Barile John P, Mitchell Sandra A, Thompson William W, Zack Matthew M, Reeve Bryce B, Cella David, Smith Ashley Wilder
Department of Psychology, University of Hawai'i at Mānoa, 2530 Dole St, Sakamaki C400, Honolulu, HI 96822. Email:
National Cancer Institute, Rockville, Maryland.
Prev Chronic Dis. 2015 Dec 17;12:E222. doi: 10.5888/pcd12.150179.
Co-occurring chronic health conditions elevate the risk of poor health outcomes such as death and disability, are associated with poor quality of life, and magnify the complexities of self-management, care coordination, and treatment planning. This study assessed patterns of both singular and multiple chronic conditions, behavioral risk factors, and quality of life in a population-based sample.
In a national survey, adults (n = 4,184) answered questions about the presence of 27 chronic conditions. We used latent class analysis to identify patterns of chronic conditions and to explore associations of latent class membership with sociodemographic characteristics, behavioral risk factors, and health.
Latent class analyses indicated 4 morbidity profiles: a healthy class (class 1), a class with predominantly physical health conditions (class 2), a class with predominantly mental health conditions (class 3), and a class with both physical and mental health conditions (class 4). Class 4 respondents reported significantly worse physical health and well-being and more days of activity limitation than those in the other latent classes. Class 4 respondents were also more likely to be obese and sedentary, and those with predominantly mental health conditions were most likely to be current smokers.
Subgroups with distinct patterns of chronic conditions can provide direction for screening and surveillance, guideline development, and the delivery of complex care services.
多种慢性健康状况并存会增加死亡和残疾等不良健康结局的风险,与生活质量差相关,并加剧自我管理、护理协调和治疗规划的复杂性。本研究评估了基于人群样本中的单一和多种慢性病模式、行为风险因素及生活质量。
在一项全国性调查中,成年人(n = 4184)回答了有关27种慢性病存在情况的问题。我们使用潜在类别分析来确定慢性病模式,并探讨潜在类别成员与社会人口学特征、行为风险因素及健康状况之间的关联。
潜在类别分析表明有4种发病情况概况:健康类别(第1类)、主要为身体健康状况的类别(第2类)、主要为心理健康状况的类别(第3类)以及既有身体健康状况又有心理健康状况的类别(第4类)。第4类受访者报告的身体健康和幸福感明显比其他潜在类别受访者差,活动受限天数更多。第4类受访者也更有可能肥胖且久坐不动,而主要有心理健康状况的受访者最有可能是当前吸烟者。
具有不同慢性病模式的亚组可为筛查和监测、指南制定以及复杂护理服务的提供提供指导。