Health-related quality of life and expectations of patients before surgical treatment of lumbar stenosis

OBJECTIVE: To evaluate the expectations of patients awaiting surgical treatment of lumbar canal stenosis and the association of Health-Related Quality of Life (HRQoL) with symptoms of anxiety and depression. METHODS: The sample included 49 patients from a university hospital. HRQoL was assessed by the Oswestry Disability Index (ODI) and 36-item Medical Outcomes Survey Short Form (SF-36) and symptoms of anxiety and depression by the Hospital Anxiety and Depression Scale (HADS). Expectations were investigated by means of questions used in international studies. Data were analyzed descriptively and by Student's t test. RESULTS: The mean time of disease progression was 34.5 months, the mean age was 58.8 years and 55.1% of the patients were women. Most patients had the expectation of improving with surgical treatment and 46.9% expected to be "much better" with regard to leg pain, walking ability, independence in activities and mental well being. The scores of anxiety and depression were respectively, 34.7% and 12.2%. We observed statistically significant differences between the groups with and without anxiety in the domains: General Health, Mental Health, and Vitality. Between the groups with and without depression there were statistically significant differences in the General Health and Mental Health domains. CONCLUSION: Patients showed great expectation to surgical treatment and the symptoms of anxiety and depression were related to some domains of HRQoL. Thus, the study contributes to broaden our knowledge and we can therefore guide the patients as to their expectations with respect to the real possibilities arising from surgery.

研究目的：评估等待腰椎管狭窄症手术治疗患者的手术预期，以及健康相关生活质量（Health-Related Quality of Life, HRQoL）与焦虑、抑郁症状的关联。
研究方法：本研究纳入某大学附属医院的49例患者。采用Oswestry功能障碍指数（Oswestry Disability Index, ODI）、36项简明健康调查量表（36-item Medical Outcomes Survey Short Form, SF-36）评估健康相关生活质量，采用医院焦虑抑郁量表（Hospital Anxiety and Depression Scale, HADS）评估焦虑与抑郁症状。通过国际研究中使用的调查问卷调查患者的术前预期。数据采用描述性统计方法及Student t检验进行分析。
研究结果：患者的平均病程为34.5个月，平均年龄58.8岁，女性占比55.1%。多数患者预期手术治疗后病情可得到改善，其中46.9%的患者认为术后腿痛、行走能力、日常活动独立性及精神健康状况将“显著好转”。焦虑与抑郁症状的阳性检出率分别为34.7%与12.2%。分析显示，存在焦虑症状与无焦虑症状的患者在总体健康、精神健康及活力维度上存在统计学显著差异；存在抑郁症状与无抑郁症状的患者在总体健康与精神健康维度上存在统计学显著差异。
研究结论：患者对手术治疗抱有较高预期，且焦虑与抑郁症状与健康相关生活质量的部分维度存在关联。本研究有助于拓展相关领域的认知，可据此为患者提供关于手术实际获益预期的临床指导。