| کلیدواژههای انگلیسی مقاله |
Behçet’s disease, Quality of life, Leeds BD-QoL, What&,rsquo s Known Beh&,ccedil et&,rsquo s disease (BD) is a chronic rheumatologic disorder that negatively impacts the quality of life of the affected patients. The Leeds Beh&,ccedil et&,rsquo s disease-quality of life (BD-QoL) questionnaire is a validated and specific tool for measuring the quality of life of patients with Beh&,ccedil et&,rsquo s disease patients. It has been shown to have a good correlation with the SF-36 questionnaire. What&,rsquo s New The QoL of BD patients was assessed using the Persian version of the Leeds BD-QoL questionnaire. The questionnaire can be used as an alternative instrument to the WHOQOL-BREF questionnaire to assess the impact of BD on the QoL of the affected patients. IntroductionBeh&,ccedil et&,rsquo s disease (BD) is a serious chronic and multisystem inflammatory disorder that can involve multiple organs of the human body leading to some degree of functional disability. 1, BD is prevalent worldwide but it is more common in the areas such as the Mediterranean Sea (Turkey and Greece), the Middle East, and the Far East. 2, After Turkey, Iran has the highest prevalence of BD with a rate of 80 per 100,000 people. 3, Like any other chronic disorder, the severity of the disease and number of symptoms negatively affects mental health, life satisfaction, and quality of life (QoL) of the affected patients. 4,- 10, Most studies on the QoL of patients with BD have focused on assessing the impact of specific symptoms such as mouth ulcers, 11,, 12, arthritis, 13, and ocular involvement. 14,, 15, A few studies have measured the QoL of patients using general questionnaires such as the Short Form 36 (SF-36) or The World Health Organization Quality of Life Instrument Short Form (WHOQOL-BREF). 4,- 6,, 8, The latter is a generally accepted and widely used instrument to measure QoL. However, the Leeds BD-QoL questionnaire has been specifically developed to assess the QoL of patients with BD. 16, This questionnaire has been translated in different languages (e.g., Persian, Arabic, and Korean) and the validity and reliability of these local versions have been confirmed. 17,- 19, To the best of our knowledge, no other studies have compared the results of the Leeds BD-QoL with the WHOQOL-BREF questionnaire. Besides, since the validation of the Persian version of the Leeds BD-QoL, we are not aware of any studies in Iran that have measured the QoL of DB patients using this questionnaire. Considering the relatively high prevalence of BD in Iran and the adverse effect of this disease, the present study aimed to assess the QoL of BD patients using the Persian version of the Leeds BD-QoL and correlate its results with those from the WHOQOL-BREF questionnaire. Materials and MethodsThe present cross-sectional study was conducted during August-December 2017 at the Beh&,ccedil et&,rsquo s Disease Clinic of Shahid Motahari Hospital affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Beh&,ccedil et&,rsquo s Disease Clinic is the main referral center in southern Iran. Based on a pilot study involving 65 participants, the required sample size was estimated using the two-sample comparison of means formula (significance level of 0.05 and statistical power of 80%). The estimated required number of patients and healthy individuals was 152 and 304, respectively. However, the number of patients was increased to 179 to ensure adequate participation. The patients were recruited using the convenient sampling method. The inclusion criteria were confirmed diagnosis of BD by a rheumatologist (according to the International Criteria for Beh&,ccedil et&,rsquo s Disease), being a patient at our clinic, and willingness to participate in the study. 20, The exclusion criteria were the presence of any other diagnosed chronic disease and/or psychiatric disorder, and unwillingness to participate. The healthy participants (control group) were selected from the medical records of family physicians using the simple randomization method. The term &,ldquo healthy&,rdquo was defined as the absence of any diagnosed disease affecting the QoL. In the course of the study, 7.2% of the recruited healthy individuals did not complete the questionnaire and therefore were substituted by the next eligible person on the list. The demographic characteristics included sex, marital status, and education level (table 1,). VariablesPatient groupControl groupP valueAge (mean&,plusmn SD)42.3&,plusmn 11.132.7&,plusmn 8.80.001Sex (n, %)Male56 (31.3%)108 (37.5%)0.44Female123 (68.7%)193 (63.5%)Marital status (n, %)Single24 (13.4%)96 (31.8%)0.05Married150 (83.8%)196 (64.9%)Widowed5 (2.8%)3 (1%)Divorced07 (2.3%)Education level (n, %)Illiterate or primary school62 (34.6%)14 (4.6%)0.001Middle or high school84 (46. 