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基于疼痛维度和精神症状预测疼痛性糖尿病周围神经病变患者的生活质量:伊朗患者的横断面患病率研究。

Predicting the quality of life based on pain dimensions and psychiatric symptoms in patients with Painful diabetic neuropathy: a cross-sectional prevalence study in Iranian patients.

机构信息

Department of Clinical Psychology, Faculty of Behavioral Science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Department of Clinical Psychology, Shahid Beheshti University, Tehran, Iran.

出版信息

Health Qual Life Outcomes. 2021 Feb 9;19(1):49. doi: 10.1186/s12955-021-01697-w.

Abstract

BACKGROUND

This study aimed to predict the quality of life (QOL) in patients with Painful Diabetic Neuropathy (PDN) based on pain severity, pain catastrophizing, pain acceptance, depression, anxiety, and sleep disturbance. Also, this study was aimed to assess the prevalence of psychiatric symptoms in Iranian patients with PDN.

METHOD

1120 patients (mean age, 53.6 ± 12.6 years) participated in the research. Data were collected by the Quality of life questionnaire (NeuroQoL); Beck Depression Inventory, Beck Anxiety Inventory, the visual analog scale for pain severity, Pain Catastrophizing Scale (PCS), Chronic Pain Acceptance Questionnaire (CPAQ) and Pittsburgh Sleep Quality Index (PSQI). Finally, the data were analyzed using SPSS-26 by multiple regression analysis.

RESULTS

The results showed the regression models' significance, and the dependent variables predicted 42% of total changes in the QOL. The most significant predicting factors were depression, pain catastrophizing, pain acceptance, pain severity, sleep disturbance, and anxiety in order. In patients with PDN, the prevalence of sleep disturbances, depression, and anxiety were 85.5%, 68.2%, and 62.1%, respectively. Also, comorbid depression and anxiety were found in 47% of patients.

CONCLUSION

Results demonstrated a significant relationship between pain-related and psychiatric dimensions with QOL. Thus, it is suggested to design more specific psychological-based rehabilitation interventions in which these variables are considered. They should focus on more significant variables (such as depression and pain catastrophizing) to reach better treatment outcomes. Furthermore, this research shows a high level of anxiety, depression, and sleep disturbance in Iranian patients with PDN. Thus, experts and clinicians are suggested to focus on reducing these psychiatric symptoms.

摘要

背景

本研究旨在基于疼痛严重程度、疼痛灾难化、疼痛接受度、抑郁、焦虑和睡眠障碍预测疼痛性糖尿病神经病变(PDN)患者的生活质量(QOL)。此外,本研究旨在评估伊朗 PDN 患者的精神症状患病率。

方法

1120 名患者(平均年龄 53.6±12.6 岁)参与了研究。通过神经生活质量问卷(NeuroQoL)、贝克抑郁量表、贝克焦虑量表、疼痛严重程度视觉模拟量表、疼痛灾难化量表(PCS)、慢性疼痛接受问卷(CPAQ)和匹兹堡睡眠质量指数(PSQI)收集数据。最后,使用 SPSS-26 通过多元回归分析对数据进行分析。

结果

结果表明回归模型的显著性,并且依赖变量预测了 QOL 总变化的 42%。最显著的预测因素依次为抑郁、疼痛灾难化、疼痛接受度、疼痛严重程度、睡眠障碍和焦虑。在 PDN 患者中,睡眠障碍、抑郁和焦虑的患病率分别为 85.5%、68.2%和 62.1%。此外,47%的患者同时患有抑郁和焦虑。

结论

结果表明疼痛相关和精神维度与 QOL 之间存在显著关系。因此,建议设计更具体的基于心理的康复干预措施,考虑这些变量。他们应该关注更重要的变量(如抑郁和疼痛灾难化),以达到更好的治疗效果。此外,本研究显示伊朗 PDN 患者焦虑、抑郁和睡眠障碍水平较高。因此,建议专家和临床医生关注降低这些精神症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16cd/7871534/892eb7104b46/12955_2021_1697_Fig1_HTML.jpg

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