焦慮症狀為大腸激躁症病人症狀嚴重度之預測因子

Anxiety Independently Predicting Symptom Severity in Patients with Irritable Bowel Syndrome

潘潔馨(Chieh-Hsin Pan) ； 蔡佩珊(Pei-Shan Tsai)

《新臺北護理期刊》 24卷1期 (2022/03) Pp. 31-41

https://doi.org/10.6540/NTJN.202203_24(1).0003

摘要

背景：大腸激躁症病人因症狀困擾嚴重干擾其生活品質，故探討影響症狀嚴重度的因素有其必要性；大腸激躁症病人常伴有情緒困擾，然病人情緒困擾是否為症狀嚴重度之獨立預測因子未有定論。目的：探討焦慮與憂鬱情緒狀態與大腸激躁症患者症狀嚴重度之相關性。方法：本研究橫斷式研究設計（cross-section study design），使用隨機臨床試驗之基準值進行次級資料分析，分析以羅馬準則III為診斷標準之大腸激躁症病人，以「大腸激躁症症狀嚴重度量表」評估症狀嚴重度、「貝克憂鬱量表第二版」評估憂鬱症狀、「貝克焦慮量表」評估焦慮症狀，並以「布里斯托大便分類紀錄」作為大腸激躁症分型依據。採線性複迴歸（Multiple linear regression）統計方式分析症狀嚴重度之預測因子。結果：本研究共納入60名20－79歲大腸激躁症病人，50%為女性。複迴歸預測因子模型中置入年齡、性別、吸菸狀態、大腸激躁症次分型、藥物治療、憂鬱等因素，結果發現控制了其他因素，焦慮狀態可顯著預測大腸激躁症病人之症狀嚴重度（p = .003），整體模式解釋力（R^2）為20.8%。結論：大腸激躁症病人之焦慮症狀為其整體狀嚴重度之獨立預測因子，建議除積極控制疾病症狀，應更重視並同步介入處置措施處理病人焦慮症狀，降低疾病嚴重度期能改善生活品質。

關鍵字

大腸激躁症 ； 症狀嚴重度 ； 焦慮

並列摘要

Background: Symptom distress significantly impairs the quality of life of patients with irritable bowel syndrome (IBS). It is thus important to identify factors predicting symptom severity in IBS patients. IBS often coexists with psychological problems. It remains uncertain whether psychological distress is an independent predictor of symptom severity in IBS. Aim: This study examined the association between psychological distress and symptom severity in patients with IBS. Methods: This cross-sectional study was a secondary analysis of baseline data from a clinical trial. The diagnosis of IBS was made according to the ROME III criteria. IBS symptom severity was measured using the IBS Symptom Severity Scale, and psychological distress including depression and anxiety was determined using the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI), respectively. The Bristol Stool Chart was used to identify phenotypes of IBS according to the ROME III criteria. Multiple linear regression was used to determine independent predictors of symptom severity. Results: In total, 60 participants aged from 20 to 79 were included. Of the participants, 50% were females After adjusting for age, gender, smoking, phenotype, medication and depression, anxiety significantly and independently predicted the magnitude of symptom severity (p =.003, R^2=20.8%). Conclusion: Anxiety independently predicts symptom severity in patients with IBS. Measures to reduce anxiety should be incorporated in the symptom management regime for patients with IBS in order to improve quality of life of these patients.

並列關鍵字

irritable bowel syndrome ； IBS ； symptom severity ； anxiety

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