Psychosocial Department, Emma Children's Hospital, AMC, Postbox 22660, 1100 DD, Amsterdam, The Netherlands.
Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Qual Life Res. 2018 Jan;27(1):159-171. doi: 10.1007/s11136-017-1696-0. Epub 2017 Sep 12.
The treatment of bleeding disorders improved in the last decades. However, the effect of growing up with bleeding disorders on developmental, emotional, and social aspects is understudied. Therefore, this study assesses HRQOL, developmental milestones, and self-esteem in Dutch young adults (YA) with bleeding disorders compared to peers.
Ninety-five YA (18-30 years) with bleeding disorders (78 men; mean 24.7 years, SD 3.5) and 17 women (mean 25.1 years, SD 3.8) participated and completed the Pediatric Quality of Life Inventory Young Adult version, the Course of Life Questionnaire, and the Rosenberg Self-Esteem Scale. Differences between patients with bleeding disorders and their peers, and between hemophilia severity groups, were tested using Mann-Whitney U tests.
YA men with bleeding disorders report a slightly lower HRQOL on the total scale, physical functioning, and school/work functioning in comparison to healthy peers (small effect sizes). YA men with severe hemophilia report more problems on the physical functioning scale than non-severe hemophilia. YA men with bleeding disorders achieved more psychosexual developmental milestones than peers, but show a delay in 'paid jobs, during middle and/or high school.' A somewhat lower self-esteem was found in YA men with bleeding disorders in comparison to peers (small effect size). For YA women with bleeding disorders, no differences were found on any of the outcomes in comparison to peers.
This study demonstrates some impairments in HRQOL and self-esteem in YA men with bleeding disorders. By monitoring HRQOL, problems can be identified early, especially with regard to their physical and professional/school functioning.
过去几十年中,出血性疾病的治疗得到了改善。然而,患有出血性疾病对发育、情感和社会方面的影响仍研究不足。因此,本研究评估了荷兰青少年(YA)与同龄人相比,患有出血性疾病的生活质量、发育里程碑和自尊。
95 名 YA(18-30 岁)患有出血性疾病(78 名男性;平均 24.7 岁,标准差 3.5)和 17 名女性(平均 25.1 岁,标准差 3.8)参与并完成了儿童生活质量问卷青少年版、生活过程问卷和罗森伯格自尊量表。使用 Mann-Whitney U 检验比较患者与同龄人、血友病严重程度组之间的差异。
与健康同龄人相比,患有出血性疾病的 YA 男性在总评分、生理功能和学校/工作功能方面报告的生活质量略低(小效应量)。患有严重血友病的 YA 男性在生理功能量表上报告的问题多于非严重血友病。患有出血性疾病的 YA 男性比同龄人达到更多的心理社会发育里程碑,但在“中学或高中期间有报酬的工作”方面存在延迟。与同龄人相比,患有出血性疾病的 YA 男性的自尊略低(小效应量)。与同龄人相比,患有出血性疾病的 YA 女性在任何结果上均未发现差异。
本研究表明,患有出血性疾病的 YA 男性在生活质量和自尊方面存在一些障碍。通过监测生活质量,可以及早发现问题,尤其是在他们的生理和职业/学校功能方面。