Por×wnanie jakoäci ycia pacjentek z owrzodzeniami koÑczyn
Transkrypt
Por×wnanie jakoäci ycia pacjentek z owrzodzeniami koÑczyn
ORIGINAL PAPER Curr Probl Psychiatry 2012; 13(4):251-258 The comparison of quality of life of female patients over and below 41 years of age with lower limbs ulcerataion treated surgically or conservatively Marta Makara- , Karo- Noszczyk !"#$ % & ' ' * +! +&!' ,$ & ./ 67 9 * * & ' *77< &&! ' * $* 67 9+ 6 ' * o,$ &,!' *77< $ + $ * & ,7 * &!' mfort =&&!'&+!&!7> !'6 *!s+' +'!* z ,*,! 67 &!!'+,$'y'6' *&!'+$6! 67?&+$'&! * czyn dolnych leczone na tere@! & '**$* %& o!&B7D FH#$%97#$J&./7! 6,$*&i u6 ,!! !'!! J6Q%S%#– >DVW7B e +F.& ,&!'! J6X $<=*&*&* *7$ a,6 , kwestionariusz 7 &&$6 &! e* ,6!+! 67 & &! &6!XY 6 ! J 6 6! y & * =< *! &! !7 &! &+&o*! 67 <%&! J6 *&& J6cze&! A Crural ulcerations are associated with age and are much more common in people over ./= 7 Ulcers etiologic factors include: && factors related to the conditions and lifestyle7Often they are the result of co-morbidities such as arterial disease$*7 Ulcerating changes cause physical discomfort*& which contributes to social 7 Research indicates that health becomes the primary and one of the main determinants of the quality of life7Complications occurring in the elderly connected with ulcersvenous insufficiency lead to lower Z==7 The study group comprised patients with leg ulcers treated in the Military Q& with Policlinic in the Public Q Institute B7 D 23 in Lublin &*= Surgery7\roup size ./ &7 To assess the quality of life of patients with leg ulcers a shortened version of the questionnaire Q%S%# - >DVW assessing the quality of life7 This survey consists of F. Z which describe the quality of life in four areas: physical & ]*7 The study also used a brief authors’ questionnaire7The research confirms that the age of patients with leg ulcers differentiates their assessment of the quality ==7 In the group of patients over 41 years of age the quality of life was assessed lower; primarily it concerned somatic & and environmental 7 The age of patients significantly influenced the assessment of the quality of ]7 : leg ulcersZ==mood]]*chronic venous insufficiency* !" J 6 ! $' y+&!'' ! + &&!7 ! &* 6 + H/-X/^ ,$ _Y`7 ! > F//j *+ j/ Yx/ + przy& , ,$ * *7 D koszty zabe& &$ ' owrzo- Copyright © 2012 Medical University of Lublin * & ! > ! + F//*,=,_F`7 % & !!' + &e ! 6! _H` +&!' Yj-20 % &7 * ' ' e * +! +&!' ,$ & ./ 6 _X`7 9 * * &d'*77<&&! '| * $* 6 $ J 252 M7 Makara- 7 Podstawka, M7 7 - Noszczyk $+ *= * & ! &_5` – nowotwory lub = ! i urazy _.