Department of Psychological Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia.
Department of Mental Health, St Vincent's Hospital, Melbourne, Australia.
Inflamm Bowel Dis. 2018 Mar 19;24(4):742-751. doi: 10.1093/ibd/izx100.
BACKGROUND: Quality of life (QoL) is commonly assessed in inflammatory bowel disease (IBD); the relationship of QoL within IBD states and relative to others has not been comprehensively evaluated. This systematic review, published across 2 papers, evaluates 5 key QoL comparisons. Part I, presented here, examines between-disease comparisons: (1) IBD/healthy(general) population and (2) IBD/other medically ill groups. Part II examines within-disease comparisons: (3) active/inactive disease, (4) ulcerative colitis/Crohn's disease, and (5) change over time. Outcomes using generic vs IBD-specific QoL measures were also examined. METHODS: Adult and pediatric studies were identified through systematic searches of 7 databases from the 1940s (where available) to October 2015. RESULTS: Of 6173 abstracts identified, 466 were selected for final review based on controlled design and validated measurement; 30 unique studies (23 adult, 7 pediatric) addressed the between-disease comparisons. The pooled mean QoL scores were (1) lower in adult and pediatric IBD samples compared with healthy controls (n = 19), and for both mental and physical QoL, where measured; and (2) higher but not significant for those with IBD compared with various medically ill controls (n = 15). Findings were consistent across IBD-specific and generic QoL measures. Study quality was generally low to moderate. The most common measures of QoL were the disease-specific Inflammatory Bowel Disease Questionnaire and generic SF-36 (adults), and the generic PedsQL (children). CONCLUSIONS: There was robust confirmation that QoL for individuals with IBD was poorer than for healthy individuals, for both adults and children. QoL in IBD may be better relative to some other gastrointestinal (GI) and non-GI medical conditions for children.
背景:生活质量(QoL)通常在炎症性肠病(IBD)中进行评估;IBD 状态下的 QoL 之间以及与其他状态的关系尚未得到全面评估。本系统评价分两部分发表,评估了 5 个关键的 QoL 比较。第一部分(本文)考察了疾病间比较:(1)IBD/健康(一般)人群与(2)IBD/其他患有医学疾病的人群。第二部分考察了疾病内比较:(3)活动期/缓解期疾病,(4)溃疡性结肠炎/克罗恩病,以及(5)随时间的变化。还考察了使用通用和 IBD 特异性 QoL 测量方法的结果。 方法:通过系统检索 7 个数据库(从 1940 年代开始,有可用记录的情况下),从 1940 年代到 2015 年 10 月,确定了成人和儿科研究。 结果:在 6173 篇摘要中,根据对照设计和验证性测量,选择了 466 篇进行最终审查;30 项独特的研究(23 项成人研究,7 项儿科研究)涉及疾病间比较。汇总的平均 QoL 评分结果为:(1)与健康对照组(n = 19)相比,成人和儿科 IBD 样本的 QoL 均较低,且无论测量何种 QoL,精神和身体 QoL 均较低;(2)与各种患有医学疾病的对照组(n = 15)相比,IBD 患者的 QoL 较高,但无统计学意义。研究结果在 IBD 特异性和通用 QoL 测量中是一致的。研究质量普遍较低至中等。最常用的 QoL 测量方法是疾病特异性的炎症性肠病问卷和通用的 SF-36(成人),以及通用的 PedsQL(儿童)。 结论:有强有力的证据表明,IBD 患者的 QoL 比健康个体差,无论成人还是儿童都是如此。对于儿童来说,IBD 的 QoL 可能比某些其他胃肠道(GI)和非 GI 医学疾病的 QoL 更好。
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