心理社会因素对肠易激综合征患者生活质量的影响  

Impact of psychosocial parameters on quality of life in patients with irritable bowel syndrome

作　　者：王伟岸[1] 何剑琴[1] 胡品津[1] 曾志荣[1] 陈为[1] 

机构地区：[1]中山大学附属第一医院消化科,广东省广州市510080

出　　处：《世界华人消化杂志》2004年第7期1626-1630,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨影响就诊肠易激综合征(IBS)患者生活质量的心理社会因素. 方法:采用肠易激综合征生活质量量表、心理学症状自评量表(SCL-90)、生活事件量表、特质应对方式问卷、应付方式问卷、社会支持评定量表及匹兹堡睡眠质量指数对符合罗马Ⅱ标准连续在消化专科门诊的41例IBS患者进行测评,并与同期诊断的匹配的37名健康自愿者对照.通过多元逐步回归分析探讨心理行为因素对患者生活质量的影响. 结果:与正常组相比,IBS组生活质量的8个因子和总分均显著降低(P<0.05),其中即烦躁不安、冲突行为、社会反应、健康忧虑降低最为明显(P=0.000).此外,TBS患者精神症状明显(40.2±4.5,t=2.63,P=0.047),焦虑0.67±0.30,t=2.16,P=0.016)和抑郁(0.64±0.24, t=2.53,P=0.020)积分也显著增高.IBS患者的消极应对(40.8±8.0,P<0.05),幻想(4.95±2.1,P=0.001)租退避(4.81±2.1,P=0.004)以及主观支持(23.9±4.2,P=0.046) 积分均明显高于正常人.同时IBS患者的睡眠质量、日间功能显著降低,PSQI、睡眠障碍积分和安眠药应用显著增加.多元回归分析显示IBS患者的生活质量降低与睡眠质量(β=0.281)和负性生活事件(β=-0.363)及焦虑状态(β= -0.175)关系更为密切. 结论:IBS患者生活质量降低与多种心理社会参数异常呈明显的负相关.AIM: To investigate the impact of psychosocial parameters on the quality of life (QOL) in healthcare seeking patients with irritable bowel syndrome (IBS). METHODS: QOL and psychosocial parameters in consecutive 41 patients with IBS irritable bowel syndrome (IBS) according to Rome Ⅱ criteria were measured by questionnaires including IBS-QOL, Pittsburgh sleep quality index (PSQI) and symptom checklist-90 (SCL-90), coping style, social supports, respectively. In the meantime, 37 normal subjects were served as a control group. The relationship between IBS-QOL and psychosocial parameters was investigated by regression analysis. RESULTS: Compared with normal subjects, all subscales scores of QOL were lower (P<0.05, respectively), especially in dysphoria, interference with activity, health worry, social reaction, and overall score (P =0.000, respectively). In addition, IBS patients had more psychiatric symptoms (40.24±4.5, t =2.63, P =0.047), and higher scores of depression (0.64±0.24, t =2.53, P=0.020) and anxiety (0.67±0.30, t =2.16, P =0.016). The score of negative coping (40.79±8.01, P<0.05), fancying (4.95±2.1, P =0.001) and withdrawal (4.81±2.1, P =0.004), as well as subjective supporting (23.92±4.2, P=0.046) in IBS was higher than that in normal subjects. Among IBS patients, the quality of sleep and daily functions significantly decreased, PSQI and sleep disturbances as well as soporific using was markedly increased. Multiple regression analysis showed poorer quality of life in IBS was related with sleep quality (P =0.281), negative life event (P =-0.363)and anxiety (β=-0.175). CONCLUSION: QOL in healthcare seeking patients with IBS is impaired significantly, which is negatively associated with the abnormalities of many of psychosocial parameters.

关 键 词：心理社会因素 肠易激综合征 生活质量 生活质量量表 心理学症状自评量表 

分 类 号：R574.4[医药卫生—消化系统]