`7 % ' + $* * $+' * +&a&$!,!$_j`7 Owrzodzen 6 ' !+6* $!* & ! 6! !' terech tygojF_}`7 !6 6 & $7 %$!*! * 6 $6 &!* , =$&o *! &+ _x`7 + J $ x/ ^ ' odzenia podudzi & 67 % ~ ^ F/ ^ + &wodowane , *66' _Y/`7 && o & &!' ! +& 6 , &7'&o*'$J ,6 $ + $ * &,_YY`7 ' & ' ' 6' e&6*'$J,67 " + *' *J arakter dys *=&Jzm+ 6 &6&w$+'!= * *z*_Y`7 Owrzodze + &!' &!, dyskomfort psychiczny z &!''& ! &! _j`7 * '& ' &6 &$* *o &!' 6 = ! $&& &!,7 & ! 6! + !' J ',$ + !'* samym ryzyko &&7 * , !' + &' $ &&o &'$6! 6&!n,7" &!,$J*enia obraz samego $! & '6 zabu$ '*e+_YFYH`7 Leczenie o 6 istot&$**,+a!'' $+ ! !' stosowanych dotychczas metod & _Y`7 * $ ! & =k!! & *!+ & &osowaw_YXY~`7 Problem skutecznego leczenia owrzodzenia na &6!!&= po uzyskaniu w! &! $ trud* * **7 $ ! $ ekono* &7 !6! ' & a* ! + ' &' &o ,6 = ! ' & *! 67 Curr Probl Psychiatry 2012; 13(4):251-258 > ! 6 !' + * dodatkiem do ilo! , dokony! ! * ! $! o$$7!',| J + & ! 6 6 & $ *!l_Y`7 ! J6'| 6 + &$* ! &! = !! o &**66o !' *+ ! ' * ' ,w6! !$$_Y.`7%!' = + 6 J i*!+ $!, $ 6 $&&o'J&!sprawowania samoopieki &,&_~`7 * ! , &!' ! J 6 ,$ ! 7 e * & + u ,$!'$& 6+!+&!! wielochorobowo7 > !'6 *!+ '+'!*,ch determinan, ! 6 _Yj`7 &!!' + ,$ ' ' 6' * &!'+$6 ! 67 Pracownicy ochrony zdrowia 6 w zapewnienie opieki i leczenia osobom chorym wymaga!' ,6 * & $ ! J6&!_Y}Yx`7 9* & $ &, ! 6 &a! * , & < XY 6 &6! XY 67 # $ > && , ./ &! z owrzodzeniami e @ ! & ' w Samodziel* $* %& Zdro!&B7D FH#$% Chi7 # $ $ & &* !'! ! J 6 Q%S%# – >DVW7 B + F. & , & ! & & ' " & Q%S%#– >DVWY//7>&& o potrzeb ,! ! !'! ! J 6 Q%S%# – >DVW7 B ~&! Y & $ $ ~ – $ $ $ 7 ,6 , autorski kw 7 & ,! 6&! * &6!XY&! 777 253 &! & *7 Kwe } & * Y & + *=-& $ ! *! amieszkani &7 &'&* $ e& &=* &$ &oprawne & 7 ono 6*J!6$*e , 7 "y $&!7 ! & &! &6 $ * 6* H..j^ &' $ * + | * * Y..j^ & * y *'7 ! !$$*!' < , ' *' YHHH^ & Y/^ $ * HHH^7 & &! &! ,6 &6 $ * 6*7 Stano XHHH^ , ! &7 D, FHHH^ & *' Y~ $ &! * y , ' *'7 ..j^ $ * & zawodowe , '$*7 \$Y7 9$$,$ % Y 1–3 lata 4–5 lat 6!~ Razem \$F7 >6~..j^$ *+6 79&'$$ '7' =**&YHHH^ &7..j^$&7 $+*' +!$HHH^7 , &! &! & FH , *+6 ...j^7 ! !o< YHHH^ & Y/^ $ * ..j^7 $ ! & & ' =rmalnym HHH^7 6j/^&! o }..j^ $ &e!&7$H/^ & YHHH^ & e &! $ awodowo ze wz+ '+ * $ 7 Analiza uzyskanych odpowiedzi pozwala stwierJ6&&! $ + $' 6 ' & ~ 7 > & 6 ! X–~ FHHH^ Y..j^- 7,!6 Y/^ $ ! &7 , &! &!~HHH^ &~7&$&a6$&& 4–~o* Y..j^ - 7 ..j^ $ &! *+7\$7Y N % 3 Y/// 5 Y..j 7 FHHH 15 ~/// 30 Y//// N % 2 ..j 5 Y..j 7 FHHH Y. ~HHH 30 Y//// \$&!