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应对策略对肢端肥大症患者健康相关生活质量的影响。

The effect of coping strategies on health-related quality of life in acromegaly patients.

机构信息

Department of Neurosurgery and Spine Surgery, Member of ENDO-ERN, University Hospital Essen, Essen, Germany.

German Cancer Consortium (DKTK) Partner Site, University Hospital Essen, Essen, Germany.

出版信息

Endocrine. 2024 Jun;84(3):1108-1115. doi: 10.1007/s12020-024-03813-4. Epub 2024 Apr 13.

Abstract

PURPOSE

Patients with acromegaly oftentimes exhibit a reduced physical and psychological health-related quality of life (HRQoL). Maladaptive coping styles are associated with poor HRQoL in a number of diseases and patients with pituitary adenomas in general exhibit less effective coping styles than healthy controls. This study aimed to assess coping strategies in acromegaly patients in order to explore leverage points for the improvement of HRQoL.

METHODS

In this cross-sectional study, we administered self-report surveys for coping strategies and HRQoL (Short Form SF-36, Freiburg questionnaire on coping with illness, FKV-LIS) in patients with acromegaly. These were set into relation with a variety of health variables.

RESULTS

About half of the 106 patients (44.3% female) with a mean age of 56.4 ± 1.3 years showed impaired physical and psychological HRQoL on average 11.2 years after the initial diagnosis. Body mass index, age at survey date and concomitant radiotherapy explained 27.8% of the variance of physical HRQoL, while depressive coping added an additional 9.2%. Depressive coping style and trivialization and wishful thinking were pivotal predictors of an impaired psychological HRQoL with a total explained variance of 51.6%, whereas patient health variables did not affect psychological HRQoL.

CONCLUSION

Our results show that maladaptive coping styles have a substantial negative impact on psychological HRQoL in patients with acromegaly, whereas physical HRQoL is influenced to a lesser extent. Specialized training programs aimed at improving coping strategies could reduce long-term disease burden and increase HRQoL in the affected patients.

摘要

目的

肢端肥大症患者的身心健康相关生活质量(HRQoL)通常较低。在许多疾病中,适应性应对方式与较差的 HRQoL 相关,一般而言,垂体腺瘤患者的应对方式比健康对照者更不有效。本研究旨在评估肢端肥大症患者的应对策略,以探索改善 HRQoL 的着力点。

方法

在这项横断面研究中,我们对肢端肥大症患者进行了应对策略和 HRQoL(SF-36 简表、弗莱堡疾病应对问卷、FKV-LIS)的自我报告调查。这些与各种健康变量相关联。

结果

在 106 例患者中(女性占 44.3%),约有一半患者(平均年龄 56.4±1.3 岁)在最初诊断后平均 11.2 年表现出身体和心理 HRQoL 受损。体质指数、调查日期的年龄和同时进行的放射治疗解释了身体 HRQoL 变异的 27.8%,而抑郁应对方式则增加了 9.2%。抑郁应对方式和轻描淡写与一厢情愿是心理 HRQoL 受损的关键预测因素,总解释方差为 51.6%,而患者健康变量对心理 HRQoL 没有影响。

结论

我们的研究结果表明,适应性应对方式对肢端肥大症患者的心理 HRQoL 有实质性的负面影响,而身体 HRQoL 的影响较小。旨在改善应对策略的专门培训计划可能会减轻长期疾病负担,提高受影响患者的 HRQoL。

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本文引用的文献

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Allostatic Load and Endocrine Disorders.应激激素负荷与内分泌紊乱
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