Ankilozan Spondilitte Hastalık Algısının Yaşam Kalitesi Üzerine Etkisi

Öz

Amaç: Ankilozan Spondilit (AS), karakteristik olarak sakroiliak eklemleri, omurga ve periferik eklemleri, bağırsakları ve gözleri etkileyebilen, kronik, inflamatuvar romatizmal ilerleyici bir hastalıktır. AS'nin klinik bulguları iyi bilinmekte ancak hastalığın, etkilenen kişinin subjektif sağlığı üzerindeki etkileri yeterince bilinmemektedir. Bu çalışmanın amacı Ankilozan Sondilitli (AS) hastalarda hastalık algısını, hastalık aktivitesini, fonksiyonel ve emosyonel durumunu ve bunların hastalık aktivitesi ile ilişkisini değerlendirmektir.
Materyal ve Metot: Altmışyedi AS’li hasta çalışmaya katıldı. Hastalıkla ilgili yaşam kalitesi Ankilozan Spondilit Yaşam Kalitesi İndeksi (ASQoL) ve hastalık algısı Kısa Hastalık Algı Ölçeği ile değerlendirildi. Hastalık aktivitesi ve fonksiyonel kapasitesi, Bath Ankilozan Spondilit Hastalık Aktivite İndeksi (BASDAI), Bath Ankilozan Spondilit Fonksiyonel İndeksi (BASFI) ile değerlendirildi. Psikolojik durumun değerlendirmesinde Beck Depresyon Ölçeği kullanıldı.

Bulgular: Sonuçlarımıza göre, hastalık algısı ile yaşam kalitesi arasında anlamlı ilişki bulunmuştur. Bununla birlikte, yaşam kalitesini en çok etkileyen faktörler fonksiyonel durum ve yaşam kalitesidir.
Sonuç: Rutin klinik uygulamada hastalık algısının değerlendirilmesi, hastanın davranışlarında tedaviye uyuma engel olabilecek sorunların daha iyi anlaşılmasına katkıda bulunabilir. Konvansiyonel terapiyeek olarak psikoterapötik yaklaşımlar, AS'de hastaların yaşam kalitesini iyileştirmede katkıda bulunabilir.

Anahtar Kelimeler

• Hastalık algısı,depresyon,yaşam kalitesi,seronegatif spondiloartropati

Effect of Illness Perception on the Quality of Life in Ankylosing Spondylitis

Abstract

Objectives: The aim of the study was to assess the illness perception in patients with ankylosing spondilitis (AS), to evaluate disease activity, functional ability, emotional status and to investigate their association with quality of life (QoL).

Materials and Methods: Sixty-seven patients with AS were included in this study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BAS­FI) were used for the assessment of disease activity and of physical functions, respectively. The Ankylosing Spondy­litis Quality of Life (ASQoL) questionnaire was used for disease-related quality of life and The Brief Illness Perception Questionnaire (B-IPQ) was used for the assessment of illness perception in AS patients. Beck Depression Inventory (BDI) was used for the assessment of psychological status.

Results: Based on our results, significant association was found between QoL and illness perceptions. However, QoL was most associated with functional status and disease activity.

Conclusion: Assessment of illness perception in routine clinical practice could contribute to a better understanding of problems in patients’ behavior that may disturb adherence to treatment. Psychotherapeutic approaches in addition to conventional therapy might attempt to improve patient’s QoL in AS.

