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[男性和女性血液透析患者健康相关生活质量的差异]

[Differences in health-related quality of life between male and female hemodialysis patients].

作者信息

Vázquez I, Valderrábano F, Fort I, Jofré R, López-Gómez J M, Moreno F, Sanz-Guajardo D

机构信息

D. Psicología Clínica y Psicobiología, Faculta de Psicología, Universidad de Santiago de Compostela.

出版信息

Nefrologia. 2004;24(2):167-78.

Abstract

BACKGROUND

Previous studies in renal patients have reported that women perceive a lower health-related quality of life (HRQOL) than men: however, these studies have been carried out without taking into account the gender-related differences shown in general population samples. The aims of the present study are: a) to define the HRQOL dimensions in which there are differences between men and women on chronic hemodialysis (HD), correcting then the differences on the generic dimensions by means of standardization by age and gender of the obtained scores, using Spanish normative data, and b) to identify the variables that cause these possible gender-related differences on HRQOL.

METHODS

A cross-sectional multi-center study was carried out with 152 patients (69 men and 83 women) receiving HD treatment in 43 Spanish centers, using the KDQOL-SF to evaluate their HRQOL. The generic KDQOL-SF scores were standardized by age and gender using Spanish normative data. Sociodemographic, clinical and psychosocial variables were also collected on each patient. A MANOVA was carried out to study the variables associated with the gender-related differences on HRQOL. The sociodemographic, clinical and psychosocial variables showing significant differences between men and women in the previous univariate analysis were entered as covariates.

RESULTS

The KDQOL-SF scores showed statistically significant differences between men and women in four scales: physical functioning, emotional role limitation, social function and emotional well-being. In contrast, standardized scores showed no differences between men and women in the profile or degree of HRQOL impairment. Although statistically significant gender-related differences were shown in educational level, employment, haemoglobin, Kt/V, trait anxiety and depressive symptoms, only the last two variables showed an independent effect on the differences in HRQOL.

CONCLUSION

Impaired HRQOL in women on HD reflects the gender-related differences that are also shown in the general population, and they are related to the higher prevalence of trait anxiety and depressive symptoms in women.

摘要

背景

先前针对肾病患者的研究报告称,女性感知到的健康相关生活质量(HRQOL)低于男性;然而,这些研究并未考虑普通人群样本中显示的性别差异。本研究的目的是:a)确定慢性血液透析(HD)中男性和女性存在差异的HRQOL维度,然后使用西班牙规范数据,通过对所得分数进行年龄和性别标准化来校正一般维度上的差异;b)确定导致HRQOL中这些可能的性别相关差异的变量。

方法

在西班牙43个中心对152例接受HD治疗的患者(69例男性和83例女性)进行了一项横断面多中心研究,使用KDQOL-SF评估他们的HRQOL。使用西班牙规范数据按年龄和性别对KDQOL-SF的一般分数进行标准化。还收集了每位患者的社会人口统计学、临床和心理社会变量。进行了多变量方差分析以研究与HRQOL性别相关差异相关的变量。在先前的单变量分析中显示男性和女性之间存在显著差异的社会人口统计学、临床和心理社会变量作为协变量纳入。

结果

KDQOL-SF分数在四个量表上显示出男性和女性之间具有统计学显著差异:身体功能、情感角色限制、社会功能和情感幸福感。相比之下,标准化分数在HRQOL损害的概况或程度上显示男性和女性之间没有差异。尽管在教育水平、就业、血红蛋白、Kt/V、特质焦虑和抑郁症状方面显示出与性别相关的统计学显著差异,但只有最后两个变量对HRQOL差异显示出独立影响。

结论

HD女性中受损的HRQOL反映了普通人群中也存在的性别相关差异,并且它们与女性中较高的特质焦虑和抑郁症状患病率有关。

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