Maeland J G, Havik O E
Institute of Hygiene and Social Medicine, University of Bergen, Norway.
Soc Sci Med. 1988;27(6):597-605. doi: 10.1016/0277-9536(88)90007-x.
Self-evaluated health represents an important aspect of quality of life that may influence the rehabilitation process after a major illness. However, health is a multi-dimensional concept and relatively little is known about the determinants of, and the interrelationships between the separate aspects of health. In a prospective longitudinal study of myocaridal infarction (MI) patients, two indices of self-evaluated health, maximal physical ability (MPA) and perceived global health (PGH), were used. On the average, both ratings were clearly reduced compared with pre-MI levels even as long as 3-5 yr after the MI. Females and older patients indicated lower MPA before and after the MI, whereas PGH was not related to any sociodemographic variable. The severity of the MI appeared to be of relatively limited importance for self-evaluated health. Heart-related symptoms before and after the MI were more strongly related to lower MPA, whereas non-cardiac health problems and psychological distress more clearly influenced PGH. However, initial illness perceptions were of some importance for both health perceptions. The data suggest that to some extent self-evaluated health can be influenced by educational or psychological support in order to faccilitate readaption and recovery after a MI.
自我评估的健康状况是生活质量的一个重要方面，可能会影响重大疾病后的康复过程。然而，健康是一个多维度的概念，人们对健康各个方面的决定因素及其相互关系了解相对较少。在一项对心肌梗死（MI）患者的前瞻性纵向研究中，使用了两个自我评估健康的指标，即最大身体能力（MPA）和感知整体健康（PGH）。平均而言，即使在心肌梗死后长达3至5年，这两项评分与心肌梗死前的水平相比都明显降低。女性和老年患者在心肌梗死前后的最大身体能力较低，而感知整体健康与任何社会人口统计学变量均无关联。心肌梗死的严重程度对自我评估的健康状况的重要性似乎相对有限。心肌梗死前后与心脏相关的症状与较低的最大身体能力的关联更强，而非心脏健康问题和心理困扰对感知整体健康的影响则更为明显。然而，最初的疾病认知对两种健康认知都有一定的重要性。数据表明，在一定程度上，自我评估的健康状况可以通过教育或心理支持来加以影响，以便促进心肌梗死后的重新适应和康复。
