Interpretation of the study results was made according to gender, age characteristics and rosacea subtypes, which is shown in Table 1.
Table 1
Patients’ demographic characteristic according to the rosacea subtypes.
|
|
Erythematotelangiectatic (N = 28)
|
Papulopustular (N = 93)
|
Phymatous
(N = 4)
|
Ocular
(N = 13)
|
p value
|
|
|
n(%)
|
n(%)
|
n(%)
|
n(%)
|
Gender
|
Male
|
5(17.86)
|
13(13.98)
|
4(100)
|
3(23.08)
|
0.0001
|
Female
|
23(82.14)
|
80(86.02)
|
0(0)
|
10(76.92)
|
0.0001
|
Age
|
< 30
|
2(7.14)
|
8(8.6)
|
0(0)
|
0(0)
|
0.6704
|
31–40
|
9(32.14)
|
33(35.48
|
1(25)
|
1(7.69)
|
0.2506
|
41–50
|
7(25)
|
27(29.03)
|
0(0)
|
2(15.38)
|
0.4614
|
51–60
|
6(21.43)
|
21(22.58)
|
1(25)
|
3(23.08)
|
0.9983
|
> 60
|
4(14.29)
|
4(4.3)
|
2(50)
|
7(53.85)
|
< 0.0001
|
Mean age
|
Mean + Sd
|
45.25 + 12.81
|
42.96 ± 10.72
|
62.08 ± 13.07
|
58.00 ± 20.15
|
0.0000
|
*Mean + Sd - mean and standard deviation (SD). †p value (P < 0.05)
Phymatous subtype (n = 4) were examined only in male patients. Other subtypes of rosacea were significantly dominant in females.
The patients' average age was significantly low in case of Erythematotelangiectatic and Papulopustular subtype and advanced in Ocular and Phymatous subtypes. Patient’s demographic characteristics and rosacea clinical subtypes are shown in Table 1.
Based on the data mean Rosacea-specific DLQI is significantly low and equals: symptoms and feelings − 3.75 ± 1.92, daily activities − 3.12 ± 1.77; leisure − 2.52 ± 1.81, work and/or school − 1.52 ± 1.50, personal relationships − 2.42 ± 1.90, treatment − 1.59 ± 1.04. Average DLQI in case of rosacea is 14.09 ± 3.18. The higher the score of DLQI the more impact the disease has on a person’s life.
During the research, we measured the average distribution of QoL according to the subtypes of the rosacea, which is presented in Fig. 1.
The higher the score of DLQI the more impact the disease has on a person’s life.
Distribution of patients’ percentage wise according to the subtypes of rosacea and DLQI is presented in Fig. 2.
The frequency of Erythematotelangiectatic subtype is higher in the group of small impact, Papulopustular subtype prevails in all other groups.
On the other stage of the research were studied correlations between DLQI, disease subtypes and patients’ demographic characteristics (Table 2).
Table 2
Dermatology Life Quality Index connection between rosacea subtype and demographic characteritics.
|
|
P
|
small effect on patient’s life
|
moderate effect on patient’s life
|
very large effect on patient’s life
|
extremely large effect on patient’s life
|
Subtypes
|
Erythematotelangiectatic
|
R
|
0.345**
|
0.194*
|
-0.188*
|
-0.211*
|
p
|
0.000
|
0.023
|
0.027
|
0.013
|
Papulopustular
|
R
|
-0.254**
|
-0.110
|
0.080
|
0.192*
|
p
|
0.003
|
0.198
|
0.351
|
0.024
|
Phymatous
|
R
|
-0.060
|
0.020
|
0.023
|
-0.001
|
p
|
0.482
|
0.814
|
0.791
|
0.987
|
Ocular
|
R
|
-0.033
|
-0.101
|
0.117
|
-0.017
|
p
|
0.701
|
0.238
|
0.170
|
0.844
|
Gender
|
Male
|
R
|
0.138
|
0.184*
|
-0.109
|
-0.144
|
p
|
0.107
|
0.031
|
0.204
|
0.091
|
Marital status
|
Married/living with partner
|
R
|
-0.079
|
-0.145
|
0.026
|
0.160
|
p
|
0.359
|
0.089
|
0.758
|
0.060
|
Single
|
R
|
-0.015
|
0.215*
|
-0.072
|
-0.105
|
p
|
0.864
|
0.011
|
0.399
|
0.219
|
Widowed
|
R
|
0.268**
|
-0.108
|
-0.044
|
-0.043
|
p
|
0.001
|
0.209
|
0.611
|
0.620
|
Divorced/ separated
|
R
|
-0.068
|
-0.001
|
0.143
|
-0.113
|
p
|
0.430
|
0.987
|
0.095
|
0.187
|
Current employment status
|
Employed
|
R
|
-0.194*
|
-0.124
|
0.031
|
0.218*
|
p
|
0.022
|
0.149
|
0.718
|
0.010
|
Education
|
High school
|
R
|
-0.141
|
0.088
|
0.079
|
-0.071
|
p
|
0.098
|
0.303
|
0.355
|
0.408
|
High school
|
R
|
0.141
|
-0.088
|
-0.079
|
0.071
|
p
|
0.098
|
0.303
|
0.355
|
0.408
|
Patient's global assessment
|
Mild
|
R
|
-0.047
|
0.345**
|
-0.071
|
− .204*
|
p
|
0.583
|
0.000
|
0.405
|
0.017
|
Moderate
|
R
|
-0.017
|
-0.023
|
0.133
|
-0.118
|
p
|
0.840
|
0.792
|
0.120
|
0.167
|
Severe
|
R
|
0.049
|
-0.204*
|
-0.093
|
0.259**
|
p
|
0.565
|
0.016
|
0.278
|
0.002
|
* p < 0.05, **p < 0.01, and ***p < 0.001; †R- correlation coefficient
Based on the correlation analysis of the discussion factors there was revealed a significant interaction between DLQI and the subtypes of the disease. Erythematotelangiectatic subtype had a significant positive correlation with a small and moderate effect on patients’ life quality and a negative correlation with a very large and extremely large effect on patients’ life quality. Papulopustular subtype had negative correlation with small effect and positive correlation with extremely large effect. Male gender and single status were connected with a moderate effect on QoL when status widowed - with the small one. Employment showed a significantly positive correlation with extremely large effect and negative - with a small one.
