Adams Katherine N, Farquhar Douglas, Senior Brent A, Thorp Brian D, Zanation Adam M, Ebert Charles S
1 Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Am J Rhinol Allergy. 2018 May;32(3):153-159. doi: 10.1177/1945892418765001. Epub 2018 Apr 12.
Introduction Chronic rhinosinusitis negatively impacts a patient's quality of life, but current studies only address the patient's perception of their disease. Caregivers living with the patient may have an alternative perception of the severity of the quality of life disturbance that patient's experience with chronic rhinosinusitis. Methods This was a prospective cohort study that enrolled patients with a confirmed chronic rhinosinusitis diagnosis who presented to clinic with a caregiver. At the initial visit, patients completed a Rhinosinusitis Disability Index. The caregiver completed a Rhinosinusitis Disability Index based on their perception of the patient's symptoms in addition to a Modified Caregiver Strain Index and a Short Form-36 to assess caregiving strain and overall health, respectively. Statistical analyses were performed with significance defined as P < 0.05 a priori. Results A total of 44 total subjects (22 patient and caregiver pairs) were enrolled. Patients reported a total Rhinosinusitis Disability Index of 36.8 (confidence interval: 26.9, 46.6), and caregivers reported a total Rhinosinusitis Disability Index of 50.4 [confidence interval: 38.8, 61.9] ( P = 0.02). The principal differences between patient and caregiver scores were noted in the emotional and physical domains ( P = 0.01 and P = 0.05, respectively). Only the functional domain was not statistically different ( P = 0.20). The patient's total Rhinosinusitis Disability Index is positively correlated with the caregiver's total Modified Caregiver Strain Index with a spearman coefficient of .60 (p ≤ 0.005). Conclusions Caregivers experience greater strain as the patient's quality of life declines. Caregivers perceive patients to have worse quality of life than patients report. Based on these data, caregivers may provide additional insight to the quality of life disturbance of chronic rhinosinusitis. In addition, the societal impact of chronic rhinosinusitis may be underestimated.
引言 慢性鼻-鼻窦炎对患者的生活质量有负面影响，但目前的研究仅关注患者对自身疾病的认知。与患者共同生活的照料者可能对患者因慢性鼻-鼻窦炎而经历的生活质量干扰的严重程度有不同的认知。方法 这是一项前瞻性队列研究，纳入确诊为慢性鼻-鼻窦炎且有照料者陪同前来就诊的患者。在初次就诊时，患者完成一份鼻-鼻窦炎残疾指数问卷。照料者除了完成一份基于其对患者症状的认知的鼻-鼻窦炎残疾指数问卷外，还完成一份改良照料者压力指数问卷和一份简短健康调查问卷-36，分别用于评估照料压力和总体健康状况。进行统计学分析，显著性定义为P<0.05（预先设定）。结果 共纳入44名受试者（22对患者和照料者）。患者报告的鼻-鼻窦炎残疾指数总分是36.8（置信区间：26.9，46.6），照料者报告的鼻-鼻窦炎残疾指数总分是50.4[置信区间：38.8，61.9]（P=0.02）。患者和照料者得分的主要差异体现在情感和身体领域（分别为P=0.01和P=0.05）。只有功能领域无统计学差异（P=0.20）。患者的鼻-鼻窦炎残疾指数总分与照料者的改良照料者压力指数总分呈正相关，斯皮尔曼系数为0.60（p≤0.005）。结论 随着患者生活质量下降，照料者承受更大压力。照料者认为患者的生活质量比患者报告的更差。基于这些数据，照料者可能为慢性鼻-鼻窦炎生活质量干扰提供额外的见解。此外，慢性鼻-鼻窦炎对社会的影响可能被低估。
