老年糖尿病周围神经病变患者生活质量调查及其影响因素

Quality of life and influencing factors in elderly patients with diabetic peripheral neuropathy

目的探讨老年糖尿病周围神经病变(DPN)患者生活质量情况及其影响因素。方法选择屯昌县人民医院2019年1月至2022年12月收治的156例老年T2DM合并DPN患者为观察组,同时期收治的263例单纯老年T2DM患者为对照组。采用糖尿病生存质量特异性量表(DSQL)调查患者生存质量,疾病进展恐惧简化量表(FoP-Q-SF)调查患者疾病进展恐惧感,汉密尔顿焦虑量表(HAMA)调查患者焦虑状况,密歇根神经病变问卷(MNSI)调查患者神经病变严重程度。采用SPSS 23.0统计软件进行数据分析。根据数据类型,分别采用单因素方差分析、t检验或χ2检验进行组间比较。采用多元线性回归分析影响观察组患者生活质量的相关因素。结果观察组患者DSQL各维度得分及量表总得分均高于对照组;FoP-Q-SF得分≥34分、心理功能失调及焦虑者占比均高于对照组;MNSI总得分高于对照组,差异均有统计学意义(P<0.05)。多元线性回归分析提示,有固定照顾者(β=-0.633;P<0.001)、年龄(β=0.287;P<0.001)、自评疾病经济负担(β=0.226;P<0.001)、疾病进展恐惧(β=0.648;P<0.001)、焦虑(β=0.513;P<0.001)、MNSI得分(β=0.578;P<0.001)及疼痛性DPN(β=0.715;P<0.001)是影响观察组患者生活质量DSQL得分的相关因素,其共同解释生活质量62.50%的变异。结论老年T2DM合并DPN患者生活质量较无并发症者普遍下降,除年龄、自评疾病经济负担、神经病变严重程度及疼痛性DPN外,疾病进展恐惧感、焦虑等心理障碍也会影响患者生活质量,此外,拥有固定照顾者的患者生活质量更高。

Objective To investigate the quality of life in the elderly patients with diabetic peripheral neuropathy(DPN)and the influencing factors.Methods A total of 156 elderly T2DM patients with DPN admitted to Tunchang People′s Hospital from January 2019 to December 2022 were included in the observation group,and 263 elderly T2DM patients without DPN in the control group.The quality of life was investigated by diabetes specific quality of life scale(DSQL),the fear of disease progression by the fear of progression questionnaire-short form(FoP-Q-SF),the anxiety status of patients by the Hamilton anxiety scale(HAMA),and the severity of neuropathy in patients by the Michigan neuropathy screening instrument(MNSI).SPSS 23.0 was used for data processing,and multivariate linear regression analysis was used to analyze the factors affecting the quality of life of patients in the observation group.Results The DSQL scores of each dimension and the total score in the observation group were higher than those in the control group,the proportions of patients with FoP-Q-SF score≥34,psychological dysfunction and anxiety were higher than those in control group;the total MNSI score was also higher in the control group,and the differences were statistically significant(P<0.05).Multivariate linear regression analysis suggested that having regular caregivers(β=-0.633;P<0.001),age(β=0.287;P<0.001),self-rated economic burden of disease(β=0.226;P<0.001),fear of disease progression(β=0.648;P<0.001),anxiety(β=0.513;P<0.001),MNSI questionnaire score(β=0.578;P<0.001)and painful DPN(β=0.715;P<0.001)were factors affecting DSQL score in the observation group,which jointly explained 62.50%of the variation in quality of life.Conclusion The quality of life in the elderly T2DM patients with DPN is generally lower than that of the patients without complications.In addition to age,self-rated economic burden of disease,severity of neuropathy and painful DPN,psychological disorders such as fear of disease progression and anxiety can also affect the patients′quality of life.Additionally,patients with regular caregivers have a higher quality of life.