Percepción de calidad de vida en pacientes con síndrome de Sjögren. Estudio de diez años / Perception of quality of life in patients with Sjögren syndrome. 10 year study

RESUMEN Introducción: El síndrome de Sjögren es una enfermedad autoinmunitaria, inflamatoria y crónica, que se caracteriza por dolor, inflamación y sequedad de mucosas. Objetivo: Determinar la percepción de la calidad de vida en pacientes con síndrome de Sjögren. Metodología: Estudio descriptivo y correlacional; universo de 457 pacientes con diagnóstico de síndrome de Sjögren. La muestra fue de 417 pacientes a quienes se les aplicó el cuestionario de láminas Coop/Wonca para determinar la percepción de calidad de vida y la versión cubana del Health Assessment Questionnaire para determinar capacidad funcional. Se utilizó coeficiente de correlación de Pearson para determinar asociación entre las variables del estudio. Se describieron las características sociodemográficas de los pacientes investigados. Resultados: Promedio de edad de 53,22 arios, predominio de pacientes entre 40 y 60 arios (63,79%), femeninas (88,25%) y con tiempo de evolución entre tres y cinco años (64,99%). Existió predominio de síndrome de Sjögren secundario (72,66%) con predominio de presencia de pacientes con artritis reumatoide (49,43%). La puntuación de percepción de calidad de vida global fue de 21,78 y las dimensiones más afectadas fueron el dolor, las actividades sociales y las actividades cotidianas; el valor de correlación de Pearson entre la presencia de discapacidad funcional y las puntuaciones de percepción de calidad de vida relacionada con la salud (CVRS) fue de 0,79. Conclusiones: Existió correlación positiva fuerte entre la presencia de discapacidad funcional y las puntuaciones de CVRS; mientras mayores fueron las puntuaciones de discapacidad peor fue la percepción de calidad de vida de los pacientes.

ABSTRACT Introduction: Sjögren's syndrome is an autoimmune, inflammatory, and chronic disease, characterised by the presence of pain, inflammation, and dry mucosa. Objective: To determine the perception of quality of life in patients with Sjögren's syndrome. Methodology: A descriptive and correlational study with a group of 457 patients diagnosed with Sjögren's syndrome. The sample consisted of 417 patients who completed the Coop/Wonca slide questionnaire to determine the perception of quality of life, as well as the Cuban version of the Health Assessment Questionnaire to determine functional capacity. Pearson's correlation coefficient was used to determine the association between the study variables. The sociodemographic characteristics of the investigated patients were described. Results: The mean age of the patients was 53.22 years, with the majority between 40 and 60 years (63.79%), of whom 88.25% were female, and with time with disease between 3 and 5 years (64.99%). There was a predominance of secondary Sjögren's syndrome (72.66%) with a predominance of the presence of patients with rheumatoid arthritis (49.43%). The overall quality of life perception score was 21.78, and the most affected dimensions were pain, social activities, and daily activities. A Pearson correlation value of 0.79 was observed between the presence of functional disability and the perception of HRQoL scores. Conclusions: There was a strong positive correlation between the presence of functional disability and health-related quality of life scores; the higher the disability scores, the worse the perception of quality of life of the patients.

Calidad de vida relacionada con la salud en pacientes con osteoartritis del cantón Riobamba / Quality of life related to health in patients with osteoarthritis of the Riobamba canton

Introducción: la osteoartritis es una enfermedad degenerativa que afecta fundamentalmente a pacientes mayores de 60 años, clinicamente se caracteriza por dolor, rigidez, deformidad, discapacidad funcional y deterioro de la percepción de calidad de vida. Objetivo: determinar la percepción de la calidad de vida relacionada con la salud en pacientes con osteoartritis del cantón Riobamba. Métodos: estudio descriptivo, de corte transversal realizado en 1263 pacientes con diagnóstico de osteoartritis. Se utilizó el cuestionario de láminas Coop/Wonca para determinar percepción de calidad de vida relacionada con la salud; el cuestionario HAQ-CU para determinar capacidad funcional y el coeficiente alfa de Cronbach para evaluar la consistencia interna y fiabilidad de las láminas Coop/Wonca. Se determinó correlación de Pearson para determinar relación entre calidad de vida relacionada con la salud y capacidad funcional. Resultados: promedio de edad de 65,31 años, predominio del sexo femenino, grupo de edades entre 56 y 65 años, afectación en rodillas (41,92 %), comorbilidades asociadas (72.26 %) y discapacidad moderada (41,57 %). Valores globales de calidad de vida superior a 23 puntos. Conclusiones: la osteoartritis influye negativamente en la capacidad funcional y en la percepción de calidad de vida. El tiempo de evolución mayor de 3 años, la presencia de comorbilidad y la localización en rodillas y manos disminuyen la percepción de calidad de vida. Existe una correlación positiva considerable entre capacidad funcional y calidad de vida. Las láminas Coop/Wonca constituyen un instrumento de gran utilidad para ser aplicado en la atención primaria de salud.

