A Study on the Psychological Profile and Coping With the Disease in Patients With Lymphangioleiomyomatosis

David Rudilla , María Molina , Claudia Valenzuela , Álvaro Casanova , Julio Ancochea
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Abstract

Introduction

Lymphangioleiomyomatosis (LAM) is a rare disease that affects women almost exclusively. We aimed to determine the psychological profile in patients with LAM, and their potential association with sociodemographic and clinical features, and to know their role in coping with the disease.

Material and methods

Cross-sectional and descriptive study in collaboration with the Spanish Association of LAM (AELAM). The variables measured were: socio-demographic, psychological (anxiety, depression, demoralization, spirituality, resilience, social support), clinical (treatment) and health-related quality of life.

Results

We studied 87 LAM patients, with a mean (SD) age of 47.7 (7.7) years, and time since diagnose was 10.1 (5.4) years. 75.9% of patients were receiving sirolimus or everolimus, and oxygen therapy was required in 34.5% of patients. Anxiety was found in 46% of patients, depression in 55%, while only 2% presented demoralization and 14% deficit in spirituality. Social support and resilience were adequate. The “non-severe” group (without oxygen therapy) presented worse results in anxiety. A structural equation model to explore association between variables, showed very adequate fit indices: χ2(14) = 29.743 (p = .074); CFI = .983; TLI = .967; SRMR = .058; RMSEA = .075[.000–.128]. The model identifies resilience, spirituality and social support as “protective factors” from anxiety, depression, and demoralization.

Conclusions

This study performed on a large series of women with LAM describes their psychological profile, in addition to showing how they cope with the disease. We have found that other psychological constructs, such as perceived social support and resilience, are protective factors. Early psychological evaluation and intervention is necessary to reduce comorbidities and prevent mental health problems in women with LAM.

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淋巴管瘤病患者的心理状况和疾病应对研究
导言淋巴管瘤(LAM)是一种罕见疾病,几乎只影响女性。我们的目的是确定 LAM 患者的心理状况及其与社会人口学和临床特征的潜在联系,并了解他们在应对疾病时所扮演的角色。测量的变量包括:社会人口学、心理学(焦虑、抑郁、意志消沉、灵性、复原力、社会支持)、临床(治疗)和与健康相关的生活质量。结果我们研究了 87 名 LAM 患者,平均(标清)年龄为 47.7(7.7)岁,确诊时间为 10.1(5.4)年。75.9%的患者正在接受西罗莫司或依维莫司治疗,34.5%的患者需要接受氧疗。46%的患者患有焦虑症,55%的患者患有抑郁症,只有2%的患者意志消沉,14%的患者缺乏灵性。患者的社会支持和恢复能力都很充足。非严重 "组(未接受氧气治疗)的焦虑程度更严重。通过结构方程模型探讨变量之间的关联,结果显示拟合指数非常理想:χ2(14) = 29.743 (p = .074);CFI = .983;TLI = .967;SRMR = .058;RMSEA = .075[.000-.128]。该模型将复原力、灵性和社会支持确定为防止焦虑、抑郁和意志消沉的 "保护因素"。我们发现,其他心理结构,如感知到的社会支持和复原力,也是保护因素。有必要及早进行心理评估和干预,以减少 LAM 女性患者的合并症,并预防她们出现心理健康问题。
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来源期刊
Open Respiratory Archives
Open Respiratory Archives Medicine-Pulmonary and Respiratory Medicine
CiteScore
1.10
自引率
0.00%
发文量
58
审稿时长
51 days
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