Institute of Psychophysiology and Rehabilitation, Lithuanian University of Health Sciences, Vydūno al. 4, 00135 Palanga, Lithuania.
Medicina (Kaunas). 2010;46(12):843-50.
The aim of this study was to evaluate the changes in health-related quality of life in patients with coronary heart disease according to age, gender, and treatment method.
The study enrolled 167 patients after acute myocardial infarction (MI), percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass grafting (CABG). The mean age was 59.3 years; there were 71.9% of males. General health-related quality of life was measured using the SF-36 questionnaire. Patients were examined at the beginning of rehabilitation and after 6-, 12-, 18-, and 24-month follow-up. Effect sizes were computed to assess the changes in health-related quality of life over time.
Health-related quality of life significantly improved at 6 months, but improvements did not continue over time. The largest effect size was seen in the pain domain. Effect sizes were greater in the physical health domains among male patients and among female patients in the mental health domain. With regard to age, effect sizes were greater in the physical functioning domain among older patients. With regard to treatment method, at baseline, the CABG patients had the poorest health-related quality of life; however, the largest effect sizes were seen in this group.
Health-related quality of life improved over 2 years; the greatest improvement was seen at 6 months. Males better improved on the physical component summary domain; there was no significant improvement in the mental component summary domain in males and females. Older patients improved better on the physical activity and physical component summary domains. Changes in health-related quality of life were related to treatment method.
本研究旨在评估冠心病患者的健康相关生活质量随年龄、性别和治疗方法的变化。
该研究纳入了 167 名急性心肌梗死(MI)、经皮腔内冠状动脉成形术(PTCA)和冠状动脉旁路移植术(CABG)后的患者。平均年龄为 59.3 岁,男性占 71.9%。采用 SF-36 问卷评估一般健康相关生活质量。患者在康复开始时以及 6、12、18 和 24 个月随访时接受检查。计算效应量以评估健康相关生活质量随时间的变化。
健康相关生活质量在 6 个月时显著改善,但改善并未随时间持续。在疼痛领域观察到最大的效应量。在男性患者的身体健康领域和女性患者的心理健康领域,效应量更大。就年龄而言,在较年长患者的身体机能领域,效应量更大。就治疗方法而言,在基线时,CABG 患者的健康相关生活质量最差;然而,该组观察到最大的效应量。
健康相关生活质量在 2 年内得到改善;最大的改善发生在 6 个月时。男性在身体成分综合领域的改善更好;男性和女性的心理健康成分综合领域没有显著改善。年龄较大的患者在身体活动和身体成分综合领域的改善更好。健康相关生活质量的变化与治疗方法有关。