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皮肤利什曼病及其治疗对患者生活的影响:一项横断面研究。

How cutaneous leishmaniasis and treatment impacts in the patients' lives: A cross-sectional study.

机构信息

Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias-Instituto René Rachou-Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil.

出版信息

PLoS One. 2019 Jan 25;14(1):e0211374. doi: 10.1371/journal.pone.0211374. eCollection 2019.

Abstract

BACKGROUND

Until now, few studies have evaluated the effect of cutaneous leishmaniasis (CL) on patients' quality of life, and none have used a specific instrument to measure this effect. The objective of this study was to identify factors that may be associated with the high impact of CL and to assess patients' satisfaction with treatment and health services by utilizing a disease-specific questionnaire.

METHODOLOGY

Between December 2015 and May 2017, 100 patients with localized cutaneous leishmaniasis were interviewed at a leishmaniasis referral center in Brazil. Data were collected by two questionnaires. One questionnaire compiled the sociodemographic, economic, and clinical information related to the disease. The second questionnaire was the Cutaneous Leishmaniasis Impact Questionnaire (CLIQ), which consisted of two subscales that measured 1) the general impact of CL and 2) patients' perceptions of treatment and health services. The median scores from each of these two subscales were used to dichotomize the dependent variables. Risk factors for the high impact of CL and for low patient satisfaction with treatment and health services were analyzed with a logistic regression analysis.

RESULTS

The chance of higher impact of CL was increased in patients with the presence of comorbidities (OR: 3.9; CI 1.25-12.36), in those with absences from work (OR: 12.0; CI 3.78-42.55), in those who relied on public transportation by a municipal bus (OR: 5.8; CI 1.27-26.77), and in those who had illness-related expenses greater than U$137 (OR: 3.5; CI 1.17-10.24). The chance of patient dissatisfaction with treatment and health services increased with higher education (OR: 5.0; CI 1.19-21.03) and with illness-related expenses exceeding U$137 (OR: 4.64; CI 1.49-14.48). Once the sample was non-probabilistic, findings are not representative of CL patients in general.

CONCLUSIONS

CL and its treatment have a negative impact on patients' quality of life. Considering these effects during public health planning may help patients to confront the disease.

摘要

背景

迄今为止,鲜有研究评估皮肤利什曼病(CL)对患者生活质量的影响,也没有研究使用专门的工具来衡量这种影响。本研究的目的是确定可能与 CL 高影响相关的因素,并通过使用特定疾病的问卷评估患者对治疗和卫生服务的满意度。

方法

2015 年 12 月至 2017 年 5 月,在巴西一家利什曼病转诊中心对 100 例局限性皮肤利什曼病患者进行访谈。通过两份问卷收集数据。一份问卷收集与疾病相关的社会人口经济学和临床信息。第二份问卷是皮肤利什曼病影响问卷(CLIQ),由两个分量表组成,分别测量 1)CL 的总体影响,2)患者对治疗和卫生服务的感知。这两个分量表的中位数分数用于将因变量二分类。使用逻辑回归分析分析 CL 高影响和患者对治疗和卫生服务低满意度的危险因素。

结果

患有合并症(OR:3.9;95%CI 1.25-12.36)、因病缺勤(OR:12.0;95%CI 3.78-42.55)、依赖城市公共汽车(OR:5.8;95%CI 1.27-26.77)和医疗费用超过 137 美元(OR:3.5;95%CI 1.17-10.24)的患者 CL 影响更高的可能性增加。患者对治疗和卫生服务的满意度随着受教育程度的提高(OR:5.0;95%CI 1.19-21.03)和医疗费用超过 137 美元(OR:4.64;95%CI 1.49-14.48)而增加。由于样本是非概率性的,因此研究结果不能代表一般的 CL 患者。

结论

CL 及其治疗对患者的生活质量有负面影响。在公共卫生规划中考虑这些影响可能有助于患者应对疾病。

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