Radford Shellie Jean, McGing Jordan, Czuber-Dochan Wladyslawa, Moran Gordon
Nottingham Digestive Diseases Centre, University of Nottingham, University Park Campus, Nottingham, UK.
NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Frontline Gastroenterol. 2020 Jan 24;12(1):11-21. doi: 10.1136/flgastro-2019-101355. eCollection 2021.
Fatigue is frequently reported in inflammatory bowel disease (IBD) and impacts on health-related quality of life (HRQoL). HRQoL has not been systematically reviewed in IBD fatigue.
To investigate what impact IBD fatigue has on HRQoL in adults with IBD.
Systematic searches (CINAHL, EMBASE, PsychINFO, Medline) were conducted on 25 September 2018, restricted to 'human', 'adult', 'primary research' and 'English language'. Search terms encompassed concepts of 'fatigue', 'IBD' and 'HRQoL'. A 5-year time limit (2013-2018) was set to include the most relevant publications. Publications were screened, data extracted and quality appraised by two authors. A narrative synthesis was conducted.
Eleven studies were included, presenting data from 2823 participants. Fatigue experiences were significantly related to three HRQoL areas: symptom acceptance, psychosocial well-being and physical activity. Patients reporting high fatigue levels had low symptom acceptance. Psychosocial factors were strongly associated with both fatigue and HRQoL. Higher social support levels were associated with higher HRQoL. Physical activity was impaired by higher fatigue levels, lowering HRQoL, but it was also used as a means of reducing fatigue and improving HRQoL. Quality appraisal revealed methodological shortcomings in a number of studies. Notably, use of multiple measures, comparison without statistical adjustment and fatigue and HRQoL assessment using the same tool were some of the methodological shortcomings.
Psychosocial factors, symptom management and acceptance and physical activity levels have significant impact on HRQoL. Results support application of psychosocial or exercise interventions for fatigue management. Further exploration of HRQoL factors in IBD fatigue is required, using validated fatigue and HRQoL measures.
CRD42018110005.
炎症性肠病（IBD）患者经常报告疲劳，这会影响健康相关生活质量（HRQoL）。IBD疲劳对HRQoL的影响尚未得到系统综述。
研究IBD疲劳对成年IBD患者HRQoL的影响。
于2018年9月25日进行系统检索（CINAHL、EMBASE、PsychINFO、Medline），检索范围限定为“人类”“成人”“原始研究”及“英语”。检索词包括“疲劳”“IBD”和“HRQoL”的概念。设定5年时间限制（2013 - 2018年）以纳入最相关的出版物。由两位作者对出版物进行筛选、数据提取和质量评估。进行叙述性综合分析。
纳入11项研究，提供了2823名参与者的数据。疲劳体验与HRQoL的三个领域显著相关：症状接受度、心理社会幸福感和身体活动。报告高疲劳水平的患者症状接受度低。心理社会因素与疲劳和HRQoL均密切相关。更高的社会支持水平与更高的HRQoL相关。更高的疲劳水平会损害身体活动，降低HRQoL，但身体活动也被用作减轻疲劳和改善HRQoL的一种手段。质量评估揭示了一些研究中的方法学缺陷。值得注意的是，使用多种测量方法、未经统计调整的比较以及使用相同工具进行疲劳和HRQoL评估是一些方法学缺陷。
心理社会因素、症状管理与接受度以及身体活动水平对HRQoL有显著影响。结果支持应用心理社会或运动干预来管理疲劳。需要使用经过验证的疲劳和HRQoL测量方法，进一步探索IBD疲劳中的HRQoL因素。
PROSPERO注册号：CRD42018110005。
