Lydick E, Martin A, Yawn B
Merck Research Laboratories, West Point, Pennsylvania, USA.
Clin Ther. 1996 Nov-Dec;18(6):1307-15. doi: 10.1016/s0149-2918(96)80084-1.
Fears and apprehensions are often cited as contributing to decreased quality of life; however, questions relating to worry over the future are rarely included in generic quality-of-life questionnaires. We report an effort to quantify the effect of fear on quality-of-life domains as measured by using the Short-Form 36 (SF-36) Health Survey. In the course of developing an osteoporosis-targeted quality-of-life (OPTQoL) questionnaire, we asked participants to complete the SF-36 Health Survey and another questionnaire containing items that women with osteoporosis could be expected to find difficult or worrisome. Two hundred twenty-two women with established osteoporosis (loss of height, kyphosis, history of fractures); 101 women with known low bone mineral density (BMD) but without established osteoporosis; and 142 women with no known osteoporosis completed both the osteoporosis questionnaire and the SF-36 Health Survey. This test version of the OPTQoL contained two domains for fears of osteoporosis and the consequent fractures and deformities; these domains were termed fears now and fears future. After adjusting for age and selected comorbidities, we estimated the additional contribution of the two fears domains on the domain scores of the SF-36 Health Survey. For women with established osteoporosis, the fears now domain explained 4% to 8% of the variance within each domain of the survey. For women with low BMD only, fears now had a significant effect only on the physical functioning domain of the survey and explained 4% of the variance of that domain. Fears future had a significant role in explaining the SF-36 Health Survey score on all domains except physical functioning among women with established osteoporosis; however, the fears future domain explained less of the variance (2% to 5%) among these women than did the fears now domain. For women with low BMD only, fears future had a significant impact only on the mental health and the general health domains (4% and 5% of the variance, respectively). Osteoporosis-related fears appear to explain a small but significant percentage of the variation in quality of life for women in midlife.
恐惧和担忧常被认为会导致生活质量下降；然而，与对未来的担忧相关的问题很少被纳入通用的生活质量问卷中。我们报告了一项旨在量化恐惧对使用简短健康调查问卷36项（SF - 36）所测量的生活质量领域的影响的研究。在开发针对骨质疏松症的生活质量（OPTQoL）问卷的过程中，我们要求参与者完成SF - 36健康调查问卷以及另一份包含骨质疏松症女性可能会觉得困难或令人担忧的项目的问卷。222名患有确诊骨质疏松症（身高降低、脊柱后凸、骨折病史）的女性；101名已知骨密度低（BMD）但未确诊骨质疏松症的女性；以及142名无已知骨质疏松症的女性完成了骨质疏松症问卷和SF - 36健康调查问卷。OPTQoL的这个测试版本包含两个关于对骨质疏松症及其导致的骨折和畸形的恐惧的领域；这些领域被称为“当下恐惧”和“未来恐惧”。在对年龄和选定的合并症进行调整后，我们估计了这两个恐惧领域对SF - 36健康调查问卷领域得分的额外贡献。对于患有确诊骨质疏松症的女性，“当下恐惧”领域解释了调查中每个领域内4%至8%的方差。对于仅骨密度低的女性，“当下恐惧”仅对调查的身体功能领域有显著影响，并解释了该领域4%的方差。“未来恐惧”在解释患有确诊骨质疏松症的女性除身体功能外所有领域的SF - 36健康调查问卷得分方面发挥了重要作用；然而，在这些女性中，“未来恐惧”领域解释的方差（2%至5%）比“当下恐惧”领域少。对于仅骨密度低的女性，“未来恐惧”仅对心理健康和总体健康领域有显著影响（分别为方差的4%和5%）。与骨质疏松症相关的恐惧似乎解释了中年女性生活质量变化中一小部分但显著的比例。
