Katz Patricia, Morris Anne, Gregorich Steve, Yazdany Jinoos, Eisner Mark, Yelin Edward, Blanc Paul
University of California, San Francisco, 3333 California Street, Suite 270, San Francisco, CA 94143-0920, USA.
J Clin Epidemiol. 2009 Feb;62(2):158-66. doi: 10.1016/j.jclinepi.2008.06.002. Epub 2008 Aug 22.
Because self-rated health (SRH) is strongly associated with health outcomes, it is important to identify factors that individuals take into account when they assess their health. We examined the role of valued life activities (VLAs), the wide range of activities deemed to be important to individuals, in SRH assessments.
Data were from three cohort studies of individuals with different chronic conditions--rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and chronic obstructive pulmonary disease (COPD). Each cohort's data were collected through structured telephone interviews. Logistic regression analyses identified factors associated with ratings of fair/poor SRH. All analyses included sociodemographic characteristics, general and disease-specific health-related factors, and general measures of physical functioning.
Substantial portions of each group rated their health as fair/poor (RA 37%, SLE 47%, COPD 40%). In each group, VLA disability was strongly associated with fair/poor health (RA: OR=4.44 [1.86,10.62]; SLE: OR=3.60 [2.10,6.16]; COPD: OR=2.76 [1.30,5.85]), even after accounting for covariates.
VLA disability appears to play a substantial role in individual perceptions of health, over and above other measures of health status, disease symptoms, and general physical functioning.
由于自评健康状况(SRH)与健康结果密切相关,因此识别个体在评估自身健康时所考虑的因素非常重要。我们研究了有价值的生活活动(VLA)在SRH评估中的作用,VLA是被认为对个体重要的广泛活动。
数据来自三项针对患有不同慢性病的个体的队列研究——类风湿性关节炎(RA)、系统性红斑狼疮(SLE)和慢性阻塞性肺疾病(COPD)。每个队列的数据通过结构化电话访谈收集。逻辑回归分析确定了与SRH评分为中等/差相关的因素。所有分析都包括社会人口学特征、一般和疾病特异性健康相关因素以及身体功能的一般测量指标。
每组中相当一部分人将自己的健康状况评为中等/差(RA为37%,SLE为47%,COPD为40%)。在每组中,即使在考虑了协变量之后,VLA残疾与健康状况中等/差也密切相关(RA:比值比[OR]=4.44[1.86,10.62];SLE:OR=3.60[2.10,6.16];COPD:OR=2.76[1.30,5.85])。
除了其他健康状况、疾病症状和一般身体功能指标外,VLA残疾似乎在个体对健康的认知中起着重要作用。