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青少年和青年炎症性肠病患者的物质使用情况:一项探索性聚类分析。

Substance Use in Adolescents and Young Adults With Inflammatory Bowel Diseases: An Exploratory Cluster Analysis.

作者信息

Plevinsky Jill M, Maddux Michele H, Greenley Rachel N

机构信息

Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

Children's Hospital Kansas City, Kansas City, MO.

出版信息

J Pediatr Gastroenterol Nutr. 2019 Sep;69(3):324-329. doi: 10.1097/MPG.0000000000002365.

Abstract

OBJECTIVES

Adolescents and young adults (AYAs) with chronic illnesses use substances at similar, if not greater, rates compared to healthy peers. The present study aimed to examine rates and patterns of tobacco use, marijuana use, and binge drinking in AYAs with inflammatory bowel diseases. We expected that substance use would be associated with poorer physical health, psychosocial functioning, and disease management.

METHODS

One hundred thirty-two AYAs completed a single set of surveys assessing demographics, disease activity, healthcare utilization, health-related quality of life (HRQoL), inflammatory bowel disease-specific self-efficacy, adherence barriers, disease management skills, and substance use in the last 30 days (eg, tobacco use, marijuana use, binge drinking). Exploratory cluster analyses, followed by chi-square tests and analyses of variance examined patterns of substance use and correlates of cluster membership.

RESULTS

Four patterns emerged from the sample: Global Users (n = 17), Marijuana Users Engaging in Binge Drinking (n = 18), Exclusive Binge Drinkers (n = 21), and Global Abstainers (n = 76). Groups differed by age, gender, disease activity, healthcare utilization, HRQoL, self-efficacy, and adherence barriers with medium and large effect sizes (P < .05).

CONCLUSIONS

Older age, male gender, active disease, at least 1 hospitalization in the past year, low self-efficacy, low HRQoL, and high adherence barriers were significantly more likely for those reporting multisubstance use. In addition, all those reporting both marijuana use and binge drinking also reported tobacco use. Future research ought to examine these associations longitudinally and throughout the transition to adult care.

摘要

目的

与健康同龄人相比,患有慢性疾病的青少年和青年(AYAs)使用物质的比例即使不更高,也相似。本研究旨在调查患有炎症性肠病的AYAs中烟草使用、大麻使用和暴饮的比例及模式。我们预计物质使用将与较差的身体健康、心理社会功能和疾病管理相关。

方法

132名AYAs完成了一组调查,评估人口统计学、疾病活动、医疗保健利用、健康相关生活质量(HRQoL)、炎症性肠病特异性自我效能、依从性障碍、疾病管理技能以及过去30天内的物质使用情况(例如,烟草使用、大麻使用、暴饮)。探索性聚类分析,随后进行卡方检验和方差分析,以检查物质使用模式和聚类成员的相关性。

结果

样本中出现了四种模式:全球使用者(n = 17)、参与暴饮的大麻使用者(n = 18)、单纯暴饮者(n = 21)和全球戒酒者(n = 76)。各组在年龄、性别、疾病活动、医疗保健利用、HRQoL、自我效能和依从性障碍方面存在差异,效应大小为中等和较大(P <.05)。

结论

对于报告多物质使用的人来说,年龄较大、男性、疾病活跃、过去一年至少住院一次、自我效能低、HRQoL低和依从性障碍高的可能性显著更高。此外,所有报告同时使用大麻和暴饮的人也报告了烟草使用。未来的研究应该纵向研究这些关联,并贯穿向成人护理过渡的全过程。

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