Department of Otorhinolaryngology-Head and Neck Surgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
Department of Dermatovenereology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
Acta Clin Croat. 2023 Apr;62(1):193-200. doi: 10.20471/acc.2023.62.01.22.
Chronic rhinitis and rhinosinusitis (CR and CRS) can lead to impairment of the health-related quality of life (HRQL) with higher psychological perceived distress, resulting in disease worsening and poor treatment outcomes. W aimed to evaluate the potential association between disease severity and HRQL impairment with the perceived acute psychological distress in newly diagnosed CR/CRS patients. This single-center cross-sectional study included otherwise healthy consecutive adults with newly diagnosed CR/CRS (European position paper on rhinosinusitis and nasal polyp criteria and International Consensus Statement on Allergy and Rhinology - Allergic Rhinitis criteria or non-allergic rhinitis), who were evaluated for CR/CRS symptom severity and HRQL (Sino Nasal Outcome Test 22 [SNOT-22], visual analog scale [VAS]) and acute perceived distress (Perceived Stress Scale [PSS]). Principal component analysis (SNOT-22 items, VAS) identified 6 components as CR/CRS severity indicators, i.e,, poor sleep, wakes-up tired, nasopharynx, obstruction, torment and rhinorrhea, which were evaluated for association with PSS score. Of the 63 included patients (20 men, age median 38, range 19-75 years), 27 suffered from CR and 36 from CRS. Upon adjustment for age and sex, higher total SNOT-22 (geometric means ratio [GMR]=1.04, 95% CI 1.01-1.06), higher "torment" (GMR=1.13, 1.04-1.24), higher "poor sleep" (GMR=1.11, 1.02-1.21) and higher "wakes-up tired" (GMR=1.11, 1.01-1.21) scores were each associated with a higher PSS score, overall and consistently in CR and CRS patients. In conclusion, more severe CR/CRS is associated with greater perceived psychological distress already at earlier stages of the disease. Paying attention to patient level of distress and anxiety over time may enable better understanding of the connection between exacerbations, symptom severity and psychological burden of the disease.
慢性鼻炎和鼻-鼻窦炎（CR 和 CRS）可导致健康相关生活质量（HRQL）受损，伴有更高的心理感知痛苦，导致疾病恶化和治疗效果不佳。我们旨在评估新诊断的 CR/CRS 患者疾病严重程度与 HRQL 损害以及感知的急性心理困扰之间的潜在关联。这项单中心横断面研究纳入了患有新诊断的 CR/CRS（欧洲鼻-鼻窦炎和鼻息肉标准和国际过敏与鼻科学学会 - 变应性鼻炎标准或非变应性鼻炎标准）的健康连续成年人，对其进行了 CR/CRS 症状严重程度和 HRQL（22 项 Sino Nasal Outcome Test [SNOT-22]、视觉模拟量表 [VAS]）和急性感知压力（感知压力量表 [PSS]）评估。主成分分析（SNOT-22 条目，VAS）确定了 6 个作为 CR/CRS 严重程度指标的成分，即睡眠不佳、醒来疲倦、鼻咽部、阻塞、折磨和流涕，评估这些成分与 PSS 评分的相关性。在纳入的 63 例患者（20 名男性，年龄中位数为 38 岁，范围 19-75 岁）中，27 例患有 CR，36 例患有 CRS。在调整年龄和性别后，更高的总 SNOT-22（几何均数比 [GMR]=1.04，95%CI 1.01-1.06）、更高的“折磨”（GMR=1.13，1.04-1.24）、更高的“睡眠不佳”（GMR=1.11，1.02-1.21）和更高的“醒来疲倦”（GMR=1.11，1.01-1.21）评分均与更高的 PSS 评分相关，在 CR 和 CRS 患者中均为总体一致。总之，CR/CRS 更严重与疾病早期更高的感知心理困扰相关。关注患者的压力和焦虑程度随时间的变化可能有助于更好地理解疾病的恶化、症状严重程度和心理负担之间的联系。
