Arne Mats, Janson Christer, Janson Staffan, Boman Gunnar, Lindqvist Ulla, Berne Christian, Emtner Margareta
Primary Care Research Unit, County Council of Varmland, Karlstad, Sweden.
Scand J Prim Health Care. 2009;27(3):141-7. doi: 10.1080/02813430902808643.
Chronic diseases interfere with the life situation of the affected person in different ways. The aim was to compare the burden of disease in three chronic diseases - chronic obstructive pulmonary disease (COPD), rheumatoid arthritis (RA), diabetes mellitus (DM) - and in healthy subjects, with a particular interest in physical activity, quality of life, and psychological health.
Cross-sectional, observational study.
Postal survey questionnaire to a stratified, random population of 68 460 subjects aged 18-84 years in Sweden. The subjects included were 40-84 years old (n = 43 589) and data were analysed for COPD (n = 526), RA (n = 1120), DM (n = 2149) and healthy subjects (n = 6960).
Some 84% of subjects with COPD, 74% (RA), 72% (DM), and 60% in healthy subjects (p < 0.001, COPD versus RA, DM, and healthy subjects) had a physical activity level considered too low to maintain good health according to guidelines. Quality of life (EuroQol five-dimension questionnaire, EQ-5D) was lower in COPD and RA than in DM. Anxiety/depression was more common in subjects with COPD (53%) than in those with RA (48%) and DM (35%) (p < 0.001, COPD versus RA and DM), whereas mobility problems were more common in RA (55%) than COPD (48%) and DM (36%) (p < 0.001, RA versus COPD and DM). All differences between groups remained significant after adjusting for age, sex, and socioeconomic background factors.
Subjects with chronic diseases had a low level of physical activity, most evident in subjects with COPD. COPD and RA had a higher negative impact on quality of life than DM. Our results indicate that increased attention regarding physical inactivity in subjects with chronic diseases is needed to minimize the burden of disease.
慢性病以不同方式影响患者的生活状况。本研究旨在比较三种慢性病——慢性阻塞性肺疾病(COPD)、类风湿关节炎(RA)、糖尿病(DM)——与健康受试者的疾病负担,特别关注身体活动、生活质量和心理健康。
横断面观察性研究。
对瑞典68460名年龄在18 - 84岁的分层随机人群进行邮政调查问卷。纳入对象年龄为40 - 84岁(n = 43589),对COPD患者(n = 526)、RA患者(n = 1120)、DM患者(n = 2149)和健康受试者(n = 6960)的数据进行分析。
根据指南,约84%的COPD患者、74%(RA)、72%(DM)以及60%的健康受试者身体活动水平被认为过低,无法维持良好健康。COPD和RA患者的生活质量(欧洲五维健康量表问卷,EQ - 5D)低于DM患者。COPD患者中焦虑/抑郁(53%)比RA患者(48%)和DM患者(35%)更常见(p < 0.001,COPD与RA和DM相比),而RA患者中行动不便问题(55%)比COPD患者(48%)和DM患者(36%)更常见(p < 0.001,RA与COPD和DM相比)。在对年龄、性别和社会经济背景因素进行调整后,组间所有差异仍然显著。
慢性病患者身体活动水平较低,在COPD患者中最为明显。COPD和RA对生活质量的负面影响高于DM。我们的结果表明,需要更多关注慢性病患者的身体活动不足问题,以减轻疾病负担。