Chronic pancreatitis (CP) is a socially significant disease due to the high morbidity and frequent primary disability (15 % patients). Thus, in the Udmurt Republic was revealed high growth of morbidity for diseases of the pancreas: the overall incidence increased from 460,5 persons per 100 thousand population in 2005 to 835,1 persons per 100 thousand people in 2013. Annual growth in the overall incidence ranged from 7,2 to 18,6 %. Thus there is a constant progression of the disease with irreversible changes in pancreatic tissue. Constant keeping diet and long-term use of drugs limit the usual rhythm of life of patients. In recent years, assessment of life quality (LQ), which determines the degree of satisfaction of human needs, is widely used to characterize the severity of the pathological process, its dynamics and the effectiveness of therapeutic interventions. Definition of quality of life is particularly important in chronic diseases that require follow-up therapy for a long time.
The aim of our study was to investigate violations of the features of quality of life in patients with CP.
Materials and methods of research. We examined 112 patients with exacerbation of CP at the age of 33–65 years. There were 45 men and 67 women. The diagnosis was verified on the basis of carefully collected medical history, laboratory data and imaging studies (ultrasonography and fibrogastroduodenoscopy). LQ was assessed using the SF-36 test «Health status survey» (Ware J.I., 1994), where 100 points mean complete health, and the test «Gastrointerstitional index of life quality» GIOLI. To study the peculiarities of patients nutrition we used special questionnaire. The results were compared with the control group (20 healthy subjects).
The data of health quality in CP patients and healthy (due to th SF-36 questionnaire
Results of research and their discussion. Testing has shown that CP patients suffer predominantly physical component of health (Figure). Thus, there were significantly limited physical functioning (PF) – 67,5 ± 8,2 points and role functioning (RP) – 32,9 ± 9,2 points, that reflect the influence of physical condition to performing exercise and daily activities (in the control group – 96,3 ± 2,4 and 87,5 ± 7,5, respectively). The general health status (GH) and pain intensity (BP) patients evaluated as 44,9 ± 7,4 points and 45,9 ± 11,3 points, in healthy, these figures were 75,3 ± 7,1 and 98,3 ± 2,1 points (p < 0,05). In the psychological component of health social functioning (SF) and role functioning (RE) due to emotional state, tended to decrease. Vital activity (VT) was limited to 47,0 ± 10,4 points, in healthy – 77,5 ± 4,2 points (p < 0,05). Mental health (MH) that characterize the presence of anxiety and depression was also significantly reduced compared with the control group: 51,1 ± 9,5 points and 80,0 ± 2,1, respectively.
According to the questionnaire GIOLI and special questionnaire, with 82,1 % of patients with CP due to the disease worsened relationship with family, 58,9 % were forced to change their way of life, 64,3 % of patients – food. 61,6 % of patients experiencing discomfort from inadequate food intake, enjoyment of food received only 57,1 % of patients. 45,5 % of the examined persons noted sleep disturbance, 43,7 % of patients marked poor coping with everyday stress. Due to stress majority of respondents (63,4 %) had appetite elevation, in case of positive emotions (when they were satisfied by themselves) 41,9 % patients allowed themselves to eat something, 27,7 % of patients could drink alcohol.
Conclusion
In the period of CP exacerbation physical and psychological components of health suffer, that connected with chronic disease and necessity to change diet. With help of the SF-36 questionnaire we can detect and quantify changes in LQ for the individual follow-up psychological treatment.
The work is submitted to the International Scientific Conference «The quality of life of patients with different pathologies», Mauritius, February, 17–24, 2015, came to the editorial office оn 15.01.2015.