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心血管疾病高危患者的健康行为与健康相关生活质量

Health Behavior and Health-related Quality of Life in Patients with a High Risk of Cardiovascular Disease.

作者信息

Petek Davorina, Petek-Ster Marija, Tusek-Bunc Ksenija

机构信息

University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, 1000, Ljubljana, Slovenia.

University of Maribor, Faculty of Medicine, Department of Family Medicine, Taborska 8, 2000, Maribor, Slovenia.

出版信息

Zdr Varst. 2018 Jan 5;57(1):39-46. doi: 10.2478/sjph-2018-0006. eCollection 2018 Mar.

Abstract

BACKGROUND

Health-related quality of life (HRQoL) is measuring a patient's experience of his health status and represents an outcome of medical interventions. Existing data proves that a healthy lifestyle is positively associated with HRQoL in all age groups. Patients with a high risk for cardiovascular disease typically led an unhealthy lifestyle combined with risk diseases. We aimed to analyse these characteristics and their reflection in HRQoL.

METHODS

A cross-sectional study in 36 family practices, stratified by location and size. Each practice invited 30 high-risk patients from the register. Data were obtained from medical records and patient questionnaire. The EQ-5D questionnaire and the VAS scale were used for measuring the patient's HRQoL as an independent variable.

RESULTS

871 patients (80.6% response rate) were included in the analysis. 60.0% had 3-4 uncontrolled risk factors for CVD. The average VAS scale was 63.2 (SD 19.4). The correlation of EQ-5D was found in the number of visits in the practice (r=-0.31, p<0.001), the socioeconomic status (r=-0.25, p=0.001), age (r=-0.27, p=0.001) and healthy diet (r=0.20, p=0.006). In a multivariate model, only physical activity among lifestyle characteristics was an independent predictor of HRQoL (p=0.001, t=3.3), along with the frequency of visits (p<0.001, t=-5.3) and age (p=0.025, t=-2.2).

CONCLUSION

This study has been performed on a specific group of patients, not being "really sick", but having less optimal lifestyle in many cases. Encouragement to improve or keep healthy lifestyle, especially physical activity, is important, not only to lower the risk for CVD, but also to improve HRQoL.

摘要

背景

健康相关生活质量(HRQoL)用于衡量患者对自身健康状况的体验,是医疗干预的一项结果。现有数据表明,健康的生活方式在所有年龄组中都与HRQoL呈正相关。心血管疾病高危患者通常有着不健康的生活方式并伴有风险疾病。我们旨在分析这些特征及其在HRQoL中的反映。

方法

在36个家庭诊所开展一项横断面研究,按地点和规模分层。每个诊所从登记册中邀请30名高危患者。数据从医疗记录和患者问卷中获取。使用EQ-5D问卷和视觉模拟量表(VAS)作为自变量来测量患者的HRQoL。

结果

871名患者(应答率80.6%)纳入分析。60.0%的患者有3 - 4个未得到控制的心血管疾病风险因素。VAS量表的平均值为63.2(标准差19.4)。发现EQ-5D与诊所就诊次数(r = -0.31,p < 0.001)、社会经济地位(r = -0.25,p = 0.001)、年龄(r = -0.27,p = 0.001)以及健康饮食(r = 0.20,p = 0.006)相关。在多变量模型中,生活方式特征中只有体育活动是HRQoL的独立预测因素(p = 0.001,t = 3.3),同时还有就诊频率(p < 0.001,t = -5.3)和年龄(p = 0.025,t = -2.2)。

结论

本研究针对的是特定患者群体,这些患者并非“真正患病”,但在很多情况下生活方式不够健康。鼓励改善或保持健康的生活方式,尤其是体育活动,不仅对于降低心血管疾病风险很重要,而且对于改善HRQoL也很重要。

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