澳門地區類風濕關節炎患者生活質量及絕望焦慮情緒相關因素調查研究

Research of related factors including quality of life,hopelessness and anxiety in patients with rheumatoid arthritis in Macao region

目的探討澳門地區類風濕關節炎(RA)患者的生活質量及焦慮絕望情緒的影響因素,為提高患者的心理健康水平,改善患者的生活質量提供科學的依據。方法採用描述性研究設計,調查鏡湖醫院2012年1月~2012年6月期間門診或住院治療自願接受調查50例類風濕關節炎患者的基本資料、評價疾病活動度、生活質量、絕望、焦慮狀況。分析RA患者生活質量、絕望焦慮情緒的相關因素。結果本組RA患者WHOQOL BREF問卷調查,(1)生活質量中的生理、心理及環境維度與合併關節破壞呈負相關(p<0.05);(2)生活質量中只有生理維度與病情活動度呈負相關(p<0.01);(3)生活質量中的社會關係、環境維度與病程長短呈負相關(p<0.01);(4)絕望情緒與生活質量各部份呈負相關(p<0.01)、與病程呈正相關(p<0.05)、與合併關節破壞呈正相關(p<0.01);(5)焦慮情緒與同患其他慢性病呈負相關(p<0.01),與生活質量中生理、心理及環境維度呈負相關(p<0.01)。結論類風濕關節炎患者生活質量與病情長短及病程活動度、合併關節破壞相關,而絕望情緒與生活質量、病程長短、合併關節破壞相關;焦慮與生活質量同患其他慢性病相關。因此有效的控制類風濕關節炎的病情,避免關節破壞應該可以改善RA患者的負面情緒及改善患者的生活質量。

Objective To investigate the effects on quality of life(QOL),sense of hopelessness and anxiety in patients with rheumatoid arthritis(RA)in Macao SAR.Methods The descriptive research was designed to investigate 50 cases of RA patients treated in Kiang Wu Hospital from 1st January 2013 to 30th June 2013,analysis of self-developed questionnaire,Disease Acitivity Score 28(DAS 28),World Health Organization Quality of Life Brief Questionnaire(WHOQOL-BREF),Beck Hopelessness Scale(BHS)and Beck Anxiety Inventory(BAI)were performed to explore the co-relation between QOL,hopelessness and anxiety.Results 1)The physical,psychological and environmental domain score of WHOQOL-BREF were negatively associated with articular damage.(p<0.05).2)Only the physical domain score of WHOQOL-BREF was negatively associated with disease activity(p<0.05).3)The social relationship and the environmental domain score of WHOQOL-BREF were negatively associated with the duration of disease course(p<0.01).4)Meanwhile hopelessness were negatively associated with every domain of quality of life and articular damage,(p<0.01)but positively associated with the duration of disease(p<0.05).5)Anxiety was negatively associated with the simultaneous prevalence of other chronic disease(p<0.01),but it was also negatively associated with physical,psychological and environmental domain of WHOQOL-BREF(p<0.01).Conclusion The quality of life of RA patients are associated with the duration of disease course,disease activity and articular damage.Hopelessness are associated with quality of life,duration of disease and articular damage.Anxiety are associated with quality of life and simultaneous prevalence of other chronic disease.Effective control of the disease activity,preventing articular damage should improve the quality of life in RA patients.