Peach H, Charlton J R
J Epidemiol Community Health. 1986 Mar;40(1):59-66. doi: 10.1136/jech.40.1.59.
A survey in a London borough showed that 15% of adults living at home were restricted in one or more areas of their lives because of illness. A sample of these adults aged 25 to 75 years was interviewed using a validated medical questionnaire, and the severity of their restrictions was also assessed using a separate instrument. Many symptoms were found which had not been reported to a doctor and many were not being treated. When the disability scores were regressed on symptoms classified as reported to a doctor, unreported, or absent, with a few exceptions it was the reported symptoms that were significantly associated with disability. Similarly, when symptoms were classified as treated (by doctor or respondent), untreated, or absent, treated symptoms were associated with disability. Some disabling symptoms were similar to the effects, mainly adverse, of commonly prescribed drugs, and these symptoms were reported more frequently by respondents taking the possible offending drug than by those not taking the drug. It appears that making general practitioners aware of unreported and untreated symptoms among their 25 to 75 year old patients will not reduce the overall level of disability in the community. However, the iatrogenic component of disability needs to be studied further.
伦敦一个行政区的一项调查显示,居住在家中的成年人中有15%因疾病在生活的一个或多个方面受到限制。使用经过验证的医学问卷对这些年龄在25至75岁的成年人进行了抽样访谈,并使用单独的工具评估了他们受限的严重程度。发现了许多未向医生报告的症状,而且许多症状未得到治疗。当根据报告给医生、未报告或不存在的症状对残疾评分进行回归分析时,除了少数例外,与残疾显著相关的是报告的症状。同样,当症状被分类为已治疗(由医生或受访者)、未治疗或不存在时,已治疗的症状与残疾相关。一些致残症状类似于常用处方药的作用,主要是不良反应,服用可能引起问题药物的受访者比未服用该药物的受访者更频繁地报告这些症状。看来,让全科医生了解其25至75岁患者中未报告和未治疗的症状,并不会降低社区的总体残疾水平。然而,残疾的医源性因素需要进一步研究。