Lyme Center Apeldoorn, Gelre Hospital, P.O. Box 9014, 7300 DS, Apeldoorn, The Netherlands.
Department of Internal Medicine, Gelre Hospital, Apeldoorn, The Netherlands.
Qual Life Res. 2022 Aug;31(8):2423-2434. doi: 10.1007/s11136-022-03094-2. Epub 2022 Feb 5.
Little is known on coping strategies in patients with chronic symptoms suspected of Lyme borreliosis (LB). Different coping strategies might influence quality of life (QoL). We assessed coping strategies and QoL in patients with chronic symptoms suspected of LB.
Adult patients referred to the Lyme Center Apeldoorn were included (November 2019-April 2021). Participants completed the RAND-36 to assess QoL and the Utrecht Coping List to assess coping strategies. Patient data were extracted from medical records. Patients were categorized based on clinical LB and serology. Linear regression analyses were conducted to examine an association between coping strategies and QoL subscales.
Included were 201 patients. Patients suspected of LB had a different coping profile and lower QoL compared to the reference population. Patients with negative serology and no clinical LB scored lowest on all QoL subscales. In multivariate analyses, correcting for age, gender, comorbidity, and patient category, a negative association was found between passive coping and the QoL subscales physical functioning (β(SE) = - 1.1(0.5)), social functioning (β(SE) = - 3.3(0.5)), role limitations (emotional) (β(SE) = - 5.5(0.8)), mental health (β(SE) = - 3.7(0.3)), vitality (β(SE) = - 2.3(0.3)), pain (β(SE) = - 2.3(0.5)), and general health (β(SE) = - 2.7(0.3)). A negative association was also found between palliative coping and the QoL subscale role limitations (physical) (β(SE) = - 1.8(0.6)) and between expressing emotions and mental health (β(SE) = - 1.3(0.6)). A positive association was found between active coping and the QoL subscales mental health (β(SE) = 1.0(0.3)) and role limitations (emotional) (β(SE) = 1.9(0.8)).
In patients suspected of LB, dysfunctional coping strategies were associated with worse quality of life. There is a need for interventions that can guide patients with chronic symptoms suspected of LB towards more active coping and increase QoL.
对于疑似莱姆病（LB）的慢性症状患者，其应对策略知之甚少。不同的应对策略可能会影响生活质量（QoL）。我们评估了疑似 LB 慢性症状患者的应对策略和 QoL。
纳入 2019 年 11 月至 2021 年 4 月期间被转诊到阿珀尔多伦莱姆中心的成年患者。参与者完成了 RAND-36 评估 QoL，完成了乌得勒支应对清单来评估应对策略。患者数据从病历中提取。根据临床 LB 和血清学将患者分类。进行线性回归分析以检查应对策略与 QoL 分量表之间的关联。
共纳入 201 名患者。疑似 LB 的患者与参考人群相比，应对方式不同，生活质量较低。血清学阴性且无临床 LB 的患者在所有 QoL 分量表上的得分最低。在多变量分析中，校正年龄、性别、合并症和患者类别后，发现消极应对与 QoL 分量表的身体功能（β（SE）=-1.1（0.5））、社会功能（β（SE）=-3.3（0.5））、角色限制（情感）（β（SE）=-5.5（0.8））、心理健康（β（SE）=-3.7（0.3））、活力（β（SE）=-2.3（0.3））、疼痛（β（SE）=-2.3（0.5））和一般健康（β（SE）=-2.7（0.3））呈负相关。消极应对与角色限制（身体）（β（SE）=-1.8（0.6））和表达情绪与心理健康（β（SE）=-1.3（0.6））呈负相关。积极应对与心理健康（β（SE）=1.0（0.3））和角色限制（情感）（β（SE）=1.9（0.8））呈正相关。
在疑似 LB 的患者中，功能失调的应对策略与较差的生活质量相关。需要干预措施来指导疑似 LB 慢性症状患者采取更积极的应对方式，提高生活质量。
