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认知功能、心理障碍和应对策略对炎症性肠病患者生活质量和疾病结局的影响:一项横断面研究。

The impact of cognitive functions, psychological disorders, and coping strategies on quality of life and disease outcomes in patients with inflammatory bowel diseases: A cross-sectional study.

机构信息

Department of Clinical Physiology, Faculty of Medicine, King Abdualziz University, Jeddah, Saudi Arabia.

Division of Gastroenterology, Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

出版信息

Medicine (Baltimore). 2024 Jul 26;103(30):e38982. doi: 10.1097/MD.0000000000038982.

Abstract

Quality of life (QoL) in patients with inflammatory bowel disease (IBD) is influenced by several factors, many of which may also impact cognitive function. However, the extent of the interaction among these factors, QoL, and disease outcomes in IBD patients remains unknown. We thus aim to characterize the relationships among psychological disorders, coping mechanisms, cognitive function, and the overall impact on QoL and disease outcomes in patients with IBD. This cross-sectional observational study was conducted at an academic care center. QoL was evaluated using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and disease severity was evaluated using the Harvey-Bradshaw Index (HBI) for Crohn's disease (CD) and the Simple Clinical Colitis Activity Index (SCCAI) for ulcerative colitis (UC). We also used the Hospital Anxiety and Depression scale (HADS). Regression models were used to test the associations among QoL, number of hospitalizations, disease severity, cognitive functioning (working memory [WM] and reaction time), and coping strategies while controlling for anxiety and depressive symptoms, age, and sex. This study included 41 patients (24 patients with CD and 17 with UC) whose mean age was 28.2 (±8.4) years (23 males) and mean SIBDQ score was 51.5 (±10.0). Patients with more WM errors had lower QoL scores (P = .041), whereas patients with higher anxiety levels had lower QoL and more active UC (P = .008 and P = .016, respectively). The use of avoidant coping mechanisms was associated with a significantly higher number of hospitalizations (P = .038), and patients who adopted more emotion-focused coping strategies had a longer illness duration (P = .021). Finally, patients with higher education levels were found to use more active coping mechanisms than others. These results confirm the impact of cognitive, psychological, and coping factors on QoL and disease outcomes in patients with IBD; however, the mechanisms by which these factors interrelate remain unclear. Therapies aimed at improving both cognitive functions and psychological conditions may thus be effective at improving QoL and disease outcomes in IBD patients, and education may play a positive role in promoting the adoption of more effective coping strategies among IBD patients.

摘要

炎症性肠病(IBD)患者的生活质量(QoL)受到多种因素的影响,其中许多因素也可能影响认知功能。然而,这些因素、QoL 和 IBD 患者疾病结局之间的相互作用程度尚不清楚。因此,我们旨在描述心理障碍、应对机制、认知功能之间的关系,并确定其对 IBD 患者的 QoL 和疾病结局的整体影响。这项横断面观察性研究在学术护理中心进行。使用短炎症性肠病问卷(SIBDQ)评估 QoL,使用克罗恩病的 Harvey-Bradshaw 指数(HBI)和溃疡性结肠炎的简单临床结肠炎活动指数(SCCAI)评估疾病严重程度。我们还使用了医院焦虑和抑郁量表(HADS)。回归模型用于测试 QoL、住院次数、疾病严重程度、认知功能(工作记忆[WM]和反应时间)和应对策略之间的关联,同时控制焦虑和抑郁症状、年龄和性别。这项研究包括 41 名患者(24 名克罗恩病患者和 17 名溃疡性结肠炎患者),平均年龄为 28.2(±8.4)岁(23 名男性),平均 SIBDQ 评分为 51.5(±10.0)。WM 错误较多的患者 QoL 评分较低(P=0.041),而焦虑水平较高的患者 QoL 和更活跃的溃疡性结肠炎评分较低(P=0.008 和 P=0.016)。回避应对机制的使用与住院次数显著增加相关(P=0.038),而采用更多情绪聚焦应对策略的患者疾病持续时间较长(P=0.021)。最后,发现教育程度较高的患者比其他人更倾向于使用主动应对机制。这些结果证实了认知、心理和应对因素对 IBD 患者 QoL 和疾病结局的影响;然而,这些因素相互关联的机制尚不清楚。因此,改善认知功能和心理状况的治疗方法可能对改善 IBD 患者的 QoL 和疾病结局有效,而教育可能在促进 IBD 患者采用更有效的应对策略方面发挥积极作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1032/11272307/1cce48dd01ed/medi-103-e38982-g001.jpg

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