Diz Osteoartriti Semptom Şiddeti, Yaşam Kalitesi ve Uyku Kalitesi Arasındaki İlişki

Öz

Amaç: Diz osteoartriti (OA), yaşla sıklığı artan yaygın bir hastalıktır ve önemli bir morbidite nedenidir.

Diz OA’lı hastalarda istirahat ve nokturnal ağrının nadiren görüldüğü yaygın bir bilgidir, ancak son

çalışmalar nadir görülmediğini göstermiştir. Uyku bozukluklarının noktürnal ağrı ile ilişkili olduğu

düşünülür ve artritli hastalarda uyku problemleri gelişmesi daha olasıdır. Gece ağrısı aynı zamanda

depresyon ve yaşam kalitesinin düşmesi ile de ilişkilidir. Bu çalışmada, diz OA'lı hastalarda uyku

kalitesini değerlendirmek ve OA şiddetiyle ağrı ve uyku bozuklukları ile kadın ve erkek hastalarda yaşam

kalitesi arasındaki ilişkiyi ortaya koymak amaçlanmıştır.

Materyal ve Metot: Bu kesitsel çalışma diz OA’sı olan 41 gönüllü hastayı (27 kadın, 14 erkek)

kapsamakta ve 40‐65 yaş arası 6 aydan fazla diz ağrısı olan ve Kellgren‐Lawrence 'e göre 2. ve 3. derece

olan hastaları kapsamaktadır. Hastalar Görsel Analog Skala (GAS), Western Ontario and McMaster

Universitesi Osteoartrit İndeksi (WOMAC), Lequesne Indeksi, Pittsburg Uyku Kalitesi İndeksi (PSQI),

Beck anksiyete envanteri (BAI), Beck depresyon envanteri (BDI) ve Kısa form‐36 (SF‐36) kullanılarak

değerlendirildi.

Bulgular: VAS, WOMAC, Lequesne indeksi, PSQI, BAI ve BDI skorları kadınlarda erkeklere göre

anlamlı olarak yüksek bulundu. Erkeklerde iyi uyku kalitesi prevalansı anlamlı olarak yüksek bulundu.

WOMAC skorları ile VAS, BAI ve BDI skorları arasında pozitif bir korelasyon vardı, fakat toplam PSQI

skoru arasında anlamlı bir ilişki yoktu. Lequesne indeks skorları ile VAS, total PSQI, BAI ve BDI skorları

arasında pozitif korelasyon vardı. WOMAC ve Lequesne indeksi ile SF‐36 arasında negatif korelasyon

bulundu.

Sonuç: Sonuç olarak, diz OA semptom şiddeti ile depresyon, anksiyete, uyku kalitesi ve yaşam kalitesi

ilişkili bulunmuştur. Yaşam kalitesini iyileştirmek için diz OA'yı yönetmek düşünülmelidir.

Anahtar Kelimeler

• Diz osteoartriti,ağrı,uyku kalitesi,yaşam kalitesi

Relationship Among the Symptom Severity of Knee Osteoarthritis, Quality of Life and Sleep Quality

Öz

Objectives: Knee osteoarthritis (OA) is a widespread disease that increases in the elderly and is an important cause of morbidity. It is common knowledge that resting and nocturnal pain is rarely seen in patients with knee OA, however latest studies showed that it is not rare. Sleep disorders are thought to be related with nocturnal pain and it is shown that in patients with arthritis are more likely to develop sleep problems. Nocturnal pain is also related with depression and decreased quality of life. This study aims to evaluate sleep quality in patients with knee OA and to reveal the relationship between severity of knee OA, pain and sleep disorders and quality of life in female and male patients.
Materials and Methods: This cross sectional study includes 41 volunteer patients (27 female,14 male) between 40-65 years with knee OA, who suffer from knee pain for more than 6 months, and the study includes patients with grade 2 and 3 OA according to the Kellgren-Lawrence classification. Patients were evaluated using Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne Index, Pittsburg Sleep Quality Index (PSQI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Short form-36 (SF-36).
Results: VAS, WOMAC, Lequesne index, PSQI, BAI and BDI scores were significantly higher in female subjects than in male subjects. Prevalence of good sleep quality was significantly higher in male patients. There was a positive correlation between WOMAC scores and VAS, BAI and BDI scores, but there was no significant relationship between total PSQI scores. There was a positive correlation between Lequesne index scores and VAS, total PSQI, BAI and BDI scores. A negative correlation was found between WOMAC and Lequesne index and SF-36.
Conclusion: Severity of knee OA is found associated with pain, depression and anxiety, sleep quality and quality of life. It should be considered to manage knee OA to improve quality of life.

