Loos-Ayav C, Chau N, Riani C, Guillemin F
Nancy-Université, EA 4003, Ecole de Santé Publique, Nancy, France.
Clin Exp Rheumatol. 2007 Sep-Oct;25(5):701-8.
To estimate the prevalence of functional disability in France and assess its association with the health-related quality of life (HRQoL).
Each member in 8,000 households randomly selected in the Lorraine population were mailed a questionnaire asking about their sociodemographic characteristics; the presence of chronic locomotor or non-rheumatic diseases; functional disability on the Health Assessment Questionnaire (HAQ); and HRQoL on the Duke Health Profile. The prevalence of functional disability was described, and its relationship with HRQoL was assessed by logistic regression analysis.
Among the 6,148 subjects who responded (mean age 46 years +/- 18.3, 48% men), the prevalence of moderate (HAQ >or= 1) and severe (HAQ >or= 2) functional disability, adjusted for age and sex, was 6.5% and 1.6% respectively. HRQoL was significantly low in all dimensions for subjects with severe functional disability. Functional disability of locomotor origin significantly affected the physical (OR = 10.6 [5.1-22.1]), mental (OR = 4.4 [2.5-7.8]), and social (OR = 2.4 [1.4-4.3]) dimensions, with a threshold effect according to the disability level and perceived health (OR= 10.6 [5.8-19.4]), with a cause-effect relationship.
The prevalence of reported (i.e., not observed) functional disability in terms of its impact on HRQoL helps physicians to better understand its differential consequences, which should ease patient dependence, facilitate the analysis of health care needs and the development of prevention measures, and improve the HRQoL of patients and their families.
评估法国功能残疾的患病率，并评估其与健康相关生活质量（HRQoL）的关联。
在洛林地区随机抽取8000户家庭，向每户中的每位成员邮寄一份问卷，询问其社会人口学特征、慢性运动或非风湿性疾病的患病情况、健康评估问卷（HAQ）中的功能残疾情况以及杜克健康状况量表中的HRQoL。描述功能残疾的患病率，并通过逻辑回归分析评估其与HRQoL的关系。
在6148名回复者中（平均年龄46岁±18.3岁，男性占48%），经年龄和性别调整后，中度（HAQ≥1）和重度（HAQ≥2）功能残疾的患病率分别为6.5%和1.6%。重度功能残疾患者在所有维度上的HRQoL均显著较低。运动源性功能残疾对身体（比值比[OR]=10.6[5.1 - 22.1]）、心理（OR = 4.4[2.5 - 7.8]）和社会（OR = 2.4[1.4 - 4.3]）维度有显著影响，且根据残疾水平和自我感知健康存在阈值效应（OR = 10.6[5.8 - 19.4]），存在因果关系。
报告的（即未观察到的）功能残疾对HRQoL的影响有助于医生更好地理解其不同后果，这应能减轻患者的依赖性，便于分析医疗保健需求并制定预防措施，从而改善患者及其家庭的HRQoL。