Keywords

• Illness representations,depression,quality of life,seronegative spondyloarthropathy

Kaynakça

1. 1. Khan MA. Ankylosing spondylitis: introductory comments on its diagnosis and treatment. Ann Rheum Dis 2002;61:3–7.
2. 2. Dagfinrud H, Mengshoel AM, Hagen KB, Loge JH, Kvien TK. Health status of patients with ankylosing spondylitis: a comparison with the general population. Ann Rheum Dis 2004; 63(12): 1605–10.
3. 3. Airaksinen O, Brox J, Cedraschi C et al. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 2006;15(2):192-300.
4. 4. Bean D, Cundy T, Petrie KJ. Ethnic differences in illness perceptions, self-efficacy and diabetes self-care. Psychol Health 2007;22(7):787–811.
5. 5. Leventhal H, Brissette I, Leventhal E. The common-sense model of self-regulation of health and illness. In: Cameron LD, Leventhal H, editors. The self-regulation of health and illness behavior. New York: Routledge; 2003.
6. 6. Murphy H, Dickens C, Creed F, Bernstein R. Depression, illness perception and coping in rheumatoid arthritis. J Psychosom Res 1999;46:155–64.
7. 7. Baubet T, Ranque B, Taieb O et al. Mood and anxiety disorders in systemic sclerosis patients. Presse Med 2011; 40:e111–9.
8. 8. Richards HL, Herrick AL, Griffin K, Gwilliam PD, Loukes J, Fortune DG. Systemic sclerosis: patients' perceptions of their condition. Arthritis Rheum 2003;49:689–96.

