接受血液透析的中国患者的健康相关生活质量模式及相关因素
Patterns of health-related quality of life and associated factors in Chinese patients undergoing haemodialysis.
作者信息
Wan Eric Y F, Chen Julie Y, Choi Edmond P H, Wong Carlos K H, Chan Anca K C, Chan Karina H Y, Lam Cindy L K
机构信息
Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong.
Institute of Medical and Health Sciences Education, The University of Hong Kong, 2/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
出版信息
Health Qual Life Outcomes. 2015 Jul 29;13:108. doi: 10.1186/s12955-015-0308-3.
BACKGROUND
Haemodialysis (HD) is a life-saving but burdensome therapy for patients with end-stage renal disease (ESRD) which can have a detrimental impact on patients' quality of life and outcomes. There is currently little data on the health related quality of life (HRQOL) of Chinese ESRD patients undergoing HD and this study sought to examine the patterns of HRQOL and its associated factors within this population, as well as in comparison with the general local population.
METHODS
A cross-sectional study of 244 ESRD patients receiving HD in the hospital and in the community in Hong Kong was conducted using the Short Form-12 Health Survey version 2 (SF-12v2). All study subjects were one-to-one matched with subjects in a Hong Kong general population database by sex and exact age. Independent t-tests were performed to compare the mean SF-12v2 scores between HD patients and the general population, followed by one-way analysis of variance with post hoc Tukey's HSD tests to compare community-based haemodialysis, hospital-based haemodialysis and the general population. Multiple linear regressions were used to identify the factors (socio-demographic, clinical characteristics and comorbidities) associated with the HRQOL scores of ESRD patients receiving HD.
RESULTS
The SF-12v2 Physical Functioning, Role Physical, Bodily Pain, General Health and Physical Component Summary scores of HD patients were significantly lower than the age-sex adjusted general population. However, the SF-12v2 Mental Health and Mental Component Summary scores of HD patients were significantly higher than the corresponding general population. Poorer HRQOL was associated with being female, smoking, unemployment and hospital-based haemodialysis.
CONCLUSIONS
HD patients had substantially poorer physical HRQOL but better mental HRQOL than the age-sex adjusted general population. Patients receiving HD in the community setting had better HRQOL. Reasons for these observations will need to be further investigated. Those patients who are female, smokers and unemployed may warrant more attention as their poorer HRQOL may be associated with poorer outcomes.
背景
血液透析（HD）对于终末期肾病（ESRD）患者而言是一种挽救生命但负担沉重的治疗方法，会对患者的生活质量和预后产生不利影响。目前关于接受HD治疗的中国ESRD患者的健康相关生活质量（HRQOL）的数据很少，本研究旨在调查该人群中HRQOL的模式及其相关因素，并与当地普通人群进行比较。
方法
采用简短健康调查问卷第2版（SF - 12v2）对香港医院和社区中244例接受HD治疗的ESRD患者进行横断面研究。所有研究对象均按照性别和确切年龄与香港普通人群数据库中的对象进行一对一匹配。进行独立t检验以比较HD患者和普通人群之间的SF - 12v2平均得分，随后进行单因素方差分析及事后Tukey's HSD检验，以比较社区血液透析、医院血液透析和普通人群。采用多元线性回归来确定与接受HD治疗的ESRD患者的HRQOL得分相关的因素（社会人口统计学、临床特征和合并症）。
结果
HD患者的SF - 12v2身体功能、角色身体、身体疼痛、总体健康和身体成分总结得分显著低于年龄和性别调整后的普通人群。然而，HD患者的SF - 12v2心理健康和心理成分总结得分显著高于相应的普通人群。较差的HRQOL与女性、吸烟、失业和医院血液透析有关。
结论
与年龄和性别调整后的普通人群相比，HD患者的身体HRQOL明显较差，但心理HRQOL较好。在社区环境中接受HD治疗的患者具有更好的HRQOL。这些观察结果的原因需要进一步研究。女性、吸烟者和失业患者可能需要更多关注，因为他们较差的HRQOL可能与较差的预后相关。
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