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多病症患者的社会脆弱性:一项横断面分析。

Social Vulnerability in Patients with Multimorbidity: A Cross-Sectional Analysis.

机构信息

Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC G7H 5H6, Canada.

Centre for Studies in Family Medicine, Department of Family Medicine, and Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 3K7, Canada.

出版信息

Int J Environ Res Public Health. 2019 Apr 8;16(7):1244. doi: 10.3390/ijerph16071244.

Abstract

BACKGROUND

Social aspects play an important role in individual health and should be taken into consideration in the long-term care for people with multimorbidity.

PURPOSES

To describe social vulnerability, to examine its correlation with the number of chronic conditions, and to investigate which chronic conditions were significantly associated with the most socially vulnerable state in patients with multimorbidity.

METHODS

Cross-sectional analysis from the baseline data of the Patient-Centred Innovations for Persons with Multimorbidity (PACEinMM) Study. Participants were patients attending primary healthcare settings in Quebec, Canada. A social vulnerability index was applied to identify social vulnerability level. The index value ranges from 0 to 1 (1 as the most vulnerable). Spearman's rank correlation coefficient was calculated for the correlation between the social vulnerability index and the number of chronic conditions. Logistic regression was applied to investigate which chronic conditions were independently associated with the most socially vulnerable state.

RESULTS

There were 301 participants, mean age 61.0 ± 10.5, 53.2% female. The mean number of chronic health conditions was 5.01 ± 1.82, with the most common being hyperlipidemia (78.1%), hypertension (69.4%), and obesity (54.2%). The social vulnerability index had a median value of 0.13 (range 0.00⁻0.78). There was a positive correlation between the social vulnerability index and the number of chronic conditions (r = 0.24, < 0.001). Obesity, depression/anxiety, and cardiovascular diseases were significantly associated with the most socially vulnerable patients with multimorbidity.

CONCLUSIONS

There was a significant correlation between social vulnerability and the total number of chronic conditions, with depression/anxiety, obesity, and cardiovascular diseases being the most related to social vulnerability.

摘要

背景

社会因素在个体健康中起着重要作用,在对患有多种疾病的人群进行长期护理时应予以考虑。

目的

描述社会脆弱性,考察其与慢性疾病数量的相关性,并探讨哪些慢性疾病与患有多种疾病的患者中最脆弱的社会状态显著相关。

方法

这是一项来自加拿大魁北克省初级保健机构就诊的患者参与的多中心创新患者为中心的多种疾病研究(PACEinMM)的基线数据的横断面分析。应用社会脆弱性指数来确定社会脆弱性水平。指数值范围为 0 到 1(1 表示最脆弱)。计算社会脆弱性指数与慢性疾病数量之间的相关性的 Spearman 秩相关系数。应用逻辑回归来探讨哪些慢性疾病与最脆弱的社会状态独立相关。

结果

共纳入 301 名参与者,平均年龄为 61.0 ± 10.5 岁,53.2%为女性。平均患有 5.01 ± 1.82 种慢性健康状况,最常见的是血脂异常(78.1%)、高血压(69.4%)和肥胖症(54.2%)。社会脆弱性指数中位数为 0.13(范围为 0.00⁻0.78)。社会脆弱性指数与慢性疾病数量之间存在正相关(r = 0.24,<0.001)。肥胖症、抑郁/焦虑和心血管疾病与患有多种疾病的最脆弱患者显著相关。

结论

社会脆弱性与慢性疾病总数之间存在显著相关性,抑郁/焦虑、肥胖症和心血管疾病与社会脆弱性的相关性最强。

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