9%)102 (33.8%)University 33 (18.4%)188 (61.6%)Table 1. Demographic characteristics of the participants with Beh&,ccedil et&,rsquo s diseaseThe validated Persian versions of the Leeds BD-QoL and WHOQOL-BREF questionnaires were used to assess the QoL of BD patients. The QoL in the control group was only assessed with the WHOQOL-BREF questionnaire. The 30-item Leeds BD-QoL questionnaire has been specifically developed to assess the QoL of BD patients. The test-retest reliability of the questionnaire was 0.84 and the validity of its Persian version was confirmed (&,alpha =0.949). 16,, 17, The questions are answered in a true (1) or false (0) response format with a maximum score of 30. Higher scores indicate a lower QoL. The 26-item WHOQOL-BREF consists of four domains, namely physical health, psychological health, social relationships, and environment, and an overall QoL and general health score. 21, Each question is scored from 1 to 5 on a response scale. Raw scores for each domain are the sum of respective item scores, and then transformed linearly to a 0-100 scale. Higher scores indicate a better QoL. WHOQOL-BREF has been standardized and validated for use in the Iranian population. The Cronbach&,rsquo s alpha values of the four domains ranged from 0.7 to 0.84. 22, The disease activity in patients with BD was assessed by a rheumatologist researcher using the Beh&,ccedil et&,rsquo s Disease Current Activity Form (BDCAF) questionnaire. The overall perceived QoL of patients and clinicians was measured using a visual analog scale (VAS). The scores ranged from 1 to 7 higher scores indicated the worst impression of the disease activity. The patient&,rsquo s index score (from 0 to 12) and the transformed index score (from 0 to 20) were then calculated higher scores indicated severer symptoms. 23, Statistical Analysis The data were analyzed using SPSS software, version 21.0. Descriptive statistics of the data were described as mean and frequency. The independent t test, Chi-squared test, Spearman&,rsquo s correlation test, and multiple linear regression analysis were also used to analyze the data. P&,lt 0.05 was considered statistically significant. Ethical ConsiderationsThe present study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Shiraz University of Medical Sciences, Shiraz, Iran (code, IR.SUMS.REC.1396.s59). Prior to the study, the research goals and methods were explained to the participants, the confidentiality of any disclosed information was guaranteed, and voluntary participation was emphasized. A member of the research team assisted illiterate participants (n=15) with filling in the questionnaires. To help participants with low vision, they were interviewed by a researcher who subsequently completed the questionnaire on their behalf. Written informed consent was obtained from all the participants.ResultsThe mean age of the participants in the patient and control groups was 42.3&,plusmn 11.1 and 32.7&,plusmn 8.8 years, respectively. There was no significant difference between the sex of the patients (P=0.25), different educational levels (P=0.14), and types of marital status (P=0.66). The mean of the Leeds BD-QoL score in the patient group was 12.3&,plusmn 8.7. The mean duration of the disease in patients with BD was 11.1&,plusmn 8.3 years, which had no significant positive correlation with the Leeds BD-QoL score (r=0.155, P=0.047). The scores obtained from the BDCAF questionnaire had a significant positive correlation with the Leeds BD-QoL score (table 2,). The mean of the WHOQOL-BREF total score in the patient and control groups was 54.5&,plusmn 19.4 and 67.6&,plusmn 15.6, respectively. The corresponding values for the domains of the WHOQOL-BREF questionnaire are shown in table 3,. VariablesLeeds BD-QoL total scoreMean&,plusmn SDP valuePatients&,rsquo VAS*,Correlation coefficient0.2943.2&,plusmn 1.6&,lt 0.001Clinician&,rsquo s VASCorrelation coefficient0.2992.8&,plusmn 1.4&,lt 0.001Patient index score**,Correlation coefficient0.3371.80&,plusmn 2.03&,lt 0.001Transformed index score**,Correlation coefficient0.3613.89&,plusmn 3.31&,lt 0.001*Visual analog scale **Beh&,ccedil et&,rsquo s disease current activity form |