摘要
目的:健康相关生活质量是新一代健康指标,可将生命作为一个整体做出主观评价。慢性病所引起的非致死性失能后果严重威胁居民的生活质量,本文旨在探讨河南省居民慢性病患病情况及其患者的生活质量。方法:调查于2000-01/12在河南省的12个城市、40个县城(乡镇)、151个村(居委会)展开。采用随机分层抽样方法抽取3000名居民,应用世界卫生组织制定的调查表进行家庭问卷调查。调查内容包括:社会人口学特征,慢性病的患病情况(患病率及顺位)以及慢性病患者的生活质量的调查。慢性病的定义为:调查的前1年内,自觉有病并经过医务人员明确诊断或自觉有病,虽未经义务人员诊断,但采取了医疗措施者。生活质量调查依据WHO对生活质量定义和描述,参照中文普适性生活质量量表中生活质量的评分方法,从生理、心理、社会适应能力3个维度、18个健康领域,具体用42个不同的指标来描述,每个指标按照健康状况最好到最坏依次可记为1,2,3,4,5分,可能得分范围为42～210分。为使得分与生活质量呈正相关,按公式:生活质量得分=犤1-(实际分值-最低可能分值)/(最高可能分值-最低可能分值)犦对原始量表中得分进行转换,使分值在1～100分,分值越高,生活质量水平越高。结果:本次共抽样调查3000户家庭,发放访谈问卷3000分,实际回收合格访谈问卷3000份,回收率为100%。在3000名调查对象中,慢性病的患病率为53.6%,患1种,2种,3种及以上慢性病的患病率分别为26.9%,13.2%和23.5%,慢性病总例次患病率达107.7%,城市为119.8%,农村为101.2%,男性为116.0%,女性为124.3%,患病率前四位依次为胃炎或胃溃疡(13.5%)、视力问题(13.1%)、压抑或焦虑(12.3%)和背痛或椎间盘问题(11.9%)。慢性病患者在生理分值、心理分值、社会适应能力分值及总生活质量分值都明显低于正常人犤(90.13±9.26,82.76±11.77,94.06±9.55,89.21±8.38),(94.99±4.92,90.63±7.57,98.09±4.24,94.62±4.31),P<0.05犦,心理纬度分值明显低于生理纬度和社会适应能力纬度的分值。随患慢性病种类的增加,生活质量3个纬度的得分及总分都明显下降。结论:河南省居民慢性病患病率处于高水平,无论是从生理、心理、社会适应能力或综合评分,慢性病患者的生活质量都明显下降,心理纬度分值更低,说明心理健康对生活质量的影响不容忽视,因慢性病的病程较长、治愈率低,患者易产生心理压力、情绪不稳定,对生活不满意,造成生活质量下降。
AIM: Quality of life correlated with health is a new type of health indicator, which can make subjective evaluation on life as a whole. The outcome of non-causing death disability induced by chronic diseases threatens severely the quality of life in residences. This study was designed to discuss the patient's condition of chronic diseases and the quality of life of patients in Henan residents. METHODS: The investigation was carried out from January to December 2000 in 12 cities, 40 counties (small towns) and 151 villages (neighborhood committees). 3 000 residents were selected by randomized stratified sampling method, and using questionnaire made by WHO to investigate family. The content of investigation included social demography character, patient's condition of chronic disease (prevalence rate and order) and life quality. The definition of chronic disease was one year before investigation, one thought oneself got sick and made clear-cut by medical staff diagnosis, or the ones thought oneself got sick, did not make clear-cut by medical staff, but measuring medicine provision. The investigation quality of life based on the definition and description of WHO, in accordance with assessment of SF-36 scale, from 3 dimension including physiology, psychology and social adjustment ability, 18 health domain, specifically using 42 different index to description from best to worst of health condition every index could be given 1,2,3,4,5 points, and possible range of score was from 42 to 210 points. In order to make positive correlation between score and quality of life, according to formula: the value of quality of life= [1-(practical points-the lowest possible points)/(the higher possible points- the lowest possible points)] the score in original scale was changed over to make the value from 1 to 100 points, and the higher the score was, the higher the quality of life was. RESULTS: 3 000 families were carried out sampling survey, sending out 3 000 questionnaires, and 3 000 qualificatory questionnaires were retrieved with 100% callback rate. Among 3 000 investigatory objects, 53.6% of the residents had chronic disease, 26.9%, 13.2% and 23.5% had one, two, three and more than three chronic disease respectively. The total prevalence rate was 107.7%, 119.8% in city, and 101.2% in village. The total prevalence rate of male and female were 116.01% and 124.3% respectively. The first four sequence of prevalence rate of chronic disease was gastritis or gastric ulcer (13.5%),eyesight problem (13.1%), oppression or anxiety (12.3%) and backache (11.9%). The value of quality of life in patients with chronic diseases was significantly lower than normal people [(90.13±9.26,82.76±11.77,94.06±9.55,89.21±8.38),(94.99±4.92, 90.63±7.57, 98.09±4.24, 94.62±4.31),(P < 0.05)] in physical dimension, psychological dimension and social adjustment ability dimension. With the increase of chronic disease class, the score and total mark of the 3 dimension of quality of life were significantly decreased.CONCLUSION: The level of prevalence rate of chronic disease in Henan residents is high. No matter physiology, psychology, social adjustment ability or integrated assessment, the quality of life in patients with chronic disease is significantly decreased, and psyche dimension is lower, which indicate that the effect of psyche health on quality of life cannot be ignored. The long course and low healing rate of chronic disease induce easily the occurrence of psyche pressure, emotional instability, unsatisfactory living, even the decrease of quality of life.
出处
《中国临床康复》
CAS
CSCD
北大核心
2005年第23期1-3,共3页
Chinese Journal of Clinical Rehabilitation
基金
河南省中青年骨干教师资助项目(200199)
世界卫生组织WHO资助项目(HQ/99/906557)~~
