被诊断患有子宫内膜异位症的西班牙女性在日常生活活动方面存在的限制。

Limitations in Activities of Daily Living Among Spanish Women Diagnosed With Endometriosis.

作者信息

Lozano-Lozano Mario, Mundo-López Antonio, San-Sebastian Ainhoa P, Galiano-Castillo Noelia, Fernandez-Lao Carolina, Cantarero-Villanueva Irene, Arroyo-Morales Manuel, Ocón-Hernández Olga, Artacho-Cordón Francisco

机构信息

Mario Lozano-Lozano, PhD, is Postdoctoral Researcher, Instituto de Investigación Biosanitaria ibs. Granada; Occupational Therapist Researcher, "Cuídate" Support Unit for Oncology Patients, Sport and Health University Research Institute; and Associate Professor, Department of Physiotherapy, University of Granada, Granada, Spain;

Antonio Mundo-López, PhD, is Postdoctoral Researcher, Instituto de Investigación Biosanitaria ibs. Granada, University of Granada, Granada, Spain, and Psychologist, Clinic Psychology Center Alarcón, Granada, Spain.

出版信息

Am J Occup Ther. 2021 Nov 1;75(6). doi: 10.5014/ajot.2021.044974.

DOI:10.5014/ajot.2021.044974

PMID:34842913

Abstract

IMPORTANCE

Understanding the impact of endometriosis symptoms on patients' activities of daily living (ADLs) is a priority to establish effective and personalized intervention programs.

OBJECTIVE

To explore limitations in ADLs and instrumental ADLs (IADLs) and their association with pelvic pain (PP), chronic fatigue, and pain-catastrophizing thoughts among women with endometriosis.

DESIGN

Cross-sectional study.

SETTING

Spain.

PARTICIPANTS

Two hundred thirty women with endometriosis. Outcomes and Measures: Information regarding performance of ADLs (Barthel Index) and IADLs (Lawton-Brody questionnaire), PP intensity (Numeric Rating Scale), chronic fatigue (Piper Fatigue Scale), and pain-catastrophizing thoughts (Pain Catastrophizing Scale) was gathered. Multivariate regression analyses were created, and mediating effects of fatigue and pain-catastrophizing thoughts on the association between PP and ADL and IADL limitations were assessed.

RESULTS

The prevalence of limitations in at least one ADL and one IADL was 22.6% (95% confidence interval [CI] [17.2, 28.1]) and 39.1% (95% CI [32.8, 45.5]), respectively. Limitations in bowel continence, housework, shopping, and meal preparation were reported most frequently. Women reporting severe PP showed higher risk for ADL (odds ratio [OR] = 3.33, 95% CI [1.10, 10.10]) and IADL (OR = 7.99, 95% CI [2.86, 22.34]) limitations. Chronic fatigue and pain-catastrophizing thoughts were also positively related to ADL-IADL limitations, showing a mediating effect on the association between PP and ADL-IADL limitations.

CONCLUSIONS AND RELEVANCE

This study reveals the widespread presence of difficulties in ADL-IADL performance among women with endometriosis, with some symptoms underlying these difficulties in occupational performance. This study points to the need for cost-effective occupational therapy interventions for affected women. What This Article Adds: This research shows that the occupational performance of women with endometriosis is frequently impaired; therefore, the effectiveness of occupational therapy interventions should be addressed in the near future.

摘要

重要性

了解子宫内膜异位症症状对患者日常生活活动（ADL）的影响是制定有效且个性化干预方案的首要任务。

目的

探讨子宫内膜异位症女性在ADL和工具性日常生活活动（IADL）方面的局限性，以及这些局限性与盆腔疼痛（PP）、慢性疲劳和疼痛灾难化思维之间的关联。

设计

横断面研究。

地点

西班牙。

参与者

230名患有子宫内膜异位症的女性。结果与测量：收集了有关ADL（巴氏指数）和IADL（Lawton-Brody问卷）表现、PP强度（数字评分量表）、慢性疲劳（Piper疲劳量表）和疼痛灾难化思维（疼痛灾难化量表）的信息。进行了多变量回归分析，并评估了疲劳和疼痛灾难化思维对PP与ADL及IADL局限性之间关联的中介作用。

结果

至少一项ADL和一项IADL存在局限性的患病率分别为22.6%（95%置信区间[CI][17.2, 28.1]）和39.1%（95% CI [32.8, 45.5]）。排便自控、家务、购物和 meal preparation（此处原文有误，可能是meal preparation，意为做饭）方面的局限性报告最为频繁。报告有严重PP的女性出现ADL（优势比[OR]=3.33，95% CI [1.10, 10.10]）和IADL（OR = 7.99，95% CI [2.86, 22.34]）局限性的风险更高。慢性疲劳和疼痛灾难化思维也与ADL - IADL局限性呈正相关，显示出对PP与ADL - IADL局限性之间关联的中介作用。