+$,$& '" Planowany Razem N % 7 FHHH 23 j..j 30 Y//// $&*&&!+ j..j^&! 6xHHH^ &!7 & && ach $ &!+ FHHH^ &! onych zachowa ..j^ $ operacy!| 7 \$7F $ 6 , & ! 6y ! ' nieznacznie 6 & &! & XY 7 67 & &! XY 6 ' + &! 6Hj~&, &! &XY 6 N % 2 ..j 28 xHHH 30 Y//// HXX7 + $6J '& w odniesieniu do zadowolenia z d & &! XY 7 67 HHF &, &! & XY 6 d FxX7 B &, $ & e ! 6 j owa & = *! 6 +&!' ,&! & XY 7 67 !$!$6&!+ *+ !*! $6ne && $, = 6 Curr Probl Psychiatry 2012; 13(4):251-258 254 M7 Makara- 7 Podstawka, M7 7 - Noszczyk za* &7 $6a6J&//X*+| 6' ' &! & XY *6Hjx &, &!ntek po 41 6HH}79 Y7 $ 6+=y so!!$ XY&6!e 7 !$! $6 ' deklarowane 6 * !*! zado & &!,7 B wskazu! 6 F &, H & ...j^ ,6nice &*!' J &! & XY 7 67 6! < a! * ! 6 *7 6! * o&&!,7 6 ,6&//Y w odpowiedz ' 6 intymnego pac! 6'' &!t &6!XY 6!& Hx.&,&! &&6!XY 6 ! & HY. H7 Y7%! 6$** badanych !* &* $ $ & ocen w stosunku do sfery psy!7 ! zest&$,$&aJ$,! 6=&!7 >& !&&u!' + ~-&' ' ,! Y &o~– $6*&$ do$ $ a7 !' * $ , & F. Y w natomiast 5 – 7 B!' 6 6J 6 $ XY 6! !' & !'+ =+ &o = !a7 !+ ,6+&u!'J & $! XY 6 Hj~ w po,&$!&6!XY 6 HF} !*! &y& &!'+7 F !&,$&! 6ycia badanych w sferze psycho!7 F7%! 6=&! a wiek badanych Curr Probl Psychiatry 2012; 13(4):251-258 H7%! 6=!! badanych !* * &+& $ $y,6 *7 %e ! 6 = ! $a7 = + m obszarem = ! $ , !$! ,6 &7 %$ & XY 7 67 6! X &, } & ~/^7 > a+&!' & < & $& $z&=+&J&$ informa! *6J ! 7 & +< o , * &, 6$ & 6!&$&6!XY7 !+ $6 ' & $& J ,$ * !| *! & J ,$ X ,! 6&! * &6!XY&! 777 255 X7 % ! 6 = o ! $7 Na wykresie nr 5 ! &,$ $ XY&6!XY!'&, =<*'&'!'i '7 ~7% ! 6&, sferach a wiek badanych Na podstawie otrzymanych dan*6rJ 6 &! & XY 7 67 !' !' ! J 6 &' 6 &! , XY 7 !+ ,6 = !! &ychologicz! * !*! ,= !!' $$7 %' + , !' ,6o & ! 6 + 6 ,J + 6 $ * a!' n!+ $! & & ! 6 ! ,6 $7 obserwo,6'& *+J 6 *7 & &ktach mimo & ,6 ' ! $6 ' &'&,&!n &XY76 ( $ 6,&! o 6 ! ' 6 &&! &XY767B &, $& !6 e- sie wszystkich analizowanych podskal sfery somatycz! 6 +&!' , &! & XY 7 67 !$! $6 &! + *+e7 !' + + *+ +! &!+&,$&6!XY 6 *6$J'& '6'7 +&!' *' &J m=*+ _Y`7 $'6J$>' o $ $niach tych gorsze samopoczucie +!+&,$&6!XX 6_j`7 6 * $ & < ! + $! u! & * & < $, = 6J * &o$& $$',67 Skutki w zakresie , i utraty ' + _F/ FY`7 Ebbeskog i Ekman (20/Y _FF` 6 bezna! * $ ! $ & &!, * pod7 $+6 $,*6 &J &! samoleczenia ! &z! *ii i !' * *$,! _FHFX`7+& zapachu i + z rany zosta= ! , czynniki !' J &' &!, z owrzodzeniami koczyn dolnych _F~`7 \ *6 $J &+ & J &! utrzymania $! oraz fizyczne ograniczenia &!' J & &,6 noszenie odpo! 6 uprawianie hobby _F.