Cwajda-Białasik Justyna, Szewczyk Maria T, Mościcka Paulina, Jawień Arkadiusz, Ślusarz Robert
Department of Surgical Nursing and Chronic Wound Treatment, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
Department of Vascular Surgery and Angiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
Postepy Dermatol Alergol. 2017 Oct;34(5):471-477. doi: 10.5114/ada.2017.71116. Epub 2017 Oct 31.
The results of previous studies suggest that the quality of life in patients with lower limb ulcerations is markedly poorer than in the general population - with regard to physical, mental and social spheres. This complex character of that parameter necessitates comprehensive analyses of its specific aspects, including the level of the acceptance of illness and associated pain symptoms.
To compare the quality of life and its specific dimensions in patients with lower limb ulcerations of various etiology.
Patients with the ulcerations resulting from venous ( = 101) or arterial pathologies ( = 98), or having mixed etiology ( = 99) were examined with the: 1) Skindex-29 instrument, 2) Acceptance of Illness Scale, 3) Beliefs about Pain Control Questionnaire, and 4) Coping Strategy Questionnaire.
The average quality of life related to physical symptoms was significantly higher in patients with venous ulcerations. Patients with ulcerations of arterial etiology more frequently used catastrophizing, and less often ignored pain sensations, used coping self-statements, and increased their activity levels; they were characterized by lower levels of control and poorer ability to decrease the pain. The internal locus of pain control increased proportionally to the global quality of life scores and levels of illness acceptance. Control over pain and ability to decrease the pain were more effective in individuals who used ignoring pain sensations, increasing the activity level, coping self-statements, and reinterpreting pain than in those using catastrophizing or praying and hoping strategies.
Physical complaints seem to be the basic determinant of the quality of life in patients with the lower limb ulceration, irrespective of its etiology.
先前研究结果表明，下肢溃疡患者在身体、心理和社会领域的生活质量明显低于普通人群。该参数的这种复杂特性需要对其具体方面进行全面分析，包括疾病接受程度和相关疼痛症状水平。
比较不同病因的下肢溃疡患者的生活质量及其具体维度。
对因静脉病变（n = 101）、动脉病变（n = 98）或病因混合（n = 99）导致溃疡的患者进行以下检查：1）Skindex - 29量表；2）疾病接受量表；3）疼痛控制信念问卷；4）应对策略问卷。
静脉溃疡患者与身体症状相关的平均生活质量显著更高。动脉病因溃疡患者更频繁地采用灾难化思维，较少忽视疼痛感觉、使用应对自我陈述以及提高活动水平；他们的特点是控制水平较低且减轻疼痛的能力较差。疼痛控制的内在控制点与总体生活质量得分和疾病接受水平成正比增加。与采用灾难化思维或祈祷和希望策略的人相比，忽视疼痛感觉、提高活动水平、使用应对自我陈述以及重新诠释疼痛的人在控制疼痛和减轻疼痛方面更有效。
无论病因如何，身体不适似乎是下肢溃疡患者生活质量的基本决定因素。