Introduction: osteoarthritis is a degenerative disease that mainly affects patients older than 60 years. Clinically it is characterized by pain, rigidity, deformity, functional disability and deterioration of the perception of quality of life. Objective: to determine the perception of quality of life related to health in patients with osteoarthritis of the Riobamba canton. Methodology: descriptive, cross-sectional study performed on 1263 patients diagnosed with osteoarthritis. The Coop / Wonca questionnaire was used to determine perception of quality of life related to health; the HAQ-CU questionnaire to determine functional capacity and the Cronbach alpha coefficient to evaluate the internal consistency and reliability of the Coop / Wonca sheets. Pearson correlation was determined to determine the relationship between quality of life related to health and functional capacity. Results: average age of 65.31 years, predominance of females, age group between 56 and 65 years, involvement in knees (41,92 %), associated comorbidities (72.26 %) and moderate disability (41,57 %). Global values of quality of life superior to 22 points. Conclusions: osteoarthritis negatively influences functional capacity and perception of quality of life. The evolution time of more than 3 years, the presence of comorbidity and the location in knees and hands diminish the perception of quality of life. There is a considerable positive correlation between functional capacity and quality of life. The Coop / Wonca sheets are a very useful instrument to be applied in primary health care.

Percepción de calidad de vida en pacientes con osteoartritis. Características sociodemográficas y clínicas. Estudio de 5 años / Perception of quality of life in patients with osteoarthritis. Sociodemographic and clinical characteristics. A 5 year study

Resumen Introducción: La osteoartritis se caracteriza por disminución o pérdida del cartílago articular. Clínicamente presenta dolor, rigidez, deformidad, distintos grados de discapacidad funcional y disminución de la percepción de la calidad de vida de los pacientes que la padecen. Objetivo: Determinar la percepción de la calidad de vida relacionada con la salud en pacientes con osteoartritis y correlacionarla con la capacidad funcional de los mismos. Materiales y métodos: Estudio descriptivo en 2.787 pacientes. Se aplicó cuestionario de láminas Coop/Wonca para determinar percepción de la calidad de vida. El alfa de Cronbach determinó la validez interna y la fiabilidad del cuestionario. Se determinó la correlación de Pearson entre calidad de vida y capacidad funcional. Se describieron las características sociodemográficas y clínicas de los pacientes incluidos en la investigación. Resultados: Promedio de edad de 65 arios, predominio de edades entre 60 y 69 arios y del sexo femenino (65,69%). El grupo articular más afectado fue el de las rodillas (37,82%). El 72,37% de los pacientes presentaron comorbilidad asociada con hipertensión arterial, diabetes y obesidad. La puntuación del cuestionario Coop/Wonca fue de 21,29 con puntuaciones más elevadas en los hombres. Las dimensiones más afectadas fueron el dolor (3,37), la forma física (3,11) y las actividades cotidianas (2,98). Predominó la discapacidad moderada. Conclusiones: La osteoartritis se asocia a un gran número de comorbilidades. Existió correlación entre capacidad funcional y calidad de vida. Las láminas Coop/Wonca constituyen un instrumento de gran utilidad para ser aplicado en la atención primaria de salud.

Abstract Introduction: Osteoarthritis is characterised by loss or loss of joint cartilage. It clinically presents with pain, rigidity, deformity, different degrees of functional disability, and a decreased perception in the quality of life of patients that suffer from it. Objective: To determine the perceived quality of life related to health in patients with osteoarthritis, and to correlate it with their functional capacity. Materials and methods: A descriptive study including 2,787 patients. A Coop/Wonca questionnaire was completed to determine perceived quality of life. Cronbach's alpha determined the internal validity and reliability of the questionnaire. Pearson correlation between quality of life and functional capacity was determined. The sociodemographic and clinical characteristics of the patients included in the study were recorded. Results: The mean age was 65 years, with the majority being between 60 and 69 years, and included 65.69% females. The knees were the most affected joint group (37.82%), with 72.37% of the patients having associated comorbidity, including arterial hypertension, diabetes, and obesity. The score of the Coop/Wonca questionnaire was 21.29, with higher scores in men. The most affected dimensions were pain (3.37), physical form (3.11), and daily activities (2.98). Moderate disability predominated. Conclusions: Osteoarthritis is associated with a large number of comorbidities. There was a correlation between functional capacity and quality of life. The Coop/Wonca chart is a very useful tool in primary health care.