The regressive analysis was conducted based on the correlation analysis (Table 3), where we combined very large and extremely large effect of DLQI (Scores − 11–30).
Table 3
Multivariate logistic regression analysis risk factors of very and extremely large effect on patients’ life.
|
Risk factor
|
Regression coefficient
|
Standard error
|
P value
|
N
|
95% C.I. for OR
|
Lower
|
Upper
|
X1
|
Male
|
-1.05
|
0.54
|
0.0498
|
0.35
|
0.12
|
0.99
|
X2
|
Employed
|
1.11
|
0.47
|
0.0187
|
3.02
|
1.20
|
7.59
|
X3
|
Patient's global assessment(mild)
|
-1.77
|
0.65
|
0.0064
|
0.17
|
0.05
|
0.61
|
X4
|
Age
|
-0.06
|
0.02
|
0.0038
|
0.94
|
0.91
|
0.98
|
X5
|
Papulopustular subtype
|
1.77
|
0.50
|
0.0004
|
5.85
|
2.22
|
15.43
|
|
Constant
|
3.08
|
1.07
|
0.0040
|
21.74
|
|
|
Regression analysis showed that Papulopustular subtype of rosacea and employed status increased very and extremely large effect of QoL, while Patient's global assessment (mild), male gender and age decreased it.
Patients’ global assessment which was measured by scorecard correlated with DLQI; in particular, mild global assessment manifested a significant positive correlation with a moderate effect on patients’ life and negative correlation with an extremely large effect on patients’ life. Severe one had a negative correlation with a moderate effect on a patient's life and positive with an extremely large effect on patient’s life.
Risk prediction model
The following regression analysis formula has been used to evaluate the risk prediction model very and extremely large effect of life quality.
Z = 3.8-1,05* X1 + 1.1* X2-1.77* X3-0.06* X4 + 1.77* X5 (1)
P = 1/1 + e− z (2)
NOTE X1 - male; X2 - Employed; X3 - Patient's global assessment (mild); X4 - age; X5 - Papulopustular subtype.
Р - The risk prediction(%) of very and extremely large effect of QoL. X - factor mean. To determine the forecast, we defined the risk factor; if the studied patient had a predictive factor - X, insert 1 in the equation, if not − 0.
The obtained results were summed up and put into (2) formula.
Based on the regression analysis formula can be calculated a large and extremely large effect according to the existing risk forecast.
Coping Strategies
According to the assessment of coping strategies (Fig. 3) the significantly negative score has - substance use. High scores have such factors as: focus on and venting of emotion; use of instrumental social support; positive reinterpretation and growth; use of emotional social support; active coping.
Correlation analysis showed a connection between the DLQI and coping strategy. Symptoms and feelings have significantly negative correlation with positive reinterpretation and growth - r=-0.225**, p = 0.008; mental disengagement - r=-0.173*, p = 0.042; acceptance - r=-0.247**, p = 0.003;
Discomfort caused by treatment is in significantly negative correlation with: positive reinterpretation and growth - r=-0.217*, p = 0.011; mental disengagement - r=-0.242**, p = 0.004; religious coping - r=-0.221**, p = 0.009; acceptance - r=-0.248**, p = 0.003;
Problems in personal relationships show significantly negative correlation with: positive reinterpretation and growth - r=-0.168*, p = 0.049 and acceptance - r=-0.197*, p = 0.021;
Problems at Work and/or School has negative correlation with mental disengagement - r=-0.170*, p = 0.047;