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[类风湿关节炎患者的生活质量、主观健康状况以及健康与生活满意度]

[Quality of life, subjective health status and health and life satisfaction in rheumatoid arthritis].

作者信息

Sato H, Araki S, Hashimoto A, Moroi Y, Kondo H, Ishihara Y, Akizuki M, Kutsuna T, Shiina Y, Hoshi K

机构信息

Department of Public Health, Faculty of Medicine, University of Tokyo.

出版信息

Nihon Koshu Eisei Zasshi. 1995 Sep;42(9):743-54.

PMID:8534873
Abstract

A Japanese version of Arthritis Impact Measurement Scales (AIMS) was developed after the original AIMS Version 2 and utilized for Quality of Life (QOL) measurement in 691 patients with Rheumatoid Arthritis (RA). Various medical (physical and laboratory) examinations, which are widely used in the clinical settings for the assessment of RA activity and severity, were also performed by physicians. Interrelationships between QOL, patient subjective health status, and health and life satisfaction were analyzed with the following results: 1: The effect of QOL impairment by RA upon patients' subjective health rating and health satisfaction were not constant over the range of severity of disease status. Pain was found to lower overall subjective health and health satisfaction regardless of RA class. On the other hand, while the deterioration of mobility aspects of QOL had negative effects upon patients' subjective health status and satisfaction among less-disabled RA patients, any of physical aspects of QOL, including the degree of mobility impairment, showed no significant association with patients' subjective health status and satisfaction in the more disabled. 2: Psychological aspects of QOL (mood and tension) had significant associations with patients' subjective health status and satisfaction. In the less severe group, mood impairment had a significant effect on subjective health and satisfaction, while in the more severe group tension showed a significant association. It was indicated that management of psychological aspects of QOL is important in RA patients to improve and advance their subjective health status and satisfaction. 3: Although social aspects of QOL, i.e. social support, social life and job status, showed no significant relationship to subjective health rating and health satisfaction, those with less disease severity who lacked social support and who had a jobless state were likely to have lower disease acceptance and life satisfaction, while those with more severe disease who had less social interaction manifested lower life satisfaction. These results suggested that social aspects of QOL, while not directly associated with subjective health rating, could be important factors affecting disease acceptance and life satisfaction.

摘要

在原始的关节炎影响测量量表(AIMS)第2版之后,开发了日语版的AIMS,并用于691例类风湿性关节炎(RA)患者的生活质量(QOL)测量。医生还进行了各种在临床环境中广泛用于评估RA活动和严重程度的医学(身体和实验室)检查。分析了QOL、患者主观健康状况以及健康和生活满意度之间的相互关系,结果如下:1:RA对QOL的损害对患者主观健康评分和健康满意度的影响在疾病状态严重程度范围内并非恒定不变。无论RA类别如何,疼痛都会降低总体主观健康和健康满意度。另一方面,虽然QOL中活动能力方面的恶化对残疾程度较轻的RA患者的主观健康状况和满意度有负面影响,但在残疾程度较重的患者中,QOL的任何身体方面,包括活动能力受损程度,与患者的主观健康状况和满意度均无显著关联。2:QOL的心理方面(情绪和紧张)与患者的主观健康状况和满意度有显著关联。在病情较轻的组中,情绪受损对主观健康和满意度有显著影响,而在病情较重的组中,紧张表现出显著关联。这表明,对RA患者QOL的心理方面进行管理对于改善和提高他们的主观健康状况和满意度很重要。3:虽然QOL的社会方面,即社会支持、社会生活和工作状况,与主观健康评分和健康满意度没有显著关系,但疾病严重程度较轻且缺乏社会支持以及处于无工作状态的患者可能疾病接受度和生活满意度较低,而疾病较严重且社交互动较少的患者生活满意度较低。这些结果表明,QOL的社会方面虽然与主观健康评分没有直接关联,但可能是影响疾病接受度和生活满意度的重要因素。

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