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基于社区的跨专业学生辅助诊所中患有多种疾病的人群的健康相关生活质量:对评估和干预的启示。

Health-related quality of life of people with multimorbidity at a community-based, interprofessional student-assisted clinic: Implications for assessment and intervention.

作者信息

Tyack Zephanie, Kuys Suzanne, Cornwell Petrea, Frakes Kerrie-Anne, McPhail Steven

机构信息

1 Central Queensland Hospital and Health Service, Queensland, Australia.

2 Queensland University of Technology, Queensland, Australia.

出版信息

Chronic Illn. 2018 Sep;14(3):169-181. doi: 10.1177/1742395317724849. Epub 2017 Aug 13.

Abstract

Objective This study examined the relationship between the number of comorbidities and health-related quality of life (HRQoL) and between select physical conditions and HRQoL. Differences in HRQoL in comparison to a normative sample were also examined. Method A cross-sectional study among people with multimorbidity ( n = 401) attending a community-based, interdisciplinary health clinic was conducted. HRQoL was measured using the eight dimensions of the SF-36. Multiple linear regression and t-tests were used to analyse the data. Results A downward trend in HRQoL continued from 2 to 14 concurrent comorbidities. Patients with a higher number of comorbidities reported greater deficits in HRQoL, when age, gender, education and perceived social support were controlled for (beta = -0.11 to -0.31). The impact of the number of comorbidities was greatest for the bodily pain dimension of the SF-36 (beta = -0.31). Deficits were greatest for people with gastrointestinal conditions and back pain or sciatica. Moderate to large deficits in HRQoL compared to a normative population were found (Cohen's d = 0.54-1.16). Discussion Understanding associations between the number and type of physical comorbidities and HRQoL may assist clinical services to design broad but targeted interventions to optimize HRQoL in this group of people.

摘要

目的 本研究探讨了共病数量与健康相关生活质量(HRQoL)之间的关系,以及特定身体状况与HRQoL之间的关系。还研究了与正常样本相比HRQoL的差异。方法 对401名患有多种疾病且在社区跨学科健康诊所就诊的患者进行了一项横断面研究。使用SF-36的八个维度来测量HRQoL。采用多元线性回归和t检验对数据进行分析。结果 HRQoL随着共病数量从2种增加到14种呈持续下降趋势。在控制了年龄、性别、教育程度和感知到的社会支持后,共病数量较多的患者报告的HRQoL缺陷更大(β=-0.11至-0.31)。共病数量对SF-36身体疼痛维度的影响最大(β=-0.31)。患有胃肠道疾病和背痛或坐骨神经痛的患者缺陷最大。与正常人群相比,发现HRQoL存在中度至较大的缺陷(科恩d值=0.54-1.16)。讨论 了解身体共病的数量和类型与HRQoL之间的关联,可能有助于临床服务设计广泛但有针对性的干预措施,以优化这群人的HRQoL。

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