IPF patients and 69 sarcoidosis patients were recruited to the study. Patient confidence in IPF was significantly negatively correlated with depression and fatigue, and significantly positively correlated with EQ5D scores, but not healthcare outcomes. No associations were found between confidence and any of the variables assessed in sarcoidosis.
Lower levels of confidence in IPF patients are associated with higher levels of depression and fatigue and worse HRQOL. Efforts should be made to improve patient confidence to assess the impact on HRQOL.
特发性肺纤维化(IPF)和结节病对健康相关生活质量(HRQOL)有显著影响。关于患者信心对这些疾病中HRQOL的影响的研究较少。
研究参与者自行完成七份问卷:医院焦虑抑郁量表、欧洲五维健康量表(EQ5D)、国王间质性肺病简易问卷、圣乔治呼吸问卷、医学研究委员会(MRC)呼吸困难量表、疲劳评估量表以及一份评估患者信心、症状持续时间和获得社区医疗保健情况的未经验证的问卷。从医院电子数据库收集肺功能和随访数据。计算斯皮尔曼等级相关系数以评估患者信心、问卷变量与住院之间的相关性。进行卡方检验以评估患者信心、死亡率和疾病严重程度之间的关联。
75例IPF患者和69例结节病患者被纳入研究。IPF患者的信心与抑郁和疲劳显著负相关,与EQ5D评分显著正相关,但与医疗保健结果无关。在结节病中,未发现信心与所评估的任何变量之间存在关联。
IPF患者较低的信心水平与较高的抑郁和疲劳水平以及较差的HRQOL相关。应努力提高患者信心以评估对HRQOL的影响。