紅斑性狼瘡個案生活品質相關因素之系統性文獻回顧

Quality of Life in Patients with Systemic Lupus Erythematosus-A Systematic Review

吳昭儀(Chao-Yi Wu) ； 潘璦琬(Ay-Woan Pan)

《職能治療學會雜誌》 33卷2期 (2015/12) Pp. 168-186

https://doi.org/10.6594/JTOTA.2015.33(2).03

摘要

目的：紅斑性狼瘡患者面臨生活品質低落的問題，即使現今醫療藥物不斷進步，仍無法改善。本研究目的為透過系統性回顧，探討紅斑性狼瘡常見症狀與生活品質之關聯，以應用於提升紅斑性狼瘡患者生活品質之方案。方法：本文收錄近五年紅斑性狼瘡生活品質文獻 (2008-2013)。系統性回顧文獻收納標準為 (1) 收錄18 歲以上個案；(2) 符合紅斑性狼瘡診斷；(3) 由Medline、CINAHL、PsycInfo、華藝線上圖書館，以及臺灣期刊論文索引系統五個資料庫中搜索，以及 (4) 文內至少使用一個生活品質評估量表。結果：本文篩選1068 篇文獻，最後共收錄16 篇，並將6 個紅斑性狼瘡生活品質預測因子歸類為3 個面向：生理層面（疲勞及疼痛）、心理層面（憂鬱及焦慮），以及疾病層面（疾病活性及疾病損傷）。疾病層面為文獻中最常被討論的生活品質預測因子，其次則為疼痛及憂鬱症狀。疲勞、憂鬱、焦慮，以及疾病損傷在大部分文獻中被證實為紅斑性狼瘡生活品質預測因子；疾病活性與生理層面生活品質相關；疼痛結果歧異性高，仍無法定論。結論：本研究可協助臨床醫療人員更加了解紅斑性狼瘡患者心理社會狀態並提供發展生活品質提升方案之方向。

關鍵字

紅斑性狼瘡 ； 生活品質 ； 預測因子 ； 症狀

並列摘要

Objective: Patients with systemic lupus erythematosus (SLE) have lower quality of life (QOL). Though the progress of medication, they still dissatisfy with their well-being. Given fewer research inspected the predictive relationships between symptoms and QOL, the purpose of study is to identify QOL predictors and to apply it clinically to enhance QOL for patients with SLE. Methods: We included correlational studies relating to QOL in patient with SLE within the last 5 years (2008-2013). The criteria of systematic review are: (1) above 18 years old, (2) fulfill the diagnostic requirement of SLE based on American Rheumatism Association, (3) peer reviewed journals and the journals were included in PubMed, CINHAL, PsycInfo, Airiti Library, and Index to Taiwan Periodical Literature System, (4) at least applied one standardized QOL measure in the study. Results: Of 1068 articles identified, 16 articles were included in our study. There were 6 potential predictors of QOL separating into 3 domains: physical (fatigue & pain), psychological (depression & anxiety), and disease-related (disease activity & disease damage). Disease related domain is the most mentioned factors, followed by pain and depression. The results demonstrated that fatigue, depression, anxiety, and disease damage are predictors of QOL. Furthermore, disease activity is correlated with physical QOL. Conclusion: The study results can help clinicians to understand psychosocial aspects of patients with SLE, It could serve as a basis for developing effective intervention strategies to enhance the QOL of these clients.

並列關鍵字

Systemic lupus erythematosus ； Quality of life ； Predictor ； Symptom