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社会人口学特征和长期并发症对糖尿病患者生活质量的影响。

Impact of socio-demographic characteristics and long-term complications on quality of life in patients with diabetes mellitus.

作者信息

Stojanović Miodrag, Cvetanović Goran, Anđelković Apostolović Marija, Stojanović Dijana, Rančić Nataša

机构信息

University of Niš, Faculty of Medicine Niš, Niš, Serbia.

Department of Biostatistics, Institute for Public Health, Niš, Serbia.

出版信息

Cent Eur J Public Health. 2018 Jun;26(2):104-110. doi: 10.21101/cejph.a5022.

Abstract

OBJECTIVE

Diabetes mellitus (DM) has been one of the leading chronic diseases worldwide over past decades. The objective of the study was to identify predictors associated with health-related quality of life (HRQOL) in diabetic patients.

METHODS

A cross-sectional questionnaire-based study was conducted at the General Hospital of the city of Leskovac, between June and November 2015. The Short Form-36 (SF-36) questionnaire, EuroQol-5D (EQ-5D) and EuroQol-VAS (EQ-VAS) questionnaires were used. Univariate and multivariate linear regression analyses were performed.

RESULTS

The total number of patients was 285, 112 men (39.3%) and 173 women (60.7%), average age 63.92 ± 1.07 years. The results of multiple linear regression of socio-demographic characteristics in relation to dimensions of the quality of life measured by SF-36 and EQ-VAS showed that age, country (rural) life, low level of education, retirement, and poor economic status are predictors of lower quality of life. Our results showed that employment has a significant association with higher Physical Component Score (PCS), Mental Component Score (MCS) and EQ-VAS score, which can be explained with higher incomes, improved economic status and less possibility for the occurrence of depressive mood. Patients without formal education have lower QOL. Univariate multiple regression analysis of the presence of micro- and macrovascular complications of DM showed that angina pectoris, heart failure, diabetic retinopathy, and diabetic nephropathy are the most important factors affecting the quality of life in our population. After including the multivariate model, all tested complications remained statistically significant.

CONCLUSION

Our results showed that both socioeconomic and chronic complications are relevant factors of HRQOL in type 1 and 2 diabetes mellitus patients. Age, rural lifestyle, retirement, lower level of education and low socioeconomic status, as well as DM complications (angina pectoris, hearth failure, diabetes nephropathy, and diabetes retinopathy) were found to be independent risk factors for the component scores of SF-36 and EQ-VAS score. Taking into consideration the results obtained, health practitioners should be aware not only of the clinical parameters of patients with DM, but also of their educational level and working status.

摘要

目的

在过去几十年里,糖尿病一直是全球主要的慢性疾病之一。本研究的目的是确定与糖尿病患者健康相关生活质量(HRQOL)相关的预测因素。

方法

2015年6月至11月期间,在莱斯科瓦茨市综合医院进行了一项基于问卷调查的横断面研究。使用了简短健康调查问卷(SF-36)、欧洲五维度健康量表(EQ-5D)和欧洲五维度视觉模拟量表(EQ-VAS)。进行了单变量和多变量线性回归分析。

结果

患者总数为285人,其中男性112人(39.3%),女性173人(60.7%),平均年龄63.92±1.07岁。关于社会人口学特征与通过SF-36和EQ-VAS测量的生活质量维度的多元线性回归结果表明,年龄、农村生活、低教育水平、退休和经济状况差是生活质量较低的预测因素。我们的结果表明,就业与较高的身体成分得分(PCS)、心理成分得分(MCS)和EQ-VAS得分显著相关,这可以用较高的收入、改善的经济状况以及抑郁情绪发生的可能性较小来解释。未接受正规教育的患者生活质量较低。对糖尿病微血管和大血管并发症的存在进行单变量多元回归分析表明,心绞痛、心力衰竭、糖尿病视网膜病变和糖尿病肾病是影响我们研究人群生活质量的最重要因素。纳入多变量模型后,所有测试的并发症在统计学上仍具有显著性。

结论

我们的结果表明,社会经济因素和慢性并发症都是1型和2型糖尿病患者HRQOL的相关因素。年龄、农村生活方式、退休、低教育水平和低社会经济地位,以及糖尿病并发症(心绞痛、心力衰竭、糖尿病肾病和糖尿病视网膜病变)被发现是SF-36成分得分和EQ-VAS得分的独立危险因素。考虑到所获得的结果,健康从业者不仅应了解糖尿病患者的临床参数,还应了解他们的教育水平和工作状况。

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