Froshaug Desireé B, Dickinson L Miriam, Fernald Douglas H, Green Larry A
Department of Family Medicine, University of Colorado Denver, Denver, Aurora, CO 80045, USA.
J Am Board Fam Med. 2009 Jul-Aug;22(4):368-74. doi: 10.3122/jabfm.2009.04.080150.
Because unhealthy behaviors have been shown to predict premature mortality and quality of life is linked to chronic disease, it is plausible that there is a relationship between unhealthy behaviors and a patient's overall well-being.
Baseline data from the Robert Wood Johnson Foundation's Prescription for Health initiative were used. Using various methods, 9 practice-based research networks collected common data about cigarette smoking, diet, exercise, and perceived physical and mental health from 5358 patients from 67 practices. Multilevel ordinal regression modeling was used to examine the relationship between risk behaviors and physical or mental unhealthy days.
Smoking, unhealthy diet, and inactivity were associated with more self-reported unhealthy days after adjusting for clustering and significant covariates. Smoking was associated with increased odds of more unhealthy days (odds ratio [OR], 1.51; P < .0001), as was a poor diet (OR, 1.10; P < .0001). More exercise (OR, 0.96; P = .0005) was associated with decreased odds of physical or mental unhealthy days.
Unhealthy patient behaviors were associated with increased odds of physical or mental unhealthy days, suggesting a further reason primary care clinicians should address behavior change with patients. Implementing a brief, 2-question, quality of life screening would target groups of primary care patients with a higher prevalence of unhealthy behaviors.
由于不健康行为已被证明可预测过早死亡,且生活质量与慢性病相关,因此不健康行为与患者的整体幸福感之间存在关联这一说法似乎是合理的。
使用了罗伯特·伍德·约翰逊基金会“健康处方”倡议的基线数据。9个基于实践的研究网络采用各种方法,从67个医疗机构的5358名患者中收集了关于吸烟、饮食、运动以及自我感知的身心健康状况的常见数据。采用多水平有序回归模型来检验风险行为与身体或精神不健康天数之间的关系。
在对聚类和显著协变量进行调整后,吸烟、不健康饮食和缺乏运动与更多自我报告的不健康天数相关。吸烟与更多不健康天数的几率增加相关(比值比[OR],1.51;P <.0001),不良饮食也是如此(OR,1.10;P <.0001)。更多的运动(OR,0.96;P =.0005)与身体或精神不健康天数的几率降低相关。
患者的不健康行为与身体或精神不健康天数的几率增加相关,这表明初级保健临床医生应与患者探讨行为改变的另一个原因。实施一项简短的、包含两个问题的生活质量筛查将针对不健康行为患病率较高的初级保健患者群体。