Loibnegger-Traußnig Katharina, Schwerdtfeger Andreas R, Flaggl Franz
Department of Psychology, University of Graz, Universitätsplatz 3, 8010, Graz, Austria.
Lymphatic Clinic, General Hospital Wolfsberg, Wolfsberg, Austria.
Int J Behav Med. 2024 Dec 10. doi: 10.1007/s12529-024-10340-z.
How does living with a chronic disease of the lymphatic system affect quality of life and mortality? Lymphedema is a chronic disease mostly affecting women and research is sparse. To this date, longitudinal studies evaluating biopsychosocial predictors for mortality and quality of life in lymphedema are largely missing. This study aims to identify possible predictors and could open innovative ways for treatment options.
Two hundred ninety-two patients with lymphedema partaking in a rehabilitation program in a lymphedema clinic were longitudinally assessed. The sample consisted of 86.2% women, aged between 18 and 83 years (M = 53.42, SD = 12.54), with a mean BMI (kg/m) of 31.64 (SD = 8.26). Beginning with baseline assessment in 2002-2006, follow-up was evaluated 15-19 years later (N = 91). We assessed a variety of potential biopsychosocial predictors of mortality and quality of life (i.e., depression, anxiety, cancer). At follow-up, 19.5% of participants were deceased.
Age, gender, and cancer significantly predicted mortality (R = .27) and quality of life (R = .29). Anxiety and depression significantly predicted both quality of life and mortality when entered simultaneously. However, further analyses indicated suppressor effects and when entered separately, effects solely for depression or anxiety did not reach significance level.
Age, gender, and cancer were the main predictors of mortality and quality of life in patients with lymphedema. Psychological predictors of mortality and quality of life were mainly due to suppressor effects, thus calling for caution when analyzing the contribution of mental health indicators for clinical outcomes.
This study was preregistered with the German Clinical Trials Register (Identifier DRKS00024450) and Open Science Framework ( https://doi.org/10.17605/OSF.IO/RHXQJ ).
患有淋巴系统慢性疾病如何影响生活质量和死亡率？淋巴水肿是一种主要影响女性的慢性疾病，相关研究较少。迄今为止，评估淋巴水肿患者死亡率和生活质量的生物心理社会预测因素的纵向研究基本缺失。本研究旨在确定可能的预测因素，并为治疗方案开辟创新途径。
对292名在淋巴水肿诊所参加康复项目的淋巴水肿患者进行纵向评估。样本包括86.2%的女性，年龄在18至83岁之间（M = 53.42，标准差 = 12.54），平均体重指数（kg/m）为31.64（标准差 = 8.26）。从2002 - 2006年的基线评估开始，15 - 19年后进行随访评估（N = 91）。我们评估了多种死亡率和生活质量的潜在生物心理社会预测因素（即抑郁、焦虑、癌症）。随访时，19.5%的参与者已死亡。
年龄、性别和癌症显著预测死亡率（R = 0.27）和生活质量（R = 0.29）。焦虑和抑郁同时纳入时显著预测生活质量和死亡率。然而，进一步分析表明存在抑制效应，单独纳入时，抑郁或焦虑的效应未达到显著水平。
年龄、性别和癌症是淋巴水肿患者死亡率和生活质量的主要预测因素。死亡率和生活质量的心理预测因素主要是由于抑制效应，因此在分析心理健康指标对临床结果的贡献时需谨慎。
本研究已在德国临床试验注册中心（标识符DRKS00024450）和开放科学框架（https://doi.org/10.17605/OSF.IO/RHXQJ）进行预注册。
