Factors Associated With Distress Related to Perceived Dignity in Patients With Rheumatic Diseases.

IF 2.4 4区 医学 Q2 RHEUMATOLOGY
JCR: Journal of Clinical Rheumatology Pub Date : 2024-06-01 Epub Date: 2024-03-09 DOI:10.1097/RHU.0000000000002083
Virginia Pascual-Ramos, Irazú Contreras-Yáñez, Maximiliano Cuevas-Montoya, Guillermo Arturo Guaracha-Basañez, Mario García-Alanis, Oscar Rodríguez-Mayoral, Harvey Max Chochinov
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引用次数: 0

Abstract

Background: The loss of perceived dignity is an existential source of human suffering, described in patients with cancer and chronic diseases and hospitalized patients but rarely explored among patients with rheumatic diseases (RMDs). We recently observed that distress related to perceived dignity (DPD) was present in 26.9% of Mexican patients with different RMDs. The study aimed to investigate the factors associated with DPD.

Methods: This cross-sectional study was performed between February and September 2022. Consecutive patients with RMDs completed patient-reported outcomes (to assess mental health, disease activity/severity, disability, fatigue, quality of life [QoL], satisfaction with medical care, and family function) and had a rheumatic evaluation to assess disease activity status and comorbidity. Sociodemographic variables and disease-related and treatment-related variables were retrieved with standardized formats. DPD was defined based on the Patient Dignity Inventory score. Multivariate regression analysis was used.

Results: Four hundred patients were included and were representative of outpatients with RMDs, while 7.5% each were inpatients and patients from the emergency care unit. There were 107 patients (26.8%) with DPD. Past mental health-related comorbidity (Odds Ratio [OR]: 4.680 [95% Confidence Interval [CI]: 1.906-11.491]), the number of immunosuppressive drugs/patient (OR: 1.683 [95% CI: 1.015-2.791]), the physical health dimension score of the World Health Organization Quality of Life-Brief questionnaire (WHOQOL-BREF) (OR: 0.937 [95% CI: 0.907-0.967]), and the emotional health dimension score of the WHOQOL-BREF (OR: 0.895 [95% CI: 0.863-0.928]) were associated with DPD.

Conclusions: DPD was present in a substantial proportion of patients with RMDs and was associated with mental health-related comorbidity, disease activity/severity-related variables, and the patient QoL.

风湿病患者与感知尊严相关的苦恼因素。
背景:尊严缺失是人类痛苦的根源之一,癌症、慢性病患者和住院病人都有过这种经历,但风湿性疾病(RMD)患者却很少有这种经历。我们最近观察到,在患有不同风湿性疾病的墨西哥患者中,有 26.9% 的人存在与尊严感知相关的痛苦(DPD)。本研究旨在调查与尊严感知相关的因素:这项横断面研究于 2022 年 2 月至 9 月间进行。连续的 RMD 患者填写了患者报告结果(以评估心理健康、疾病活动/严重程度、残疾、疲劳、生活质量 [QoL]、医疗护理满意度和家庭功能),并进行了风湿病评估,以评估疾病活动状态和合并症。社会人口学变量以及与疾病和治疗相关的变量均采用标准化格式进行检索。DPD是根据患者尊严量表评分来定义的。采用多变量回归分析:共纳入 400 名 RMD 患者,其中门诊患者占 7.5%,住院患者和急诊科患者各占 7.5%。107名患者(26.8%)患有精神分裂症。过去与精神健康相关的合并症(比值比 [OR]:4.680 [95% 置信区间 [CI]:1.906-11.491])、免疫抑制药物/患者的数量(比值比 [OR]:1.683 [95% 置信区间 [CI]:1.015-2.791])、世界卫生组织生活质量简明问卷(WHOQOL-BREF)的身体健康维度评分(OR:0.937 [95% CI:0.907-0.967])和 WHOQOL-BREF 的情绪健康维度评分(OR:0.895 [95% CI:0.863-0.928])与 DPD 相关:结论:相当一部分 RMD 患者存在 DPD,并且与心理健康相关合并症、疾病活动/严重程度相关变量和患者 QoL 有关。
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来源期刊
CiteScore
3.50
自引率
2.90%
发文量
228
审稿时长
4-8 weeks
期刊介绍: JCR: Journal of Clinical Rheumatology the peer-reviewed, bimonthly journal that rheumatologists asked for. Each issue contains practical information on patient care in a clinically oriented, easy-to-read format. Our commitment is to timely, relevant coverage of the topics and issues shaping current practice. We pack each issue with original articles, case reports, reviews, brief reports, expert commentary, letters to the editor, and more. This is where you''ll find the answers to tough patient management issues as well as the latest information about technological advances affecting your practice.
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