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血友病患者的情绪困扰:与成年人焦虑和抑郁症状存在相关的因素。

Emotional distress in haemophilia: Factors associated with the presence of anxiety and depression symptoms among adults.

机构信息

Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.

ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.

出版信息

Haemophilia. 2018 Sep;24(5):e344-e353. doi: 10.1111/hae.13548. Epub 2018 Jul 13.

Abstract

INTRODUCTION

Haemophilia is related to several clinical and psychosocial challenges that have been associated with increased emotional distress. These may impact on disease adjustment and health outcomes, reinforcing the attention given to psychosocial health of people with haemophilia (PWH), in the scope of optimal comprehensive care.

AIM

To identify potentially modifiable factors associated with the presence of anxiety and depression symptoms among adult PWH.

METHODS

This was a cross-sectional observational study examining socio-demographic, clinical and psychosocial variables among 102 patients with haemophilia A or B who participated on a mail survey of haemophilia in Portugal.

RESULTS

People with haemophilia revealing higher anxiety and depression symptoms were more likely to have had, in the previous year, more urgent hospital visits due to haemophilia, more bleeding episodes, more affected joints and pain, as well as worst levels of perceived functionality and quality of life. After controlling for demographic (age and education) and clinical (haemophilia severity and joint deterioration) variables in multivariate hierarchical logistic regression analyses, professional status (OR = 4.646, P = .004; OR = 3.333, P = .029) and pain interference (OR = 1.397, P = .011; OR = .1.347, P = .037) were significantly associated with both anxiety and depression symptoms. Additionally, physical activity (OR = 0.302, P = .024) and the perception of consequences underlying haemophilia (OR = 1.600, P = .012) also emerged as key factors significantly associated with depression symptoms.

CONCLUSION

Current findings increased knowledge on factors associated with anxiety and depression among PWH. These highlight potential intervention targets, which are amenable to change through evidence-based tailored interventions aiming to decrease emotional distress, promote well-being and improving haemophilia-related health outcomes among these patients.

摘要

简介

血友病与多种临床和社会心理挑战有关,这些挑战与情绪困扰增加有关。这些因素可能会影响疾病的调整和健康结果,从而加强对血友病患者(PWH)的社会心理健康的关注,这是最佳综合护理的一部分。

目的

确定与成年 PWH 焦虑和抑郁症状相关的潜在可改变因素。

方法

这是一项横断面观察性研究,检查了葡萄牙血友病邮件调查中 102 名血友病 A 或 B 患者的社会人口统计学、临床和社会心理变量。

结果

有更高焦虑和抑郁症状的血友病患者,在过去一年中,由于血友病更频繁地紧急住院、更多的出血事件、更多受影响的关节和疼痛,以及感知功能和生活质量更差。在多元层次逻辑回归分析中控制人口统计学(年龄和教育)和临床(血友病严重程度和关节恶化)变量后,职业状况(OR=4.646,P=.004;OR=3.333,P=.029)和疼痛干扰(OR=1.397,P=.011;OR=0.1347,P=.037)与焦虑和抑郁症状显著相关。此外,体育活动(OR=0.302,P=.024)和对血友病潜在后果的感知(OR=1.600,P=.012)也成为与抑郁症状显著相关的关键因素。

结论

目前的研究结果增加了对 PWH 焦虑和抑郁相关因素的认识。这些因素突出了潜在的干预目标,这些目标可以通过基于证据的定制干预措施来改变,目的是减轻情绪困扰,促进这些患者的幸福感,并改善血友病相关的健康结果。

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