9. 9. Kotsis K, Voulgari PV, Tsifetaki N et al. Anxiety and depressive symptoms and illness perceptions in psoriatic arthritis and associations with physical health-related quality of life. Arthritis Care Res (Hoboken). 2012;64(10):1593–601.
10. 10. Hyphantis T, Kotsis K, Tsifetaki N et al.The relationship between depressive symptoms, illness perceptions and quality of life in ankylosing spondylitis in comparison to rheumatoid arthritis. Clin Rheumatol 2013;32:635–44.
11. 11. Van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A pro¬posal for modification of the New York criteria. Arthritis Rheum 1984;27:361-8. 12. Calin A, Garrett S, Whitelock H et al. A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath ankylosing spondylitis functional index. J Rheumatol. 1994; 21: 2281-5.
12. 13. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new ap¬proach to defining disease status in ankylosing spon¬dylitis: the bath ankylosing spondylitis disease activity index. J Rheumatol 1994;21:2286-91.
13. 14. Akkoc Y, Karatepe AG, Akar S, Kirazli Y, Akkoc N. A Turkish ver¬sion of the Bath Ankylosing Spondylitis Disease Activity Index: reliability and validity. Rheumatol Int 2005;25:280-4.
14. 15. Doward LC, Spoorenberg A, Cook SA. Development of ASQoL: a quality of life instrument specific to an¬kylosing spondylitis. Ann Rheum Dis 2003;62:20-6.
15. 16. Duruöz MT, Doward L, Turan Y et al. Translation and validation of the Turkish version of the ankylos¬ing spondylitis quality of life (ASQoL) Questionnaire. Rheumatol Int 2013; 33:2717-22. 17. Beck AT, Ward CN, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-71.
16. 18. Hisli N. Beck Depresyon Envanteri’nin geçerliliği üzerine bir çalışma. Psikoloji Dergisi 1998; 6:118-26 (In Turkish).
17. 19. Broadbent E, Petrie KJ Main J, Weinman J.The Brief Illness Perception Questionnaire. J Psychosomatic Res 2006; 60:631-7.
18. 20. Oflaz S, Yüksel Ş, Şen F, Ozdemiroğlu F, Kurt R, Oflaz H et al. Does Illness Perception Predict Posttraumatic Stress Disorder in Patients with Myocardial Infarction? Arch Neuropsychiatry 2014;51: 103-9.
19. 21. Petrie KJ, Cameron LD, Ellis CJ, Buick D, Weinman J.Changing illness perceptions after myocardial infarction: an early intervention randomized controlled trial. Psychosom Med 2002; 64:580–6.
20. 22. Pesut DP, Bursuc BN, Bulajic MV et al. Illness perception in tuberculosis by implementation of the Brief Illness Perception Questionnaire – a TBNET study. SpringerPlus 2014;3:664.
21. 23. Petriček G,Vrcić-Keglević M,Vuletić G,Cerovečki V, Ožvačić Z, Murgić L. Illness Perception and Cardiovascular Risk Factors in Patients with Type 2 Diabetes: Cross-sectional Questionnaire Study. Croat Med J 2009;50:583-93. 24. Hallegraeff JM, van der Schans CP, Krijnen WP, de Greef MH. Measurement of acute nonspecific low back pain perception in primary care physical therapy: reliability and validity of the brief illness perception questionnaire. BMC Musculoskelet Disord 2013;14(53). doi: 10.1186/1471-2474-14-53.
22. 25. Nowicka-Sauer K, Banaszkiewsicz D, Staskiewicz I et al. Illness perception in Polish patients with chronic diseases: Psychometric properties of the Brief Illness Perception Questionnaire. J Health Psyc 2016; 21(8):1739-49.
23. 26. Özgül A, Peker F, Taşkaynatan MA, Tan AK, Dinçer K, Kalyon TA. Effects of Ankylosing spondylitis on health-related quality of life and different aspects of social life in young patients. Clin Rheum 2006;25(2): 168–74.
24. 27. Bostan EE, Borman P, Bodur H, Barca N.Functional disability and quality of life in patients with ankylosing spondylitis. Rheumatol Int 2003;23:121–6.
25. 28. Ariza-Ariza R, Hernandez-Cruz B, Navarro-Sarabia F.Physical function andhealth-related quality of life of Spanish patients with ankylosing spondylitis. Arthritis Rheum 2003;49(4):483–7.
26. 29. Martindale J, Smith J, Sutton CJ, Grennan D, Goodacre L, Goodacre JA. Disease and psychological status in ankylosing spondylitis. Rheumatology 2006;45:1288–93.
27. 30. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: The Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 1994;21(12):2286–91.
28. 31. Zink A, Braun J, Listing J, Wollenhaupt J.Disability and handicap in rheumatoid arthritis and ankylosing spondylitis– results from the German rheumatological database. J Rheumatol 2000;27:613–22.
29. 32. Nas K, Çevik R, Bozkurt M, Gür A, Saraç AJ. Relationship Between Clinical Findings, Quality of Life and Functional Disability Related to Disease Activity in Patients with Ankylosing Spondylitis. Turk J Rheumatol 2011;26(1):29-37.
30. 33. Sullivan M, Karlsson J. The Swedish: SF-36 Health Survey III. Evaluation of criterionbased validity: Results from normative population. J Clin Epidemiol1998;51(11):1105–1332.
31. 34. Hopman WM, Towheed T, Anastassiades T et al. Canadian normative data for the SF-36 health survey. CMAJ 2000;163(3):265–71. 35. Ozkan Y, Kütük SG. Ankylosing spondylitis and quality of life. Med Sci Tech 2016;57: 81-7.
32. 36. Demyttenaere K, Reed C, Quail D, Bauer M, Dantchev N, Montejo AL, et al. Presence and predictors of pain in depression: results from the FINDER study. J Affect Disord 2010;125:53–60.
33. 37. Altan L, Sivrioğlu Y, Ercan İ. Can Bath Ankylosing Spondylitis Disease Activity Index be Affected by Accompanying Fibromyalgia or Depression? Arch Rheumatol 2015;30(1):34-9.
34. 38. Baysal O, Durmuş B, Ersoy Y, Altay Z, Senel K, Nas K et al. Relationship betweenpsychological status and disease activity and quality of life inankylosing spondylitis. Rheumatol Int 2011;31(6):795–800.
35. 39. Hakkou J, Rostom S, Aissaoui N et al. Psychological statusin Moroccan patients with ankylosing spondylitis and its relationshipswith disease parameters and quality of life. J Clin Rheumatol 2011;17(8):424–8.
36. 40. Broadbent E, Wilkes C, Koschwanez H, Weinman J, S, Petrie KJ. A systematic review and meta-analysis of the Brief Illness Perception Questionnaire. Psychology & Health 2015;30(11): 1361–85.