`7 Podczas gdy ! $ , *'+ J '& = ! &! *' * &J + $& ! + 6 $ ,&e&&,$ _5`7 Znaczenie zadowolenia z , &!, z owrzodzeniami podudzi zaobserwowano w 2004 $ &! * o*&'$_YFFj`7 &7 $,'*! &+ zm+| & $ $ r !*6&J+&a,&!_YHFHF}`7>,$6n * !+! +&!'* , &!, * & = ! zyn &!' !+ $6 ! 6y&!,$+ _FxH/HY`7 B!'+&**66J +&*! ,=&o!!!_HFX`7 Curr Probl Psychiatry 2012; 13(4):251-258 F~. M7 Makara- 7 Podstawka, M7 7 - Noszczyk > $&XY *66!e!'& & !'+=+ & = !7 !+ ,6 '& &dskali negatywnych odJ7 ' & ' ,! wiek kobiet nie +& ,6 $ &!'=7&& alach (&6 !a $ 6 $ & XY * 67 Z analizy 6 +! y+&&,$&XY 67%*n >' !' 6 w grupi$&XY *6!'+ **&*$6'! '6_j`7 6* && &! &' owrzodzenia p $ +& negatywnych J _HHFF`7 = !onowania psychologicznego badacze zaobserwowali ,6 $! , &!n,* nych: poczucie utraty kon =! &,! $6 samopoczucie – & ' *' $!a* &! - + &+&!' *_HX H~H.`7 > & > !' 6 , $ ch z owrzodzeniem podudzi '&&&! 6&!apii) $ = !' W-H. !' * = !o *!7 *6 J + &!, & * &+&* $ _Hj`7 $ & !' 6 * & Klub Leg&S!Eileen Teresy Lindsay z Newport ( > ,* &d' ! & & * =r*! & *! * + ! & !* & * =*! * 6 6 profilaktyczna opieka po leczeniu _H}Fx`7 $ 6+=o!! $ XY &6! 7 !$! $6 ' 6 * !*! - za & &!,7 $ 6!<!* o! 6 *7 6! natomiast zadowolenie ze ws& &!,7 & $ &e&F//~7 &76 & }/ ^ & * * &!e 6 ! & *! + +J & '!*o&+*o* & _YH`7 odobne wyniki pre!'B_YFHxX/XY`7 Curr Probl Psychiatry 2012; 13(4):251-258 & = ! ogr ' +&!, owrzodzeniami ,_Y/Fj`7 >, *$J $ & prowadzi do ! &!7 && $ &!*'J& &7Potwierdza tD&&7_XF`7 6 ! J 6 &' ! &!*6$J&&J7 %$ & XY 7 67 6! ,w6= !<&ucie $& $& = +&J &bnych =*! *6J ! n7 &$+ +& =*! , a+!6Yxx~ 97 ! B + ,6 &$' & o*$J_HX`7 & +< , * o &, 6$ z trans& 6! & $ &6!XY7 = ! $ &6! XY 6*!&$& *6 $J ' &!'* + * zdro & * '* & ydolno' 6'7 # &!' 6 + & &+&!' 6 +&'_YHXHXX`7 ! 1 && $ stwierdzo6! 6&!,6t &!,7 Y7 6' ! J 6 !' &! &6! XY 6=*a!&!!!7 F7 ! &6! XY 6 !' !' !a J66*&*7 ) * Y7 F7 H7 X7 ~7 .7 7B 7 J6$ +677 7# 7F//}FX<YXY- F.}7 7 W 7 \ costs of skin breakdown and "7 @ 7\*&W"7F//j<.-YF7 7 D7 # 7 ! "7 F//jYx~<HH-Hj7 7 V== = ] patients’ Z==77F/YFF.H}<XF-Xx7 *B7Issues affecting concordance with leg ulcer Z= =7 7F/Y/ FXX~< 51-~}7 Q97#$%& 777 9 Leg-ulcer-venous @7&7 # ac<FY7F/YF7 ,! 6&! * &6!XY&! 777 257 j7 }7 x7 Y/7 YY7 YF7 YH7 YX7 Y~7 Y.7 Yj7 Y}7 Yx7 F/7 FY7 FF7 FH7 >' ?7 \ 7 B7 &7 W !a ! J 6 * & e*7* BF/YY@@@H<Yxj-F/F7 > 7 9 7 \ &] = ation: a ] = 7 ' ( )* 7F//HHFYX-F/7 Salavastru CM7 Nedelcu LE7 Tiplica GS7 Management of leg ulcers in patients with chronic venous insufficiency: &=*9>Do*7 * \7 < Y/7YYYY!7Y~Fx}/Yx7F/YF7/Y~YH7 2012; 25(4): 304-YH7 7 == = ] 7 7F/YFF.X~<~F-.F7 7 & 7 % ! &oblem * < B*$! ,$ 6 7 & 7 % ?77 ? <F//Y7 Q B7 ?