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多发性硬化症中的疲劳与社会经济因素有关。

Fatigue in multiple sclerosis is associated with socioeconomic factors.

作者信息

Broch Line, Flemmen Heidi Øyen, Simonsen Cecilia Smith, Berg-Hansen Pål, Ormstad Heidi, Brunborg Cathrine, Celius Elisabeth Gulowsen

机构信息

Department of Neurology, Vestre Viken Hospital Trust, Drammen, Norway; Department of Neurology, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway.

Department of Neurology, Hospital Telemark HF, Skien, Norway; Institute of Health and Society, University of Oslo, Norway.

出版信息

Mult Scler Relat Disord. 2022 Aug;64:103955. doi: 10.1016/j.msard.2022.103955. Epub 2022 Jun 9.

Abstract

OBJECTIVES

Fatigue is one of the leading causes of reduced quality of life and inability to work in people with multiple sclerosis (pwMS). Currently, no treatment effectively ameliorates fatigue. We still know little about what causes fatigue and which factors may contribute to fatigue. Knowledge about socioeconomic factors' role in fatigue might help us recognize strategies for the management of fatigue. Our aim was to explore whether socioeconomic factors are associated with the presence or level of perceived fatigue.

METHODS

This is a cross-sectional study of the MS population in three Norwegian counties. We used the Fatigue Scale for Motor and Cognitive Functions to assess self-reported fatigue, and obtained socioeconomic data from Statistics Norway and questionnaires. To assess self-reported anxiety and depression, we employed the Hospital Anxiety and Depression Scale. Clinical data were gathered from the hospital record system.

RESULTS

The response rate was 64% (1599/2512). Seventy percent of the respondents were female, and the mean age was 52 years. Higher levels of education were associated with lower levels of fatigue. Receiving a disability pension, being divorced and having children were all factors associated with higher levels of fatigue, as were low parental education, low income, current smoking, and autoimmune comorbidities. We found a higher prevalence of anxiety and depression in pwMS with fatigue compared to those without fatigue CONCLUSION: Female sex, high level of disability, anxiety, depression and socioeconomic factors were independently associated with fatigue in contemporary patients with MS. These factors should be considered when devising management strategies.

摘要

目的

疲劳是导致多发性硬化症患者(pwMS)生活质量下降和无法工作的主要原因之一。目前,尚无有效治疗方法能改善疲劳症状。我们对疲劳的成因以及哪些因素可能导致疲劳仍知之甚少。了解社会经济因素在疲劳中的作用或许能帮助我们找到管理疲劳的策略。我们的目的是探讨社会经济因素是否与感知到的疲劳的存在或程度相关。

方法

这是一项对挪威三个郡的多发性硬化症患者群体进行的横断面研究。我们使用运动和认知功能疲劳量表来评估自我报告的疲劳情况,并从挪威统计局和问卷中获取社会经济数据。为评估自我报告的焦虑和抑郁情况,我们采用医院焦虑抑郁量表。临床数据从医院记录系统收集。

结果

回复率为64%(1599/2512)。70%的受访者为女性,平均年龄为52岁。受教育程度较高与疲劳程度较低相关。领取残疾抚恤金、离婚和育有子女都是与较高疲劳水平相关的因素,低父母教育水平、低收入、当前吸烟以及自身免疫性合并症也是如此。我们发现,与无疲劳的pwMS患者相比,有疲劳的pwMS患者焦虑和抑郁的患病率更高。结论:在当代多发性硬化症患者中,女性、高残疾水平、焦虑、抑郁和社会经济因素与疲劳独立相关。在制定管理策略时应考虑这些因素。

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