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慢性阻塞性肺病加重患者的社会特征。性别分析。

Social Profile of Patients Admitted for COPD Exacerbations. A Gender Analysis.

机构信息

Grupo NeumoVigo I+i. Instituto de Investigación Sanitaria Galicia Sur (IISGS). Servicio de Neumología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, España.

Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela. Servicio de Medicina Preventiva, Hospital Clínico Universitario de Santiago de Compostela. CIBER de Epidemiología y Salud Pública (CIBERESP), Santiago de Compostela, La Coruña, España.

出版信息

Arch Bronconeumol (Engl Ed). 2020 Feb;56(2):84-89. doi: 10.1016/j.arbres.2019.03.009. Epub 2019 Apr 11.

Abstract

OBJECTIVE

To describe and compare from a gender perspective the social profile of patients admitted to a respiratory unit for COPD exacerbations (COPDE).

METHODOLOGY

A cross-sectional study in patients with serious COPDE in which demographic, clinical, and social data (economic situation, care, dependency for basic and instrumental activities, social risk, caregiver overload, use of social services) were collected using questionnaires and indices such as Barthel, Lawton-Brody, Zarit, Barber, and Gijón. A descriptive analysis was made of patients' social and healthcare situation, compared on the basis of gender.

RESULTS

We included 253 patients, aged 68.9±9.8years, 58 (23%) women, FEV1 42.1±14.2%, and Charlson index 1.8±0.9; 37.9% were active smokers. In total, 55.2% had an income of less than €800/month, 46.2% had some dependency for basic activities, and 89.3% for instrumental activities, 89% presented social fragility, while 64% were in a situation of social problem/risk; 49% had a caregiver, 83% in a non-formal arrangement, 90.9% of whom were women, with some overload reported by 69.2%. A total of 21.4% lived alone, and 22.9% had contacted social services. Women with COPDE are younger, smoke more actively, and have fewer comorbidities. They have more scant economic resources and assistance and are in a poorer socio-familiar situation, but they are less dependent for some activities.

CONCLUSIONS

The social profile of patients with serious COPDE admitted to respiratory units is very unfavorable, especially among women. These inequalities appear to go beyond differences in the expression of COPD, and are associated with gender.

摘要

目的

从性别角度描述和比较因 COPD 加重(COPDE)住院的呼吸科患者的社会特征。

方法

这是一项针对严重 COPDE 患者的横断面研究,使用问卷和 Barthel、Lawton-Brody、Zarit、Barber 和 Gijón 等指数收集人口统计学、临床和社会数据(经济状况、护理、基本和工具性活动的依赖程度、社会风险、护理人员负担过重、社会服务的使用情况)。根据性别对患者的社会和医疗状况进行描述性分析。

结果

我们纳入了 253 名年龄 68.9±9.8 岁的患者,其中 58 名(23%)为女性,FEV1 为 42.1±14.2%,Charlson 指数为 1.8±0.9;37.9%为主动吸烟者。共有 55.2%的患者月收入低于 800 欧元,46.2%的患者基本活动有一定依赖性,89.3%的患者工具性活动有一定依赖性,89%的患者存在社会脆弱性,64%的患者处于社会问题/风险状态;49%的患者有护理人员,83%的护理人员是非正规安排,其中 90.9%为女性,69.2%的护理人员存在一定程度的负担。共有 21.4%的患者独居,22.9%的患者曾联系过社会服务。患有 COPDE 的女性更年轻,吸烟更活跃,合并症更少。她们的经济资源和援助较少,社会家庭状况较差,但某些活动的依赖性较低。

结论

因严重 COPDE 住院的呼吸科患者的社会特征非常不利,尤其是女性。这些不平等似乎超出了 COPD 表现的差异,与性别有关。

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