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纤维肌痛患者的生活质量:疾病症状、生活方式及多种药物治疗的影响

Quality of life in patients with fibromyalgia: Contributions of disease symptoms, lifestyle and multi-medication.

作者信息

Fernandez-Feijoo Fátima, Samartin-Veiga Noelia, Carrillo-de-la-Peña María Teresa

机构信息

Brain and Pain Lab, Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain.

出版信息

Front Psychol. 2022 Oct 3;13:924405. doi: 10.3389/fpsyg.2022.924405. eCollection 2022.

Abstract

Fibromyalgia (FM) is a disease characterized by the presence of chronic and widespread musculoskeletal pain, which causes a high negative impact on the quality of life (QoL). Although there are many studies about the QoL of patients with FM, it is unknown which variables have a main influence on it. Therefore, in the present study, we aimed to determine which FM symptoms predict a worse QoL and also to establish whether lifestyle and multi-medication are associated to QoL. We assessed a sample of 134 women with FM using a semi-structured clinical interview to explore lifestyle (diet, exercise, smoking) and medication use, and questionnaires to cover the main symptoms of this disease and QoL (SF-36). We found that the patients with FM had a poor QoL, being "physical pain" and "vitality" the most affected domains. A linear regression analysis showed that depression and anxiety assessed by HADS were the FM symptoms which most significantly predicted QoL, explaining 49% of the variance. Concerning lifestyle/medication influences, we found that multiple drug treatment and smoking also predicted a worse QoL (14%). Moreover, patients who practiced exercise regularly showed better QoL than patients who did not (regardless of the severity of FM). Thus, our results suggest that treatment strategies to improve QoL in FM should be focused on improving psychological distress, promoting regular exercise and reducing smoking and multi-medication. The data highlights the role of positive self-management practices to improve QoL in FM.

摘要

纤维肌痛(FM)是一种以慢性广泛性肌肉骨骼疼痛为特征的疾病,对生活质量(QoL)产生严重负面影响。尽管有许多关于纤维肌痛患者生活质量的研究,但尚不清楚哪些变量对其有主要影响。因此,在本研究中,我们旨在确定哪些纤维肌痛症状预示着更差的生活质量,并确定生活方式和多种药物治疗是否与生活质量相关。我们通过半结构化临床访谈评估了134名纤维肌痛女性患者的样本,以探讨生活方式(饮食、运动、吸烟)和药物使用情况,并使用问卷来涵盖该疾病的主要症状和生活质量(SF-36)。我们发现纤维肌痛患者的生活质量较差,“身体疼痛”和“活力”是受影响最严重的领域。线性回归分析表明,用医院焦虑抑郁量表(HADS)评估的抑郁和焦虑是最能显著预测生活质量的纤维肌痛症状,解释了49%的方差。关于生活方式/药物治疗的影响,我们发现多种药物治疗和吸烟也预示着更差的生活质量(14%)。此外,经常锻炼的患者比不锻炼的患者生活质量更好(无论纤维肌痛的严重程度如何)。因此,我们的结果表明,改善纤维肌痛患者生活质量的治疗策略应侧重于改善心理困扰、促进规律锻炼以及减少吸烟和多种药物治疗。这些数据突出了积极的自我管理措施在改善纤维肌痛患者生活质量方面的作用。

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