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遗传性骨骼发育异常患者的健康相关生活质量

Health-related quality of life of patients with genetic skeletal dysplasias.

作者信息

Apajasalo M, Sintonen H, Rautonen J, Kaitila I

机构信息

Children's Hospital, University of Helsinki, Finland.

出版信息

Eur J Pediatr. 1998 Feb;157(2):114-21. doi: 10.1007/s004310050781.

Abstract

UNLABELLED

While medical knowledge on genetic skeletal dysplasias has expanded, very little is known about the patients' health-related quality of life (HRQOL). To test the validity and sensitivity of the fifteen and sixteen dimensional measures of HRQOL in patients with chondrodysplasias, we examined 121 adults aged 16-54 and 19 adolescents aged 12-15 with achondroplasia, cartilage-hair hypoplasia and diastrophic dysplasia. The age and sex standardized overall HRQOL score of the adult patients (0.885 on a scale from 0 to 1) was significantly lower than that of normal controls (0.928) (P < 0.001). The difference in the HRQOL between the patients and the controls consisted mainly of the differences in dimensions of mobility, usual activities, sexual activity and discomfort, for which the patients reported a significantly lower status (more problems) than the controls (P < 0.001). Adolescent patients demonstrated HRQOL profiles similar to those of adults. However, age-specific problems occurred on the dimensions of school and hobbies, friends and physical appearance (P < 0.05). In a detailed examination of different patient groups, some clinically unexpected findings were observed, suggesting that denial is at least in part involved.

CONCLUSION

Subjective assessment of HRQOL of patients with chondrodysplasias is valuable for provision of optimal care. In treatment and management special attention should be paid to those dimensions on which the patients' perceived status is currently suboptimal, especially during adolescence which probably is the most critical period in the lives of these individuals.

摘要

未标注

尽管关于遗传性骨骼发育不良的医学知识不断扩展,但对于患者与健康相关的生活质量(HRQOL)却知之甚少。为了测试软骨发育不良患者HRQOL的十五维和十六维测量方法的有效性和敏感性,我们检查了121名年龄在16 - 54岁的成年人以及19名年龄在12 - 15岁的青少年,他们分别患有软骨发育不全、软骨毛发发育不全和畸形性发育不良。成年患者年龄和性别标准化后的总体HRQOL评分(0至1分制下为0.885)显著低于正常对照组(0.928)(P < 0.001)。患者与对照组在HRQOL上的差异主要体现在活动能力、日常活动、性活动和不适等维度上,患者在这些方面的状况(问题更多)显著低于对照组(P < 0.001)。青少年患者的HRQOL概况与成年人相似。然而,在学校与爱好、朋友和外貌等维度上出现了与年龄相关的问题(P < 0.05)。在对不同患者群体的详细检查中,观察到了一些临床上意想不到的发现,提示否认态度至少在一定程度上存在。

结论

对软骨发育不良患者的HRQOL进行主观评估对于提供最佳护理很有价值。在治疗和管理中,应特别关注患者目前自我认知状况欠佳的那些维度,尤其是在青春期,这可能是这些个体生命中最关键的时期。

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