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性别差异在痛风患者的疾病认知和疾病管理中的作用:来自瑞典西部的问卷调查研究结果。

Gender differences in illness perceptions and disease management in patients with gout, results from a questionnaire study in Western Sweden.

机构信息

Region Halland, Research and development department, Halmstad, Sweden.

Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden.

出版信息

BMC Musculoskelet Disord. 2023 Apr 15;24(1):300. doi: 10.1186/s12891-023-06416-8.

Abstract

BACKGROUND

Aims were to examine gender differences in patients with gout with regard to a) self-reported gout severity, b) illness perceptions (IP), c) impact on daily activities and Quality of Life (QoL), d) advice from healthcare professionals, e) having changed dietary- or alcohol habits.

METHODS

Adult patients with gout identified in primary and secondary care in Sweden between 2015 and 2017 (n = 1589) were sent a questionnaire about demographics, gout disease severity, IP (using the Brief Illness Perception Questionnaire, (B-IPQ)) and disease management. T-tests, Chi square tests, ANalysis Of VAriance (ANOVA) and linear regression models were used for gender comparisons.

RESULTS

Eight hundred sixty-eight patients responded to the questionnaire. Women, n = 177 (20%), experienced more severe gout symptoms (p = 0.011), albeit similar frequencies of flares compared to men. Women experienced modest but significantly worse IP with regard to consequences, identity, concerns and emotional response (p < 0.05) as well as daily activities such as sleeping (p < 0.001) and walking (p = 0.042) and QoL (p = 0.004). Despite this and a higher frequency of obesity in women (38 vs 21%, P < 0.001) and alcohol consumption in men (p < 0.001), obese women had received significantly less advice regarding weight reduction (47 vs 65%, p = 0.041) compared to obese men. On the other hand, women reported having acted on dietary advice to a larger degree.

CONCLUSIONS

Despite only modestly worse gout severity and perception, women appear to have been given less information regarding self-management than men. These gender differences should be given attention and addressed in clinical care.

摘要

背景

本研究旨在探讨痛风患者的性别差异,包括:a)自我报告的痛风严重程度;b)疾病认知(illness perception,IP);c)对日常活动和生活质量(Quality of Life,QoL)的影响;d)来自医护人员的建议;e)改变饮食或饮酒习惯的情况。

方法

2015 年至 2017 年,在瑞典的初级和二级保健机构中发现的成年痛风患者(n=1589)收到了一份关于人口统计学、痛风严重程度、疾病认知(使用简短疾病认知问卷,Brief Illness Perception Questionnaire,B-IPQ)和疾病管理的调查问卷。采用 t 检验、卡方检验、方差分析(Analysis Of Variance,ANOVA)和线性回归模型进行性别比较。

结果

共 868 名患者对问卷做出了回应。女性,n=177(20%),经历了更严重的痛风症状(p=0.011),尽管与男性相比,发作频率相似。女性在后果、身份、担忧和情绪反应(p<0.05)以及日常活动(如睡眠,p<0.001;步行,p=0.042)和生活质量(p=0.004)方面的疾病认知较差。尽管如此,女性肥胖的发生率更高(38% vs 21%,P<0.001),男性饮酒的发生率更高(p<0.001),但肥胖女性接受的减肥建议明显少于肥胖男性(47% vs 65%,p=0.041)。另一方面,女性报告更愿意接受饮食建议并采取行动。

结论

尽管女性的痛风严重程度和认知仅略差,但她们似乎得到的自我管理信息比男性少。这些性别差异应在临床护理中引起重视并加以解决。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bbf/10105391/ddcf0d6e856a/12891_2023_6416_Fig1_HTML.jpg

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