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自我评定健康状况在帕金森病功能状态与健康相关生活质量之间的关联中起中介作用。

Self-rated health mediates the association between functional status and health-related quality of life in Parkinson's disease.

作者信息

Ghorbani Saeedian Radka, Nagyova Iveta, Klein Daniel, Skorvanek Matej, Rosenberger Jaroslav, Gdovinova Zuzana, Groothoff Johan W, van Dijk Jitse P

机构信息

Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Safarik University, Kosice, Slovak Republic; Institute of Public Health, Department of Social Medicine, Faculty of Medicine, Safarik University, Kosice, Slovak Republic.

出版信息

J Clin Nurs. 2014 Jul;23(13-14):1970-7. doi: 10.1111/jocn.12442. Epub 2013 Dec 20.

Abstract

AIMS AND OBJECTIVES

To explore whether self-rated health acts as a potential mediator in the association between functional status and health-related quality of life in Parkinson's disease.

BACKGROUND

Older persons (as most patients with Parkinson's disease are) who reported poor self-rated health compared with those with excellent self-rated health were two-and-a-half times more likely to have experienced a decline in functional ability.

DESIGN

Cross-sectional.

METHODS

Socio-demographic and clinical data of the patients (n = 176) were obtained during a structured interview and from medical records. Functional status was measured with the Unified Parkinson's Disease Rating Scale (total score), self-rated health with the first item of the Short-Form 36-item Health Survey Questionnaire and health-related quality of life with the disease-specific questionnaire called the Parkinson's Disease Quality of Life Questionnaire-39. Multiple linear regression analyses and the Sobel test were employed to assess mediation.

RESULTS

Self-rated health seems to have a mediating effect on the association between functional status and health-related quality of life. The Sobel test confirmed an indirect effect of functional status via self-rated health on health-related quality of life and showed a statistically significant indirect effect of functional status on health-related quality of life via self-rated health against the direct route without the mediator.

CONCLUSIONS

Self-rated health partially mediates the deteriorating effect of functional status on health-related quality of life.

RELEVANCE TO CLINICAL PRACTICE

Supportive and adaptation psychosocial intervention programmes leading to restored self-rated health may enhance the quality of life regardless of disability in Parkinson's disease.

摘要

目的与目标

探讨在帕金森病中,自我评估健康状况是否在功能状态与健康相关生活质量之间的关联中起到潜在中介作用。

背景

与自我评估健康状况良好的老年人(大多数帕金森病患者为老年人)相比,自我评估健康状况较差的老年人出现功能能力下降的可能性要高出2.5倍。

设计

横断面研究。

方法

在结构化访谈期间及从病历中获取患者(n = 176)的社会人口学和临床数据。使用统一帕金森病评定量表(总分)测量功能状态,使用简短36项健康调查问卷的第一项测量自我评估健康状况,使用名为帕金森病生活质量问卷-39的特定疾病问卷测量健康相关生活质量。采用多元线性回归分析和索贝尔检验来评估中介作用。

结果

自我评估健康状况似乎在功能状态与健康相关生活质量之间的关联中起到中介作用。索贝尔检验证实了功能状态通过自我评估健康状况对健康相关生活质量产生的间接效应,并显示在没有中介变量的直接路径下,功能状态通过自我评估健康状况对健康相关生活质量产生的间接效应具有统计学意义。

结论

自我评估健康状况部分介导了功能状态对健康相关生活质量的恶化影响。

与临床实践的相关性

导致自我评估健康状况恢复的支持性和适应性心理社会干预项目可能会提高帕金森病患者的生活质量,而不论其残疾状况如何。

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