Anahtar Kelimeler

• Knee osteoarthritis,pain,sleep quality,quality of life

Kaynakça

1. 1. Pavelka K, Gatterova J, Altman RD. Radiographic progression of knee osteoarthritis in a Czech cohort. Clin Exp Rheumatol 2000;18: 473-7.
2. 2. Woolhead G, Gooberman-Hill R, Dieppe P, Hawker G. Night pain in hip and knee osteoarthritis: a focus group study. Arthritis Care Res (Hoboken) 2010;62: 944-9.
3. 3. Hawker GA, Stewart L, French MR, et al. Understanding the pain experience in hip and knee osteoarthritis--an OARSI/OMERACT initiative. Osteoarthritis Cartilage 2008;16: 415-22.
4. 4. Power JD, Perruccio AV, Badley EM. Pain as a mediator of sleep problems in arthritis and other chronic conditions. Arthritis Rheum 2005;53: 911-9.
5. 5. Abad VC, Sarinas PS, Guilleminault C. Sleep and rheumatologic disorders. Sleep Med Rev 2008;12: 211-28.
6. 6. Sasaki E, Tsuda E, Yamamoto Y, et al. Nocturnal knee pain increases with the severity of knee osteoarthritis, disturbing patient sleep quality. Arthritis Care Res (Hoboken) 2014;66: 1027-32.
7. 7. Mesci E, Icagasioglu A, Mesci N, Turgut ST. Relation of physical activity level with quality of life, sleep and depression in patients with knee osteoarthritis. North Clin Istanb 2015;2: 215-21.
8. 8. Küçükşen S, Yılmaz H, Karahan AY, Bağçacı S. The prevalence of depression and its relevance to clinical and radiological characteristics among older adults with knee osteoarthritis. Clinical Medicine Research 2014;2:25-30.

9. 9. Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis 1957;16: 494-502. 10. American College of Rheumatology Subcommittee on Osteoarthritis. Recommendations for the medical management of osteoarthritis of the hip and knee. 2000 update. Arthritis Rheum 2000;43: 1905-15.
10. 11. Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 1990;13: 227-36.
11. 12. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988;15: 1833-40.
12. 13. Tuzun EH, Eker L, Aytar A, Daşkapan A, Bayramoğlu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage 2005;13: 28-33.
13. 14. Lequesne MG, Samson S. Indices of severity in osteoarthritis for weight bearing joints. J Rheumatol Suppl 1991;27:16-8.
14. 15. Faucher M, Poiraudeau S, Lefevre-Colau MM, Rannou F, Fermanian J, Revel M. Assessment of the test-retest reliability and construct validity of a modified Lequesne index in knee osteoarthritis. Joint Bone Spine 2003;70: 521-5.
15. 16. Basaran S, Guzel R, Seydaoglu G, Guler-Uysal F. Validity, reliability, and comparison of the WOMAC osteoarthritis index and Lequesne algofunctional index in Turkish patients with hip or knee osteoarthritis. Clin Rheumatol 2010;29: 749-56.
16. 17. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28: 193-213.
17. 18. Ağargün MY, Kara H, Anlar Ö. Pittsburgh Uyku Kalitesi Indeksi’nin geçerliği ve güvenirliği. Türk Psikiyatri Dergisi 1996;7:107-15. 19. Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş A. Kısa Form-36 (KF 36)’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. İlaç ve Tedavi Dergisi 1999;12:102-6.
18. 20. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-71.
19. 21. Ulusoy M, Şahin N, Erkman H. Turkish Version of The Beck anxiety inventory: psychometric properties. J Cognitive Psychotherapy: Int Quaterly 1998;12:28-35.
20. 22. Sayar K, Kirmayer LJ, Taillefer SS. Predictors of somatic symptoms in depressive disorder. Gen Hosp Psychiatry 2003;25: 108-14.
21. 23. Keefe FJ, Lefebvre JC, Egert JR, Affleck G, Sullivan MJ, Caldwell DS. The relationship of gender to pain, pain behavior and disability in osteoarthritis patients: the role of catastrophizing. Pain 2000;87: 325-34.
22. 24. Meana M. The meeting of pain and depression: comorbidity in women. Can J Psychiatry 1998;43: 893-9.
23. 25. Iijima H, Aoyama T, Fukutani N, et al. Psychological health is associated with knee pain and physical function in patients with knee osteoarthritis: an exploratory cross-sectional study. BMC Psychology 2018;6:19. doi:10.1186/s40359-018-0234-3.
24. 26. Supartini A, Oishi T, Yagi N. Sex Differences in the relationship between sleep behavior, fish consumption, and depressive symptoms in the general population of South Korea. Int J Environ Res Public Health 2017;14. pii: E789. doi: 10.3390/ijerph14070789.
25. 27. Creamer P, Lethbridge-Cejku M, Hochberg MC. Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology (Oxford) 2000;39: 490-6.
26. 28. Aşkın A, Özkan A, Tosun A, Demirdal ÜS, İsnaç F. Quality of life and functional capacity are adversely affected in osteoarthritis patients with neuropathic pain. Kaohsiung J Med Sci 2017;33: 152-8.