评估沙特塔伊夫曼苏尔王子军事医院 1 型糖尿病患者的生活质量和抑郁症患病率

Sultan Al-Nozha, Khalid AlShehri, Manal AlJabri, Hani Abozaid, Ayman Atalla
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摘要

背景:研究表明,糖尿病患者的生活质量较差,并伴有严重的抑郁症状。目前只有少数调查对沙特籍糖尿病患者的抑郁程度以及抑郁如何调节糖尿病对生活质量的影响进行了评估。研究方法本研究是一项基于问卷的横断面观察性调查,采用简单随机抽样方案。我们采用世界卫生组织生活质量简明版(WHOQOL-BREF)和初级健康问卷 PHQ-9 评估抑郁症状和生活质量。我们使用广义线性回归和中介分析来估计临床和人口统计学变量对生活质量的影响以及抑郁症状的中介效应。结果:(n = 203)同意被纳入研究。在参与研究的患者中,重度抑郁症的发病率为 11.3%,中度抑郁症的发病率为 18.7%。研究发现,退休患者、糖尿病病程较长、抑郁评分和经历过 DKA 的患者的 QoL 较差。值得注意的是,我们发现糖尿病病程与 HbA1c 水平对生活质量的综合影响之间存在明显的交互作用。在糖尿病病程较长的患者中,HbA1c 水平与较差的生活质量相关。然而,矛盾的是,在新诊断的糖尿病患者中,HbA1c 越高,生活质量越好。在调整 HbA1c*DM 持续时间的交互作用后,年龄对生活质量的影响为负。我们发现,在糖尿病患者中,抑郁评分明显介导了年龄对生活质量的负面影响(Sobel 检验 t = -2.851,p = 0.004);然而,抑郁介导的糖尿病病程对生活质量评分的影响在统计学上并不明显(Sobel 检验 t = -0.021,p = 0.984)。建议:鉴于抑郁症状对生活质量的不利影响,糖尿病患者在整个病程中都应接受抑郁症状的筛查和治疗。鉴于抑郁症状对生活质量的影响,无论糖尿病病程长短或有无并发症,老年糖尿病患者都需要改善抑郁症状。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of Quality of Life and Prevalence of Depression Among Type 1 Diabetic Patients at Prince Mansour Military Hospital, Taif, KSA
Background: Patients with diabetes were shown to report poor quality of life and significant depressive symptoms. Only a dearth of surveys was conducted to evaluate the extent of depression among Saudi patients with diabetes and how depression mediate the effect of diabetes on perceived quality of life. Method: The study is a cross sectional questionnaire-based observational investigation using a simple random sampling scheme. We utilized World Health Organization Quality of Life Brief Version (WHOQOL-BREF) and Primary Health Questionnaire PHQ-9 to evaluate depressive symptoms and quality of life. We used generalized linear regression and mediation analysis to estimate the effect of clinical and demographic variables on quality of life and the mediating effect for depressive symptoms. Results: (n = 203) agreed to be included in the study. The prevalence for severe depression was (11.3%), and for moderate depression was (18.7%) among the participating patients. Poor QoL was found in retired patients, prolonged duration of diabetes, depressive score, and experiencing DKA. Notably, we found significant interaction between duration of DM and HbA1c level in terms of their combined effect on quality of life. Among patients with prolonged diabetes duration HbA1c level was associated with poorer quality of life. However, paradoxically, among newly diagnosed diabetes patients the higher the HbA1c the better was the quality of life. Age effect was negative on the QoL, after adjusting for the HbA1c*DM duration interaction. We found that depression score significantly mediated the negative effect of age on quality of life among patients living with diabetes (Sobel test t = -2.851, p = 0.004); however, the depression-mediated effect on the path from duration of diabetes to quality-of-life score was statistically not significant (Sobel test t = -0.021, p = 0.984). Recommendations: Patients with diabetes should be screened and treated for symptoms of depression throughout the course of their illness, given their detrimental effect on their life quality. Older patients with diabetes require amelioration of depressive symptoms given their effect on life quality regardless of duration of diabetes or presence of complications.
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