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纤维肌痛患者的虐待史与症状严重程度及生活质量的关联

Association of abuse history with symptom severity and quality of life in patients with fibromyalgia.

作者信息

Jiao Juan, Vincent Ann, Cha Stephen S, Luedtke Connie A, Oh Terry H

机构信息

Department of Physical Medicine and Rehabilitation, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.

出版信息

Rheumatol Int. 2015 Mar;35(3):547-53. doi: 10.1007/s00296-014-3113-0. Epub 2014 Aug 18.

Abstract

A high prevalence of abuse has been reported in patients with fibromyalgia. We aimed to examine the association between self-reported abuse history and symptom severity and quality of life (QOL) in 962 patients with fibromyalgia. All patients completed the Fibromyalgia Impact Questionnaire (FIQ) and the Short Form 36 health survey (SF-36). Multivariate regression analyses were performed. In total, 289 patients (30%) reported a history of abuse. Of those who specified abuse types, 161 patients (59%) reported more than 1 type of abuse (36% emotional, 32% physical, 25% sexual, and 7% verbal). Patients in the abuse group were younger and more likely to be female, unemployed, unmarried, and current smokers compared with patients who reported no abuse. After adjusting for these differences, abuse history was associated with worse symptoms, as indicated by a higher FIQ total score (P < .001) and higher FIQ subscale scores in physical function (P = .001), work missed (P < .001), job ability (P < .001), pain (P = .02), depression (P < .001), and anxiety (P < .001). Similarly, abuse history was associated with worse QOL, with lower SF-36 scores in all domains except the physical component summary. In conclusion, abuse history in patients with fibromyalgia was associated with worse symptoms and QOL compared with those patients without abuse history. Future studies are needed to assess whether additional tailored interventions as part of fibromyalgia treatment are helpful for patients with a history of abuse.

摘要

据报道,纤维肌痛患者中虐待行为的发生率很高。我们旨在研究962例纤维肌痛患者自我报告的虐待史与症状严重程度及生活质量(QOL)之间的关联。所有患者均完成了纤维肌痛影响问卷(FIQ)和简短健康调查36项量表(SF-36)。进行了多变量回归分析。共有289例患者(30%)报告有虐待史。在明确了虐待类型的患者中,161例患者(59%)报告遭受了不止一种类型的虐待(36%为情感虐待,32%为身体虐待,25%为性虐待,7%为言语虐待)。与未报告有虐待史的患者相比,虐待组患者更年轻,更可能为女性、失业、未婚且为当前吸烟者。在对这些差异进行调整后,虐待史与更严重的症状相关,FIQ总分更高(P <.001)以及FIQ身体功能、误工、工作能力、疼痛、抑郁和焦虑等分量表得分更高(分别为P =.001、P <.001、P <.001、P =.02、P <.001和P <.001)表明了这一点。同样,虐待史与更差的生活质量相关,除身体成分总结外,所有领域的SF-36得分均较低。总之,与无虐待史的纤维肌痛患者相比,有虐待史的患者症状更严重,生活质量更差。未来需要开展研究,以评估作为纤维肌痛治疗一部分的额外针对性干预措施对有虐待史的患者是否有帮助。

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