Diz Osteoartritli Yaşlı Hastalarda Yorgunluğun Fonksiyonel Durum, Depresyon ve Yaşam Kalitesi ile İlişkisi

Öz

Amaç: Bu çalışmanın amacı diz osteoartritli yaşlı hastalarda yorgunluk düzeylerini araştırmak, yorgunluğun depresyon ve radyolojik evre, fonksiyonel durum ve ağrı gibi klinik parametrelerle ilişkisini değerlendirmek ve yaşam kalitesi üzerine etkisini saptamaktı.

Materyal ve Metot: Çalışmaya diz osteoartritli, 65-80 yaşları arasında seksen hasta (60 kadın, 20 erkek) alındı. Osteoartritin radyolojik evresi, Kellgren-Lawrence evreleme skalası ile saptandı. Western Ontario ve McMasters Üniversiteleri Osteoartrit İndeksi [Western Ontario and McMasters UniversitiesIndex of Osteoarthritis(WOMAC)] fonksiyonel durumu belirlemede kullanıldı. Yorgunluk Semptom Envanteri [Fatigue Symptom Inventory (FSI)] yorgunluğu, Nottingham Sağlık Profili [Nottingham Health Profile (NHP)] yaşam kalitesini ve Beck Depresyon Skalası [Beck Depression Scale (BDS) ] ise depresyonu değerlendirmede kullanıldı. Ağrı şiddeti, Görsel Analog Skala [Visual Analog Scale (VAS)]- ağrı ile ölçüldü.

Bulgular: Hastalar günlük ağrı biçimlerinişu şekilde ifade ettiler: daha çok akşamları yorgun (%30), tam olarak yorgun değil (%21,3), daha çok sabahları yorgun (%20), sabit bir günlük ağrı biçimi yok (%17,5), daha çok öğleden sonraları yorgun (%11,3). FSI’nın yorgunluk şiddeti, yorgunluk süresi ve yaşam kalitesine etkisi alt grupları WOMAC, VAS-ağrı, BDS ve NHP’nin ağrı, enerji ve emosyonel reaksiyonlar alt grupları ile belirgin olarak koreleydi (p<0,05). NHP’nin fiziksel mobilite ve uyku alt grupları sadece yorgunluk şiddeti, yorgunluk süresi ile koreleydi (p<0,05). FSI alt grupları ile NHP’nin sosyal izolasyon alt grubu arasında istatistiksel olarak anlamlı bir korelasyon yoktu (p>0,05). Lojistik regresyon analizi; radyolojik evrelerin FSI üzerine anlamlı etkisini ortaya koydu (p<0,05).

Sonuç: Yorgunluk diz osteoartritli yaşlı hastalarda yaygındır ve ağrı, fonksiyonel durum, uyku, enerji ve emosyonel fonksiyonlar açısından kötü yaşam kalitesi ile ilişkilidir. Yorgunluk kompleks bir semptom olduğundan FSI gibi kapsamlı bir anket ile değerlendirilmelidir.

Anahtar Kelimeler

• yaşlı,depresyon,yorgunluk,osteoartrit,yaşam kalitesi

Fatigue Among Elderly Patients with Knee Osteoarthritis and Its Association with Functional Status, Depression and Quality of Life

Abstract

Objectives: Aims of the present study were to investigate fatigue in the patients with knee osteoarthritis, to evaluate association of fatigue with depression and clinical parameters such as radiological grade, functional status and pain; and to determine its impact on quality of life.

Materials and Methods: Eighty patients (60 women, 20 men) with knee osteoarthritis, aged between 65 and 80 were included in the study. Radiological grade of osteoarthritis was determined by Kellgren-Lawrence grading scale. Western Ontario and McMasters UniversitiesIndex of Osteoarthritis(WOMAC) was used for assessing functional status. Fatigue Symptom Invento (FSI) was used for evaluating fatigue, Nottingham Health Profile (NHP) for quality of life, and Beck Depression Scale (BDS) for depression. Pain severity was measured by using Visual Analog Scale (VAS)-pain.

Results:  Patients reported their daily patterns of fatigue as follows:  mostly fatigued in the evenings (30%), not at all fatigued (21.3%), mostly fatigued in the mornings (20%), no consistent daily pattern of fatigue (17.5%), mostly fatigued in the afternoons (11.3%). Intensity of fatigue, duration of fatigue and interference with quality of life subgroups of FSI were found to be significantly correlated with WOMAC, VAS-pain, BDS, and pain, energy, and emotional reactions subgroups of NHP (p<0.05). Physical mobility and sleep subgroups of NHP were only correlated with intensity of fatigue and duration of fatigue (p<0.05). There was no statistically significant correlation between FSI subgroups and social isolation subgroup of NHP (p>0.05) Logistic regression analysis revealed the significant impact of radiological grades on FSI (p<0.05).

Conclusion: Fatigue is common in elderly patients with knee osteoarthritis and associated with poor quality of life regarding pain, functional status, sleep, energy and emotional functions. Since fatigue is a complex symptom; it should be assessed by using a comprehensive questionnaire such as FSI. 

Keywords

• aged,depression,fatigue,osteoarthritis,quality of life

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