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尼泊尔加德满都高血压患者健康相关生活质量的影响因素

Factors Associated With Health-Related Quality of Life among Hypertensive Patients in Kathmandu, Nepal.

作者信息

Ghimire Saruna, Pradhananga Praful, Baral Binaya Kumar, Shrestha Naveen

机构信息

Agrata Health Education and Development (AHEAD)-Nepal, Kathmandu, Nepal.

Department of Biochemistry, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal.

出版信息

Front Cardiovasc Med. 2017 Nov 6;4:69. doi: 10.3389/fcvm.2017.00069. eCollection 2017.

Abstract

INTRODUCTION

Nepal has a high prevalence of hypertension. While improving the overall health-related quality of life (HRQOL) is a central tenet to public health plans in developed nations, this focus has yet to be articulated in Nepal. Therefore, this study aims to identify the factors associated with HRQOL among hypertensive patients in Nepal.

METHOD

The EuroQol-5Dimension HRQOL survey was administered to 180 hypertensive patients, attending the outpatient clinic at Shahid Gangalal National Heart Center in Kathmandu, Nepal. Multiple linear regression models, adjusted for age and sex, were used to identify factors associated with HRQOL.

RESULTS

The mean age and EuroQol visual analytic scale of the participants were 53.2 years and 63.7, respectively. Age [β = -0.56; 95% confidence interval (CI): -0.75 to -0.37], income (β = 0.02; 95% CI: 0.01, 0.03), family size (β = -0.98; 95% CI: -1.89, -0.07), number of antihypertensive drugs use (β = 4.62; 95% CI: 1.33, 7.90), and compliance to dietary salt advise (β = 4.86; 95% CI: 0.29, 9.43) were significant factors associated with HRQOL among participants. In addition, levels of education and self-perceived health were associated in a positive gradient to HRQOL. In mediation analysis, both, dietary low salt compliance and use of antihypertensive drugs, had a significant direct effect on HRQOL, and the use of antihypertensive drugs did not significantly mediate the relationship between dietary salt compliance and HRQOL.

CONCLUSION

Various factors were found to be associated with HRQOL among hypertensive patients in Kathmandu. Assessing HRQOL is a valuable technique to identify populations in need of services and interventions. This assessment can serve as a baseline, and in conjunction with multiple stakeholders, can guide public health policy, planning, and practices, especially those aimed toward improving the HRQOL of Nepalese with hypertension.

摘要

引言

尼泊尔高血压患病率很高。虽然改善总体健康相关生活质量(HRQOL)是发达国家公共卫生计划的核心宗旨,但在尼泊尔这一重点尚未得到明确阐述。因此,本研究旨在确定尼泊尔高血压患者中与HRQOL相关的因素。

方法

对尼泊尔加德满都沙希德·甘加拉尔国家心脏中心门诊的180名高血压患者进行了欧洲五维健康量表(EuroQol-5Dimension)HRQOL调查。使用针对年龄和性别进行调整的多元线性回归模型来确定与HRQOL相关的因素。

结果

参与者的平均年龄和欧洲五维健康量表视觉分析量表得分分别为53.2岁和63.7分。年龄[β=-0.56;95%置信区间(CI):-0.75至-0.37]、收入(β=0.02;95%CI:0.01,0.03)、家庭规模(β=-0.98;95%CI:-1.89,-0.07)、使用降压药的数量(β=4.62;95%CI:1.33,7.90)以及对饮食中盐建议的依从性(β=4.86;95%CI:0.29,9.43)是参与者中与HRQOL相关的显著因素。此外,教育水平和自我感知健康与HRQOL呈正相关梯度。在中介分析中,饮食低盐依从性和降压药的使用对HRQOL均有显著直接影响,且降压药的使用并未显著介导饮食盐依从性与HRQOL之间的关系。

结论

发现加德满都高血压患者中多种因素与HRQOL相关。评估HRQOL是识别需要服务和干预人群的一项有价值的技术。该评估可作为基线,并与多个利益相关者共同指导公共卫生政策、规划和实践,尤其是那些旨在改善尼泊尔高血压患者HRQOL的政策、规划和实践。

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