| Abstract | Cilj istraživanja: Cilj ovog istraživanja bio je prikazati učestalost NMS-a u bolesnika oboljelih od PB-a u Splitsko-dalmatinskoj županiji, utjecaj različitih čimbenika na broj i strukturu NMS-a, te utjecaj NMS-a na kvalitetu života bolesnika. Ispitanici i metode: Ovo opisno presječno istraživanje provedeno je u Klinici za neurologiju u KBC-u Split. U istraživanju koje je trajalo od studenog 2017. do travnja 2018. sudjelovao je 31 bolesnik koji je hospitaliziran ili liječen ambulantno u Klinici za neurologiju. Uvidom u medicinsku dokumentaciju prikupili smo demografske i kliničke podatke o bolesnicima. Ispitanici su potom pregledani te anketirani uz pomoć za PB specifičnih upitnika: NMSQuest, Hoehn i Yahr skala, UPDRS, PDQ-39, Schwab i England skala. U statističkoj obradi podataka koristili smo Mann-Whitney U test, Kruskal-Wallis test, Spearmanov koeficijent korelacije, hi-kvadrat test i ANOVA test. Rezultati: U prosjeku 12 različitih NMS-a je prijavljeno po bolesniku. Najčešće prijavljeni NMS-i su nokturija (67,74%), urgencija mokrenja (61,29%), konstipacija (61,29%), intenzivni snovi (58,06%) i zaboravljivost (58,06%). Najrjeđe prijavljeni NMS-i su deluzije (6,45%), halucinacije (16,12%) i dnevna pospanost (25,80%). Između muškaraca i žena nismo ustanovili statistički značajnu razliku u broju NMS-a, niti u demografskim značajkama bolesti. Porastom duljine trajanja bolesti dolazi do porasta opterećenja NMS-a. Depresija, anksioznost i simptomi domene razno značajno rastu s porastom duljine trajanja bolesti. Ustanovili smo povezanost broja NMS-a sa stadijem bolesti po Hoehn i Yahru. Bolesnici većih stadija (srednji i teški) bolesti imali su više NMS-a, s tim da su bolesnici srednjeg stadija u našem istraživanju imali najviše NMS-a. Kroz sve stadije bolesti simptomi mokrenja najviše opterećuju bolesnike. U blagom stadiju bolesti ispitanike uz mokrenje opterećuju simptomi probave i kognicije, u srednjem stadiju problemi spolnog odnosa i kardiovaskularni problemi, a u teškom stadiju bolesti uz kardiovaskularne probleme, depresija i anksioznost. Smanjenje mogućnosti obavljanja svakodnevnih aktivnosti (-0,820, P<0,001) i NMS-i (0,786, P<0,001) najviše utječu na kvalitetu života bolesnika. Bolesnicima srednjeg stadija bolesti kvalitetu života najviše narušavaju NMS-i (oštećenje kognitivnosti, komunikativnosti i emocionalno) dok bolesnicima teškog stadija motorički simptomi (oštećenje pokretljivosti i obavljanja dnevnih aktivnosti). Zaključci: Bolesnike najviše opterećuje autonomni spektar NMS-a, pogotovo simptomi mokraćnog sustava. Na ukupni broj NMS-a utječe duljina trajanja bolesti i stadij bolesti, a ne utječe dob postavljanja dijagnoze, trenutna dob i spol. Bolesnici srednjeg stadija bolesti prijavili su najviše NMS-a. Bolesnicima kvalitetu života najviše oštećuju nemogućnost obavljanja svakodnevnih aktivnosti i NMS-i. Bolesnicima srednjeg stadija bolesti kvalitetu života narušavaju NMS-i, a bolesnicima teškog stadija bolesti motorički simptomi. |
| Abstract (english) | Objectives: The aim of this study was to review the prevalence of NMS in patients with Parkinson′s disease in Split-Dalmatia County, to investigate effects of other variables on the number and structure of NMS, and to describe the effect of NMS on the quality of life in patients. Subjects and methods: This descriptive cross-sectional study was conducted at the Department of Neurology, University Hospital of Split. This study lasted from November 2017. to April 2018. and it included 31 patient, hospitalized or treated in infirmary at the Department of Neurology. By examining medical documentation we acquired necessary demographic and medical informations about our subjects. Subjects were than examined and subjected to filling out Parkinson′s disease specific questionnaires: NMSQuest, Hoeh and Yahr scale, UPDRS, PDQ-39, and Schwab and England scale. To analyse given variables we used Mann-Whitney U test, Kruskal-Wallis test, Spearman′s coefficient of correlation, chi-square test and ANOVA test. Results: In average 12 different NMS were reported per patient. Most prevalent NMS were reported to be nocturia (67.74%), urinary urgency (61.29%), constipation (61.29%), intense dreams (58.06%), and forgetfulness (58.06%). Least prevalent NMS reported were delusions (6.45%), hallucinations (16.12%), and daytime sleepiness (25.80%). There were neither statistical differences in the total number of NMS nor in demografic variables between men and women. The increased burden of NMS corellated with the disease duration. Prevalence of depression, anxiety and miscellanious symptoms rose with the lenght of disease duration. We established connection between the number of NMS and the stage of disease according to Hoehn and Yahr. Patients in higher stages of disease (moderate and severe) reported more severe NMS burden than patients in mild stage of disease, while patients in moderate stage had the largest NMS score of all groups. Patients in mild stage reported urinary, also digestive and cognitive symptoms, in moderate stage urinary symptoms, sexual disfunction, and cardiovascular symptoms were most reported, while in severe stage of disease, patients reported cardiovascular symptoms, depression and anxiety alongside urinary symptoms as most prevalent. Of all problems associated with Parkinson′s disease, inability to perform everyday activities (-0.820, P<0.001) and NMS (0.786, P<0.001) had most effect on deteriorating quality of life. NMS (cognition, communication, and emotional symptoms) predominantly affected quality of life of patients in moderate stage of disease, while motor symptoms (mobility, everyday activities) were the biggest contibutor of poor quality of life in patients in severe stage of disease. Conclusions: Patients are most affected by autonomic spectrum of NMS, especially urinary symptoms. Duration of the disease, and stage of the disease are proven to affect the total number of NMS, while age at onset, current age and sex have been disproven to have any affect on total NMS score. Patients in moderate stage reported the most NMS. Patients in moderate stage have their quality of life affected by NMS, while patients in severe stage have their quality of life affected by motor symptoms. |