& 7 = \7 @]ntions to enhance patient compliance with leg ulcer treatment: a re]=7* +, 7F//j YjY<Fx-Hx7 \7B79 7&7% & = ! & e'6'*7* B7F//~FF<F.5-Fj/7 * 7 + ! &$* @ e 7 W*F//}Y<Y/-YY7 9 7 ? &* o7 ?#<F//}7 %>7 VB7 ] = =<==!al psychological 7@D7Yx}XYX<xx-Y/}7 B7 \$-B* >7 > 7 &7 o, ! 6 &!, !*! .~&&6!.X 6&&e!* ! $7 ? 7 2012; 20(1): 28-Hj7 > 7 V] *& & = ] 7 7F//XY//j<H/-HY7 == 97 7 7 &osocial = 7 7 F//. 102(30): 51-~H7 B>7 S = = =* &&&]7* + 7F//XYH (11): 17-F/7 > #7 # **< & & *&] 7 "+ 7F//~F/.Hx-XY7 V$$ >7 V * #7 V & &iences of living with venous leg ulcer: living in a dialectal relation& $ =* *&*7 - * +,F//YY~H<FH~-FXH7 7 > 7 D$ 7 9 97 & &]7* + 7F//.FYY~&&7YY<Yj-FH7 FX7 " = Q 7 " + "("' ./ " 0), . 7#Vu&<F//X7 F~7 7#]<nsight into &&=7* +' ,7 F//YY/x<H~~-H./V#F//H& do not comply *&$7* + 7F//HYFYY<~-Y/7 F.7 BQ]9D! ] =9]B$\7#<e]=*&=7=9sF//4; 13: 341–H~X7 Fj7 Q B7 >$ B7 > 7 ? ?7 Q$$D7 *\7*&= ] Z = =7 = 9F//~YX<~H–~j7 F}7 VQ797W7#ey V7B*=**unity intervention: improved quality of life and healing for clients with 7 * + , 7 F//x Y} (11): 1541-Y~Xx7 Fx7 Gonz´lez-9 D S of life in people with venous leg ulcers: an integrative re]7Journal of Advanced NursingF/YY7.j@s ~< xF.-xXX Yx&7 %@<Y/7YYYY!7YH.~F.X}7F/Y/7/~~.}7 H/7 >7W**7977#]#"eration: A Meta-synthesis =S]D7jF7\ F//. @ D 9=7 #nD97 HY7 7 = ] < * ories $ ] & ==7 = %*97Yxx}F~<Y~}– 1.}7 HF7 Q$ ##7 < & = & &7 , ++- 7F//Y ~Y 35-X/7 HH7 & \ > ] B # D7 B = *&=Z==<= psychologic i*&7 = B* Bd*=*7YxxXHY<Xx–~H7 HX7 9 Q7 & r7 =\$7F//FYF<Y~X–Y~}7 H~7 7B7?7V79**xperienced by the well elder< *&7 = ?e7F//HFx<H}–X.7 H.7 ==97W 797D7>eD DW7]=#&&a7S7F//Xxj<XHY–XHj7 Hj7 J @7 Medenica L7 *]J 7 ! ]J-! ]J O7_S== &]`7_B $`7>9*7 _V&$=&`7F/YF F}YFY<Yj7 H}7 #V7#$<&&ch to patient-centred **7 Q 7 F///F<YHx–YXY7 Curr Probl Psychiatry 2012; 13(4):251-258 258 M7 Makara- 7 Podstawka, M7 7 - Noszczyk Hx7 Q& B7 & ]< ] & egies for non-7* + 7 F//XYHx<~~.-~.H7 X/7 V$$ >7 V** B7 % patients’ experience of ] <* ! &7 * + , 7 F//~ 14(10): 1223-YFHY7 XY7 D B # #7 Q ] == people’s daily life: a nurse- 7 * + ' ,7F//HYFF<~Y-~X7 XF7 D&7#7\B7/# (+ )-+#-7V$ 79#]F///7 XH7 Q 97 Knispel J7 Lopes M7 > B7 Maus E7 Clinical and cost efficacy of advanced wound care matric = ] 7 9 *7 2012; 18(5): 375-8X7 Curr Probl Psychiatry 2012; 13(4):251-258 XX7 Q* D7>7 = 7 V &< &&&]**7r=97F//HYF<Yx~–Yxx7 % Samodzielna Pracownia Zdrowia Psychicznego Uniwersytet Medyczny w Lublinie 79 Y~F/-/xH#$ e-mail<& &7&