School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Department of Nephrology, Monash Health, Melbourne, VIC, Australia.
Health Qual Life Outcomes. 2018 Nov 19;16(1):215. doi: 10.1186/s12955-018-1044-2.
Little is known about how patient reported barriers to health care impact the quality of life (HRQoL) of patients with comorbid disease. We investigated patient reported barriers to health care and low physical and mental well-being among people with diabetes and chronic kidney disease (CKD).
Adults with diabetes and CKD (estimated Glomerular Filtration Rate < 60 ml/min/1.73m) were recruited and completed a questionnaire on barriers to health care, the 12-Item HRQoL Short Form Survey and clinical assessment. Low physical and mental health status were defined as mean scores < 50. Logistic regression models were used.
Three hundred eight participants (mean age 66.9 ± 11 years) were studied. Patient reported 'impact of the disease on family and friends' (OR 2.07; 95% CI 1.14 to 3.78), 'feeling unwell' (OR 4.23; 95% CI 1.45 to 12.3) and 'having other life stressors that make self-care a low priority' (OR 2.59; 95% CI 1.20 to 5.61), were all associated with higher odds of low physical health status. Patient reported 'feeling unwell' (OR 2.92; 95% CI 1.07 to 8.01), 'low mood' (OR 2.82; 95% CI 1.64 to 4.87) and 'unavailability of home help' (OR 1.91; 95% CI 1.57 to 2.33) were all associated with higher odds of low mental health status. The greater the number of patient reported barriers the higher the odds of low mental health but not physical health status.
Patient reported barriers to health care were associated with lower physical and mental well-being. Interventions addressing these barriers may improve HRQoL among people with comorbid diabetes and CKD.
对于患者报告的医疗保健障碍如何影响合并疾病患者的生活质量（HRQoL）知之甚少。我们调查了患有糖尿病和慢性肾脏病（CKD）的患者报告的医疗保健障碍和身心健康不良。
招募了患有糖尿病和 CKD（估计肾小球滤过率<60 ml/min/1.73m）的成年人，并完成了一份关于医疗保健障碍、12 项 HRQoL 简短表格调查和临床评估的问卷。身心健康不良定义为平均得分<50。使用逻辑回归模型。
研究了 308 名参与者（平均年龄 66.9±11 岁）。患者报告的“疾病对家人和朋友的影响”（OR 2.07；95%CI 1.14 至 3.78）、“感觉不适”（OR 4.23；95%CI 1.45 至 12.3）和“有其他生活压力源，使自我护理成为低优先级”（OR 2.59；95%CI 1.20 至 5.61），与较低的身体健康状况的可能性相关。患者报告的“感觉不适”（OR 2.92；95%CI 1.07 至 8.01）、“情绪低落”（OR 2.82；95%CI 1.64 至 4.87）和“家庭帮助不可用”（OR 1.91；95%CI 1.57 至 2.33），与心理健康状况较低的可能性相关。患者报告的障碍越多，心理健康状况越低，但身体健康状况越低。
患者报告的医疗保健障碍与身心健康状况较差有关。解决这些障碍的干预措施可能会改善合并患有糖尿病和 CKD 的人的 HRQoL。
