Department of Diagnostics and Applied Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.
Department of Diagnostics and Applied Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.
Epilepsy Behav. 2019 Apr;93:94-101. doi: 10.1016/j.yebeh.2019.01.035. Epub 2019 Mar 6.
The patients with neurological disorders often report a different quality of life (QoL), which is in part explained by clinical-pathological or psychosocial variables. This study evaluated spirituality in patients with chronic brain pathologies, aiming to clarify its specificity and position to a multidimensional model of QoL.
A hundred and ninety-nine adult patients with epilepsy (E) (n = 88), mild cognitive impairment (MCI) (n = 32), ischemic vascular disorders (n = 29), tumors (n = 28), or multiple sclerosis (MS) (n = 22), and 66 healthy subjects were assessed using the World Health Organization Quality of Life (WHOQoL) 100, Spiritual, Religious and Personal Beliefs (SRPB), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI) for the QoL, spirituality, depression, and anxiety. The Multiple Ability Self-Report Questionnaire (MASQ) and neuropsychological tests evaluated the cognitive functions.
Factor analysis of the SRPB, STAI, and BDI scores yielded four factors: Personal Meaning, Inner Freedom, Awe and Openness, and Mood. Quality of life and spirituality were very similar between the patient groups. In comparison with the controls, all of the patients showed worse QoL, spirituality, mood, and lexical-memory abilities, and the patients with MCI and brain vascular disorders (BVD) also revealed worse cognitive impairments. Trait anxiety, self-rated health, age, and the SRPB Inner independence and Hope and optimism facets predicted the patients' WHOQoL 100 total score; the spiritual, affective, and socioeconomic variables predicted many QoL domains, but diagnosis only affected the Physical domain. Anxiety, self-rated health, Hope and optimism, and Personal beliefs predicted the controls' WHOQoL 100 total score.
Spirituality, as marked by the meaning of self, inner independence, and transcendence, is distinct from mood. It cooperates, together with the affective states, to determine the QoL of the patients with chronic brain pathologies whereas diagnosis has a limited impact. These findings support a multidimensional cross-disease model for the QoL in neurological disorders.
神经系统疾病患者的生活质量（QoL）往往存在差异，这部分可以通过临床-病理或心理社会变量来解释。本研究评估了慢性脑部疾病患者的灵性，旨在阐明其在多维 QoL 模型中的特异性和地位。
199 名成年癫痫（E）患者（n=88）、轻度认知障碍（MCI）患者（n=32）、缺血性血管疾病患者（n=29）、肿瘤患者（n=28）和多发性硬化症（MS）患者（n=22）以及 66 名健康受试者使用世界卫生组织生活质量（WHOQoL）100 量表、灵性、宗教和个人信仰（SRPB）量表、贝克抑郁量表（BDI）和状态-特质焦虑量表（STAI）评估生活质量、灵性、抑郁和焦虑。多重能力自评问卷（MASQ）和神经心理学测试评估认知功能。
SRPB、STAI 和 BDI 评分的因子分析得出了四个因素：个人意义、内在自由、敬畏和开放、情绪。患者组之间的生活质量和灵性非常相似。与对照组相比，所有患者的生活质量、灵性、情绪和词汇记忆能力均较差，MCI 和脑血管疾病（BVD）患者的认知障碍也更为严重。特质焦虑、自我报告的健康状况、年龄以及 SRPB 的内在独立性和希望与乐观方面预测了患者的 WHOQoL 100 总分；精神、情感和社会经济变量预测了许多 QoL 领域，但诊断仅影响身体领域。焦虑、自我报告的健康状况、希望与乐观和个人信仰预测了对照组的 WHOQoL 100 总分。
自我、内在独立性和超越的意义为标志的灵性与情绪不同。它与情感状态一起合作，决定了慢性脑部疾病患者的 QoL，而诊断的影响有限。这些发现支持了神经系统疾病 QoL 的多维跨疾病模型。