Comorbilidades y calidad de vida en Osteoartritis / Comorbidities and quality of life in Osteoarthritis

Introducción: la osteoartritis es considerada la enfermedad reumática más antigua y frecuente que existe. A pesar de ser considerada una patología benigna se asocia a un gran número de comorbilidades que pueden influir en el curso de la enfermedad. Objetivo: determinar la influencia de las comorbilidades en la percepción de la calidad de vida relacionada con la salud en pacientes con osteoartritis del cantón Riobamba. Método: estudio descriptivo, transversal y observacional en 1263 pacientes con diagnóstico de osteoartritis. Se utilizó el cuestionario de láminas Coop/Wonca para determinar percepción de calidad de vida relacionada con la salud. Se determinó el valor del coeficiente alfa de Cronbach para evaluar la consistencia interna y fiabilidad del cuestionario. Resultados: promedio de edad de 71,83 años, predominio del sexo femenino y grupo de edades entre 66 y 75 años. Las articulaciones más afectadas fueron las rodillas, seguidos de las manos, columna vertebral y caderas respectivamente. Existió un alto por ciento de comorbilidades asociadas (72.13 por ciento), con destaque para la hipertensión arterial, la diabetes mellitus, el síndrome metabólico y el hipotiroidismo, las que se presentaron por encima del 10 por ciento del total de pacientes. Valores globales de calidad de vida superiores a los 20 puntos. Las dimensiones más afectadas fueron el dolor, la forma física y las actividades cotidianas. Conclusiones: la presencia de comorbilidades empeoró la percepción de CVRS de los pacientes con OA, por lo que se debe tener una vigilancia estricta sobre la aparición o descompensación de las mismas(AU)

Introduction: osteoarthritis is considered the oldest and most frequent rheumatic disease that exists. Despite being considered a benign pathology is associated with a large number of comorbidities that can influence the course of the disease. Objective: to determine the influence of comorbidities on the perception of quality of life related to health in patients with osteoarthritis of the Riobamba canton. Method: descriptive, cross-sectional and observational study in 1263 patients diagnosed with osteoarthritis. The Coop/Wonca questionnaire was used to determine the perception of quality of life related to health. The value of Cronbach's alpha coefficient was determined to evaluate the internal consistency and reliability of the questionnaire. Results: average age of 71.83 years, female sex and age group between 66 and 75 years of age. The most affected joints were the knees, followed by the hands, spine and hips respectively. There was a high percentage of patients with associated comorbidities (72.13 percent), especially for arterial hypertension, diabetes mellitus, metabolic syndrome and hypothyroidism, which occurred in over 10 percent of all patients. Global values ​​of quality of life higher than 20 points. The most affected dimensions were pain, physical form and daily activities. Conclusions: the presence of comorbidities worsened the perception of HRQoL of patients with OA, so strict monitoring of the onset or decompensating of them must be taken(AU)

The Role of COOP/WONCA Charts in Predicting Psychological Distress in Patients with Medically Unexplained Symptoms and Doctor-shopping Behavior / General Medicine

BACKGROUND: Prior research indicates that patients with medically unexplained symptoms and doctorshopping behavior are more likely to have psychological distress. In patients with somatic symptoms, we hypothesized that high scores on COOP/WONCA Functional Assessment Charts, in addition to the presence of medically unexplained symptoms and doctor-shopping behavior, might have an important role in diagnosing psychological distress.<BR>METHODS: Between November 2002 and March 2003, the patients who presented themselves to the hospital for the first time with somatic symptoms were enrolled in this study. In this study, we defined psychological distress as disease conditions, including Mood disorders, Anxiety disorders, Adjustment disorders, and Somatoform disorders, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM-IV) . Symptoms that, in the doctor's judgment, could not be medically explained were regarded as medically unexplained symptoms. Doctor shopping was defined as those patients with a complaint of sustained and unsolved symptoms for more than one month who had visited two or more medical facilities prior to visiting our hospital and arrived without any physician's referral.<BR>RESULTS: One hundred and six patients out of 496 were diagnosed as having psychological distress. Among these 106 patients, 49 (46.2%) had doctorshopping behavior, 86 (81.1%) had medically unexplained symptoms, and 95 (89.6%) showed high scores on COOP/WONCA charts. Odds ratios and 95% confidence intervals of medically unexplained symptoms and doctor shopping were 24.12 (11.91-48.84) and 4.18 (2.16-8.07), respectively. High scores on COOP/WONCA charts 2, 3 and 6 were significantly associated with the presence of psychological distress, and the odds ratios (95% confidence intervals) of these three items were 1.41 (1.01-1.98), 1.41 (1.02-1.94), and 2.88 (1.68-4.95), respectively.<BR>Positive and negative likelihood ratios for 4 items (i.e., age of not less than 45 years; duration of symptoms of not less than 6 months, ; doctorshopping behavior; and, medically unexplained symptoms) were 1.16 and 0.85; 1.43 and 0.55; 3.16 and 0.63; and, 3.96 and 0.24, respectively. Positive and negative likelihood ratios for high scores on COOP/WONCA charts were 1.42 and 0.28. Under ROC curves for the diagnosis of psychological distress, the information of COOP/WONCA charts, in addition to that of clinical data, medically unexplained symptoms, and doctor shopping behavior, increased the accuracy in diagnosing psychological distress.<BR>CONCLUSIONS: In patients with somatic symptoms, COOP/WONCA charts increased diagnostic accuracy in predicting psychological distress when patients showed sustained symptoms for more than 6 month, doctor shopping, and medically unexplained symptoms.