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[系统性红斑狼疮患者慢性病的社会支持与管理策略]

[Social support and management strategies for chronic disease in patients with systemic lupus erythematosus].

作者信息

Xu Qianyun, Liu Di, Zeng Furong, Luo Hui, Zuo Xiaoxia, Li Yisha

机构信息

Department of Rheumatology and Immunology, Xiangya Hospital; Institute of Rheumatology and Immunology, Central South University, Changsha 410008, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2019 Jan 28;44(1):67-73. doi: 10.11817/j.issn.1672-7347.2019.01.011.

Abstract

To investigate the social support level and its influencial factors in patients with systemic lupus erythematosus (SLE), and to develop the management strategies for chronic disease.
 Methods: Patients with SLE were investigated by Social Support Rating Scale (SSRS), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), 36-Item Short-Form Health Survey (SF-36) and Visual Analogue Scale (VAS) of fatigue. The demographic and clinical data of SLE patients were recorded. SLE disease activity and damage severity were assessed by SLE Disease Activity Index (SLEDAI) and SLE Damage Index (SDI), respectively. Influencial factors for social support were analyzed.
 Results: A total of 246 patients were included. Social support scores for these patients were 40.76±7.93 and the scores showed no significant difference with the national norm (P>0.05). Patients who were younger than 18, single, unemployed or damaged by disease showed lower level of social support (P<0.05). Compared with the high social support group, patients in the low social support group experienced more severe depression or anxiety, and scored lower on mental component summary scale (vitality, social functioning, emotional role and mental health perception) and physical role of SF-36 (P<0.05).
 Conclusion: Social support levels for patients with SLE are closely related to the quality of life, and influenced by age, marital status, professional condition, and disease damage. Health education for patients and their families should be strengthened in chronic disease management to enhance social support and finally, improve their quality of life.

摘要

探讨系统性红斑狼疮(SLE)患者的社会支持水平及其影响因素,制定慢性病管理策略。方法:采用社会支持评定量表(SSRS)、患者健康问卷(PHQ-9)、广泛性焦虑障碍量表(GAD-7)、36条目简明健康调查量表(SF-36)及疲劳视觉模拟量表(VAS)对SLE患者进行调查。记录SLE患者的人口学和临床资料。分别采用SLE疾病活动指数(SLEDAI)和SLE损伤指数(SDI)评估SLE疾病活动度和损伤严重程度。分析社会支持的影响因素。结果:共纳入246例患者。这些患者的社会支持得分为40.76±7.93,与全国常模相比差异无统计学意义(P>0.05)。年龄<18岁、单身、无业或有疾病损伤的患者社会支持水平较低(P<0.05)。与高社会支持组相比,低社会支持组患者抑郁或焦虑更严重,SF-36心理维度量表(活力、社会功能、情感角色和心理健康感知)及生理角色得分更低(P<0.05)。结论:SLE患者的社会支持水平与生活质量密切相关,受年龄、婚姻状况、职业状况及疾病损伤影响。慢性病管理中应加强对患者及其家属的健康教育,以增强社会支持,最终提高其生活质量。

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