成人类风湿关节炎患者健康相关生活质量的决定因素：一项系统综述

IF 4.6 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism Pub Date : 2025-04-09 DOI:10.1016/j.semarthrit.2025.152717

Nejat Hassen , Kasra Moolooghy , Jacek Kopec , Hui Xie , Karim M Khan , Diane Lacaille

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引用次数: 0

摘要

目的系统回顾类风湿关节炎（RA）中健康相关生活质量（HRQoL）决定因素的当代研究，并综合相关证据。方法检索2000年及以后发表的横断面或前瞻性队列研究，这些研究使用多变量预测模型确定HRQoL的决定因素，并使用SF-36/12/8/6D或EQ-5D评估HRQoL。两位作者进行了筛选、数据提取和质量评估。研究结果采用叙事综合方法进行综合。结果共纳入21项研究。评估了70个决定因素。决定因素被分为五个领域：(i)社会人口学，（ii） ra相关，（iii）合并症和一般健康，（iv）健康行为，以及(v)心理社会。ra相关的决定因素是研究最多的决定因素。44个决定因素被确定为具有统计学意义的HRQoL决定因素。在社会人口学领域，年龄和性别是评估最多的决定因素，但年龄越大、女性性别越好与HRQoL之间的关联并不一致。疾病持续时间、疾病活动性和身体功能是ra相关领域中评估最多的决定因素。较高的疾病活动性和较差的身体功能与较低的HRQoL相关，但较长的疾病持续时间与HRQoL之间的关联并不一致。所有确定的合并症均与较低的HRQoL相关。运动和睡眠是健康行为领域的唯一重要决定因素，与更好的HRQoL相关。焦虑和抑郁是评估最多的社会心理变量，并与较低的HRQoL相关。结论hrqol的决定因素存在多个域。现有文献多为横断面研究。需要更多的前瞻性研究来评估决定因素与HRQoL之间的时间关系。

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Determinants of health-related quality of life in adults living with rheumatoid arthritis: a systematic review

Objective

To systematically review contemporary studies identifying health-related quality of life (HRQoL) determinants in rheumatoid arthritis (RA) and synthesize the evidence.

Methods

Three electronic databases were searched for cross-sectional or prospective cohort studies published 2000 or later that identified HRQoL determinants using multivariable prediction models and evaluated HRQoL using the SF-36/12/8/6D or EQ-5D. Two authors conducted screening, data extraction, and quality assessment. Findings were synthesized using a narrative synthesis approach.

Results

Twenty-one studies were included. Seventy determinants were evaluated. Determinants were classified into five domains: (i) sociodemographic, (ii) RA-related, (iii) comorbidities and general health, (iv) health behaviours, and (v) psychosocial. RA-related determinants were the most studied determinants. Forty-four determinants were identified as statistically significant HRQoL determinants. Age and gender were the most evaluated determinants in the sociodemographic domain, but associations between older age and female gender and better HRQoL were inconsistent. Disease duration, disease activity, and physical function were the most evaluated determinants in the RA-related domain. Higher disease activity and worse physical function were associated with lower HRQoL, but association between longer disease duration and HRQoL was inconsistent. All comorbidities identified were associated with lower HRQoL. Exercise and sleep were the only significant determinants in the health behaviours domain and were associated with better HRQoL. Anxiety and depression were the most evaluated psychosocial variables and were associated with lower HRQoL.

Conclusion

HRQoL determinants were identified from multiple domains. The existing literature consists mostly of cross-sectional studies. More prospective studies are needed to assess temporal relationship between determinants and HRQoL.

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来源期刊

Seminars in arthritis and rheumatism 医学-风湿病学

CiteScore

9.20

自引率

4.00%

发文量

176

审稿时长

46 days

期刊介绍： Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.