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美国成年人的活动受限、慢性病及共病严重心理困扰——2007年美国国家健康访问调查

Activity limitation, chronic disease, and comorbid serious psychological distress in U.S. adults--BRFSS 2007.

作者信息

McKnight-Eily Lela R, Elam-Evans Laurie D, Strine Tara W, Zack Matthew M, Perry Geraldine S, Presley-Cantrell Letitia, Edwards Valerie J, Croft Janet B

机构信息

Division of Adult and Community Health, Centers for Disease Control and Prevention, 4770 Buford Highway N.E., Atlanta, GA 30341-3717, USA.

出版信息

Int J Public Health. 2009 Jun;54 Suppl 1:111-9. doi: 10.1007/s00038-009-0015-0.

Abstract

OBJECTIVES

This study examines the prevalence of self-reported activity limitation from poor physical or mental health in the past 30 days among a sample of noninstitutionalized U.S. adults. The associations between frequent activity limitation, chronic diseases, and comorbid serious psychological distress (SPD) were also examined.

METHODS

2007 Behavioral Risk Factor Surveillance System (BRFSS) data were used to generate prevalence estimates of days of self-reported activity limitation in the past 30 days (i. e., 0 days, 1-13 days, 14-29 days, 30 days, and 14 or more days) by selected sociodemographic characteristics, chronic disease conditions (i. e., lifetime diagnosis of diabetes, hypertension, coronary heart disease, stroke, asthma), and comorbid serious psychological distress. Multivariate logistic regression analysis was used to generate adjusted odds ratios of frequent activity limitation (14-30 days in the past 30 days) among persons with selected chronic disease conditions and among those with comorbid serious psychological distress.

RESULTS

A total of 21 % of adults reported activity limitation for at least 1 day in the past 30 days; 6.6 % reported 14 or more days, and 3.4 % reported all 30 days. Comorbid serious psychological distress was significantly associated with reported frequent activity limitation among persons who also reported a lifetime diagnosis of selected chronic diseases. Furthermore, in multivariate models adjusted for sociodemographic variables and the presence of the other chronic conditions, adults with comorbid lifetime diagnosis of a selected chronic disease and serious psychological distress were significantly more likely to report 14 or more days of activity limitation than those with only a lifetime diagnosis of a chronic condition.

CONCLUSION

Physicians should proactively screen and effectively treat co-occurring mental conditions in patients with chronic diseases who report frequent days of activity limitation because serious psychological distress may contribute to their level of impairment.

摘要

目的

本研究调查了美国非机构化成年人样本中,过去30天内因身体或心理健康不佳而自我报告的活动受限情况。同时还研究了频繁活动受限、慢性病和共病严重心理困扰(SPD)之间的关联。

方法

利用2007年行为危险因素监测系统(BRFSS)的数据,按选定的社会人口学特征、慢性病状况(即糖尿病、高血压、冠心病、中风、哮喘的终生诊断)和共病严重心理困扰,得出过去30天自我报告活动受限天数(即0天、1 - 13天、14 - 29天、30天以及14天或更多天)的患病率估计值。采用多因素逻辑回归分析,得出选定慢性病患者和共病严重心理困扰患者频繁活动受限(过去30天内14 - 30天)的调整比值比。

结果

共有21%的成年人报告在过去30天内至少有1天活动受限;6.6%报告有14天或更多天活动受限,3.4%报告30天均活动受限。在那些还报告有选定慢性病终生诊断的人群中,共病严重心理困扰与报告的频繁活动受限显著相关。此外,在针对社会人口学变量和其他慢性病存在情况进行调整的多因素模型中,共病选定慢性病和严重心理困扰的成年人比仅患有慢性病终生诊断的成年人更有可能报告14天或更多天的活动受限。

结论

医生应积极筛查并有效治疗报告频繁活动受限天数的慢性病患者中同时存在的精神状况,因为严重心理困扰可能会加重他们的受损程度。

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