Department of Clinical Epidemiology, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Health Qual Life Outcomes. 2020 Sep 4;18(1):298. doi: 10.1186/s12955-020-01542-6.
Many previous studies have reported factors that contribute to health-related quality of life (HRQoL) for a single skin disease. However, little is known about generalized factors associated with HRQoL across skin diseases. The objective of this study was to investigate overall HRQoL, and to identify factors related to severely impaired HRQoL among patients with 16 different skin diseases.
A cross-sectional study of 9845 patients with skin disease was conducted in 9 hospitals in China. HRQoL was assessed with the Chinese version of the Skindex-29 which measures dermatology-specific health along three domains (symptoms, emotions and functioning). With the published Skindex-29 cut-off scores for severely impaired HRQoL, logistic regression models assessed the relationship between severely impaired HRQoL and demographic/clinical characteristics, with adjustments for different skin diseases. To guarantee the models' convergence, 16 skin diseases with frequencies of at least 100 were included, and the sample size was 8789.
Emotions was the most impaired aspect of HRQoL. Co-existing chronic diseases, 3 years or longer duration, and more severity were identified as associated factors for severely impaired HRQoL for each Skindex-29 domain, and for the aggregate. Being female, under 45 years old, and consuming alcohol were associated with a severely impaired emotion domain; Lack of exercise and smoking were associated with severely impaired symptoms and function domains, respectively.
Skin diseases can affect many facets of HRQoL, but the emotional impairment deserves more attention. In addition to skin disease severity, this study shows that other chronic diseases and long duration are correlated with severely impaired HRQoL for patients with 16 clinical common skin diseases. This suggests the need for increased awareness in treating skin disease as a chronic disease. It also suggests that disease management decisions should consider HRQoL improvement, especially emotional conditions, when making management decisions.
许多先前的研究报告了影响单一皮肤病患者健康相关生活质量（HRQoL）的因素。然而，对于与多种皮肤病相关的广义因素知之甚少。本研究旨在调查整体 HRQoL，并确定 16 种不同皮肤病患者中与严重受损 HRQoL 相关的因素。
在中国 9 家医院进行了一项横断面研究，共纳入 9845 名皮肤病患者。使用中文版 Skindex-29 评估 HRQoL，该量表从三个领域（症状、情绪和功能）衡量皮肤病特异性健康。使用已发表的 Skindex-29 严重受损 HRQoL 截断值，逻辑回归模型评估了严重受损 HRQoL 与人口统计学/临床特征之间的关系，并对不同的皮肤病进行了调整。为了保证模型的收敛性，纳入了频率至少为 100 的 16 种皮肤病，样本量为 8789 例。
情绪是 HRQoL 受损最严重的方面。共存的慢性疾病、病程 3 年或以上以及更严重的疾病被确定为每个 Skindex-29 领域和综合领域严重受损 HRQoL 的相关因素。女性、年龄小于 45 岁和饮酒与情绪障碍严重受损相关；缺乏运动和吸烟分别与严重受损的症状和功能领域相关。
皮肤病会影响 HRQoL 的多个方面，但情绪损害更值得关注。除了皮肤病的严重程度外，本研究还表明，对于 16 种常见临床皮肤病患者，其他慢性疾病和较长病程与严重受损的 HRQoL 相关。这表明需要提高治疗皮肤病作为慢性病的意识。这也表明在做出管理决策时，应考虑改善 HRQoL，尤其是情绪状况。
