Impact of pain, fatigue and bowel incontinence on the quality of life of people living with inflammatory bowel disease: A UK cross-sectional survey.

IF 5.8 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Chris Roukas, Laura Miller, Fionn Cléirigh Büttner, Thomas Hamborg, Imogen Stagg, Alisa Hart, Vladimir Sergeevich Gordeev, James O Lindsay, Christine Norton, Borislava Mihaylova
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Abstract

Background and aims: People with inflammatory bowel disease (IBD) often experience pain, fatigue and bowel incontinence and are at an increased risk of anxiety and depression. Our aim was to assess the impact of these symptoms on health-related quality of life (QoL) in IBD.

Methods: In the IBD-BOOST survey, over 26,000 people with IBD across the UK were approached; 8486 participant-completed surveys were returned. Participants' QoL was measured using the EQ-5D-5L questionnaire and their QoL was calculated on a scale ranging from 1 (perfect health) to -0.594 (worst health). Item non-response was imputed. Stages of linear regression models assessed the associations of symptoms with QoL controlling for IBD type, socio-demographic characteristics, co-morbidities and, in further analysis, for IBD activity and IBD control.

Results: The EQ-5D-5L questionnaire was fully completed by 8093 (95.4%) participants (mean age of 50 years [SD 15]; 49% with Crohn's disease). The mean QoL was 0.76 (SD 0.23). From the three IBD-related symptoms, pain was associated with the largest QoL decrement (-0.159), followed by fatigue (-0.140) and bowel incontinence (-0.048). Co-occurrence of pain and fatigue further reduced QoL. Clear graded associations were observed between symptom severity and QoL decrements (all trend p < 0.001). Depression and anxiety were also associated with significant QoL decrements (-0.102 and -0.110 for moderate-to-severe anxiety and moderately severe depression, respectively). Worse IBD control and higher IBD activity were associated with lower QoL.

Conclusions: We report strong associations between symptoms of pain, fatigue, bowel incontinence, anxiety, depression, and their severity and reduced QoL in IBD. These estimates could inform future IBD management interventions.

疼痛、疲劳和大便失禁对炎症性肠病患者生活质量的影响:英国横断面调查。
背景和目的:炎症性肠病(IBD)患者经常会感到疼痛、疲劳和大便失禁,而且患焦虑症和抑郁症的风险也会增加。我们的目的是评估这些症状对 IBD 患者健康相关生活质量(QoL)的影响:在 IBD-BOOST 调查中,我们接触了英国 26,000 多名 IBD 患者,共收回 8486 份填写完整的调查问卷。调查采用 EQ-5D-5L 问卷对参与者的 QoL 进行测量,QoL 的计算范围为 1(完美健康)至-0.594(最差健康)。对未回答的项目进行了估算。分阶段线性回归模型评估了症状与 QoL 的相关性,并控制了 IBD 类型、社会人口特征、合并疾病,在进一步分析中还控制了 IBD 活动和 IBD 控制:8093名(95.4%)参与者(平均年龄50岁[SD 15];49%患有克罗恩病)完整填写了EQ-5D-5L问卷。平均 QoL 为 0.76(SD 0.23)。在三种 IBD 相关症状中,疼痛导致的 QoL 下降幅度最大(-0.159),其次是疲劳(-0.140)和大便失禁(-0.048)。疼痛和疲劳同时出现会进一步降低 QoL。症状严重程度与 QoL 下降之间存在明显的分级关系(所有趋势均为 p 结论:症状严重程度与 QoL 下降之间存在明显的分级关系:我们报告了 IBD 患者疼痛、疲劳、大便失禁、焦虑、抑郁等症状及其严重程度与 QoL 下降之间的密切联系。这些估计结果可为未来的 IBD 管理干预措施提供参考。
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来源期刊
United European Gastroenterology Journal
United European Gastroenterology Journal GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
10.50
自引率
13.30%
发文量
147
期刊介绍: United European Gastroenterology Journal (UEG Journal) is the official Journal of the United European Gastroenterology (UEG), a professional non-profit organisation combining all the leading European societies concerned with digestive disease. UEG’s member societies represent over 22,000 specialists working across medicine, surgery, paediatrics, GI oncology and endoscopy, which makes UEG a unique platform for collaboration and the exchange of knowledge.
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