Lee Hwi-Won, Song Minkyo, Yang Jae Jeong, Kang Daehee
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea.
J Prev Med Public Health. 2015 Nov;48(6):287-300. doi: 10.3961/jpmph.15.048. Epub 2015 Oct 23.
Self-rated health is a measure of perceived health widely used in epidemiological studies. Our study investigated the determinants of poor self-rated health in middle-aged Korean adults with diabetes.
A cross-sectional study was conducted based on the Health Examinees Study. A total of 9759 adults aged 40 to 69 years who reported having physician-diagnosed diabetes were analyzed with regard to a range of health determinants, including sociodemographic, lifestyle, psychosocial, and physical variables, in association with self-rated health status using multivariate logistic regression models. A p-value <0.05 was considered to indicate statistical significance.
We found that negative psychosocial conditions, including frequent stress events and severe distress according to the psychosocial well-being index, were most strongly associated with poor self-rated health (odds ratio [OR](Frequent stress events), 5.40; 95% confidence interval [CI], 4.63 to 6.29; OR(Severe distress), 11.08; 95% CI, 8.77 to 14.00). Moreover, younger age and being underweight or obese were shown to be associated with poor self-rated health. Physical factors relating to participants' medical history of diabetes, such as a younger age at diagnosis, a longer duration of diabetes, insulin therapy, hemoglobin A1clevels of 6.5% or more, and comorbidities, were other correlates of poor reported health.
Our findings suggest that, in addition to medical variables, unfavorable socioeconomic factors, and adverse lifestyle behaviors, younger age, being underweight or obese, and psychosocial stress could be distinc factors in predicting negative perceived health status in Korean adults with diabetes.
自我评估健康状况是一种在流行病学研究中广泛使用的对健康感知的衡量方法。我们的研究调查了韩国中年糖尿病患者自我评估健康状况不佳的决定因素。
基于健康体检者研究进行了一项横断面研究。对9759名年龄在40至69岁之间、报告有医生诊断糖尿病的成年人进行了分析，涉及一系列健康决定因素，包括社会人口统计学、生活方式、心理社会和身体变量，并使用多变量逻辑回归模型将其与自我评估健康状况相关联。p值<0.05被认为具有统计学意义。
我们发现，消极的心理社会状况，包括根据心理社会幸福感指数频繁出现的压力事件和严重困扰，与自我评估健康状况不佳的关联最为强烈（优势比[OR]（频繁压力事件），5.40；95%置信区间[CI]，4.63至6.29；OR（严重困扰），11.08；95%CI，8.77至14.00）。此外，年龄较小以及体重过轻或肥胖与自我评估健康状况不佳有关。与参与者糖尿病病史相关的身体因素，如诊断时年龄较小、糖尿病病程较长、胰岛素治疗、糖化血红蛋白A1c水平达到或超过6.5%以及合并症，也是报告健康状况不佳的其他相关因素。
我们的研究结果表明，除了医学变量、不利的社会经济因素和不良生活方式行为外，年龄较小、体重过轻或肥胖以及心理社会压力可能是预测韩国成年糖尿病患者消极健康感知状况的独特因素。
