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解释慢性 Q 热和 Q 热疲劳综合征对心理社会功能的长期影响:与糖尿病和普通人群的比较。

Explaining the long-term impact of chronic Q fever and Q fever fatigue syndrome on psychosocial functioning: A comparison with diabetes and the general population.

机构信息

Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.

Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.

出版信息

J Psychosom Res. 2019 Jun;121:37-45. doi: 10.1016/j.jpsychores.2019.03.185. Epub 2019 Apr 1.

Abstract

OBJECTIVE

After Q fever infection, 1-5% of patients develop chronic Q fever, while about 20% develops Q fever fatigue syndrome (QFS). This study examines whether these two conditions have a long-term impact on psychosocial functioning compared to the general population and patients with type 2 diabetes (DM) and investigate which mediating factors influence outcomes.

METHODS

Cross-sectional study was performed, measuring psychosocial functioning including quality of life (depression and satisfaction with life), anxiety, social functioning and relationship satisfaction in patients with proven or probable chronic Q fever or QFS, 5-9 years after acute Q fever infection. Multivariate linear regression was used to analyse differences between groups, correct for confounders and identify relevant mediators (fatigue, physical or cognitive functioning, illness perception).

RESULTS

Quality of life and social functioning of chronic Q-fever and QFS patients was significantly lower and anxiety significantly higher compared to DM patients and the general population. The impact was completely mediated by fatigue in both Q fever groups. Physical and cognitive functioning and illness perception partially mediated the impact.

CONCLUSIONS

Health care workers need to be aware of the long-term impact of chronic Q fever and QFS on psychosocial functioning of patients in order to provide proper guidance.

摘要

目的

感染 Q 热后,1-5%的患者会发展为慢性 Q 热,而约 20%的患者会发展为 Q 热疲劳综合征(QFS)。本研究旨在比较这两种情况与普通人群以及 2 型糖尿病(DM)患者相比,对社会心理功能是否存在长期影响,并探讨哪些中介因素影响结局。

方法

本研究为横断面研究,在急性 Q 热感染后 5-9 年,对确诊或疑似慢性 Q 热或 QFS 的患者进行社会心理功能(包括生活质量[抑郁和生活满意度]、焦虑、社会功能和关系满意度)的测量。采用多变量线性回归分析比较组间差异,校正混杂因素,并确定相关中介因素(疲劳、身体或认知功能、疾病感知)。

结果

与 DM 患者和普通人群相比,慢性 Q 热和 QFS 患者的生活质量和社会功能显著降低,焦虑显著升高。在这两个 Q 热组中,疲劳完全介导了这种影响。身体和认知功能以及疾病感知部分介导了这种影响。

结论

医疗保健工作者需要意识到慢性 Q 热和 QFS 对患者社会心理功能的长期影响,以便提供适当的指导。

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