Lam C L, Lauder I J
Family Medicine Unit, Department of Medicine and Department of Statistics, University of Hong Kong, Hong Kong.
Fam Pract. 2000 Apr;17(2):159-66. doi: 10.1093/fampra/17.2.159.
Ageing of the population results in an increasing number of people living with chronic diseases that can adversely affect their quality of life. Information on the impact of chronic diseases on quality of life can make health services more patient-centred.
The aim of this study was to determine the impact of eight chronic diseases on the health-related quality of life (HRQOL) of Chinese patients.
A cross-sectional case-control study was carried out on 760 adult Chinese patients of a family medicine clinic in Hong Kong. Each subject answered the COOP/WONCA charts and a standard questionnaire on demographic and morbidity data. The likelihood of sub-optimal COOP/WONCA scores of each disease group was compared with that of patients without any of the surveyed diseases. The independent effects of each disease on the COOP/WONCA scores were analysed by multivariate logistic regression, controlling for demographic variables and co-morbidity.
Depression increased the risks for sub-optimal scores in all but one COOP/WONCA chart with odds ratios (OR) ranging from 2.1818 to 3.8645. Hypertension increased the risk of a sub-optimal physical fitness score (OR 1.7263). Increased risk of limitations in daily activities was associated with stroke (OR = 1.8771), osteoarthritis of the knee (OR = 1.5867), diseases of joints other than the knees (OR 2.0187) and asthma/COPD (OR 2.1679). Osteoarthritis of the knees also increased the risk of sub-optimal overall health (OR = 1.7927).
Depression was the most disabling disease, and osteoarthritis of the knee had more impact on the HRQOL than many other chronic diseases. The lack of adverse effects of diabetes mellitus and heart disease on the HRQOL of Chinese patients deserves further studies.
人口老龄化导致患慢性病的人数增加，这些慢性病会对患者的生活质量产生不利影响。有关慢性病对生活质量影响的信息可使医疗服务更加以患者为中心。
本研究旨在确定八种慢性病对中国患者健康相关生活质量（HRQOL）的影响。
对香港一家家庭医学诊所的760名成年中国患者进行了横断面病例对照研究。每位受试者回答了COOP/WONCA图表以及一份关于人口统计学和发病数据的标准问卷。将每个疾病组COOP/WONCA评分不理想的可能性与未患任何所调查疾病的患者进行比较。通过多因素逻辑回归分析每种疾病对COOP/WONCA评分的独立影响，并控制人口统计学变量和合并症。
除一个COOP/WONCA图表外，抑郁症增加了所有图表评分不理想的风险，比值比（OR）范围为2.1818至3.8645。高血压增加了体能评分不理想的风险（OR 1.7263）。日常活动受限风险增加与中风（OR = 1.8771）、膝关节骨关节炎（OR = 1.5867）、膝关节以外的关节疾病（OR 2.0187）和哮喘/慢性阻塞性肺疾病（OR 2.1679）有关。膝关节骨关节炎还增加了整体健康评分不理想的风险（OR = 1.7927）。
抑郁症是最致残的疾病，膝关节骨关节炎对健康相关生活质量的影响比许多其他慢性病更大。糖尿病和心脏病对中国患者健康相关生活质量缺乏不利影响值得进一步研究。
