老年人慢性病患病及健康相关生存质量影响因素研究  

Study on the influencing factors of chronic diseases and health-related quality of life in the elderly

作　　者：李慎良 谭志军 张海悦 翟中杰 尚磊 梁英 LI Shenliang;TAN Zhijun;ZHANG Haiyue;ZHAI Zhongjie;SHANG Lei;LIANG Ying(No.3 Cadet Regiment,School of Basic Medical Sciences,School of Military Preventive Medicine,Air Force Medical University,Xi an 710032,China;Department of Military Health Statistics,School of Military Preventive Medicine,Air Force Medical University,Xi an 710032,China)

机构地区：[1]空军军医大学基础医学院学员三大队,陕西西安710032 [2]空军军医大学军事预防医学系军队卫生统计学教研室,陕西西安710032

出　　处：《空军军医大学学报》2022年第6期705-710,共6页Journal of Air Force Medical University

基　　金：陕西省社会发展基金(2020SF-288)。

摘　　要：目的 探讨慢性病对老年人健康相关生存质量(HRQoL)的影响。方法 采用2013年陕西省国家卫生服务调查的数据,HRQoL通过欧洲五维健康量(EQ-5D)表进行测量。采用ANOVA分析和χ^(2)检验或秩和检验比较连续性变量和分类变量的组间差异。采用两个多元线性回归模型考察社会经济学因素、健康行为、慢性病患病数量和慢性病种类对HRQoL的影响。结果 单因素分析结果显示慢性病组与非慢性病组老年人社会经济学特征及行为因素比较差异均有统计学意义(P<0.05)。EQ-5D各维度中疼痛/不适维度报告问题比例最高为31.85%,慢性病组报告问题比例高于非慢性病组(P<0.01),特别是在疼痛维度(慢性病组vs非慢性病组:42.39%vs 22.57%)。多元线性回归提示年龄、就业、受教育程度、收入、吸烟、运动、慢性病数量对HRQoL的影响均有统计学意义(P<0.05)。慢性病对HRQoL有较大的负向效应,其中肿瘤(β=-0.240)和精神疾病(β=-0.218)是损害老年人HRQoL最严重的两种慢性病,其次是肌肉骨骼疾病(β=-0.157)、损伤和中毒(β=-0.152)及泌尿生殖系统疾病(β=-0.145)。结论 慢性病是老年人生存质量的重要影响因素,患病数量越多生存质量越低;在13种慢性病中,肿瘤和精神疾病对HRQoL的影响最严重。Objective To explore the effects of chronic diseases on health-related quality of life(HRQoL)in the elderly.Methods Using data from the national health service survey of Shaanxi Province in 2013,HRQoL was measured by EuroQol Five Dimensions Questionnaire(EQ-5D).ANOVA analysis and Chi-square test or Wilcoxon test were used to compare the group differences of continuous variables and classification variables,respectively.Two multiple linear regression models were used to investigate the effects of socioeconomic factors,health behaviors,and the number and type of chronic diseases on HRQoL.Results The results of univariate analysis showed that there were significant differences in the socioeconomic characteristics and behavioral factors between chronic disease group and non-chronic disease group(P<0.05).Among the dimensions of EQ-5D,the highest proportion of problems reported in pain/discomfort dimension was 31.85%.The proportion of problems reported in the chronic disease group was higher than that in the non-chronic disease group(P<0.01),especially in pain dimension(42.39%vs 22.57%).Multiple linear regression models showed that age,employment,education,income,smoke,exercise and the number of chronic diseases had statistical significance on HRQoL(P<0.05).Chronic diseases had a significant negative effect on HRQoL,among which tumors(β=-0.240)and mental disorders(β=-0.218)were the two most serious chronic diseases that damaged HRQoL in the elderly,followed by musculoskeletal diseases(β=-0.157),injury and poisoning(β=-0.152)and urogenital diseases(β=-0.145).Conclusion Chronic disease is an important factor affecting the quality of life of the elderly,and the number of diseases is negatively associated with the quality of life.Among the 13 chronic diseases,tumors and mental disorders have the most serious influence on HRQoL.

关 键 词：老年人 健康相关生存质量 慢性病 欧洲五维健康量表 

分 类 号：R195[医药卫生—卫生统计学]