多病症如何影响中年成年人？新加坡初级医疗保健环境中的横断面调查。
How does multimorbidity affect middle-aged adults? A cross-sectional survey in the Singapore primary healthcare setting.
机构信息
Clinical Research Unit, National Healthcare Group Polyclinics, 3 Fusionopolis Link, Nexus@one-north. South Tower, # 05-10, Singapore, 138543, Singapore.
Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road Level 11, Singapore, 119228, Singapore.
出版信息
BMC Fam Pract. 2020 Sep 14;21(1):190. doi: 10.1186/s12875-020-01262-2.
BACKGROUND
Multimorbidity is of increasing prevalence and importance. It has been associated with poorer health-related quality of life (HrQoL) especially in the elderly population. Despite substantial multimorbidity in the middle-aged population, defined as those aged between 40-64 years old, there is a paucity of research investigating the impact of multimorbidity in this population. This study aimed to investigate the association between multimorbidity and HrQoL in the middle-aged primary care population in Singapore.
METHODS
A cross-sectional study was conducted at a primary care centre in Singapore. Interviewer-administered questionnaires were used to collect data regarding the participants' sociodemographic characteristics, chronic conditions, and HrQoL, as measured by the EuroQol five dimensions 3-levels questionnaire (EQ5D). We defined multimorbidity as the presence of three or more conditions, out of a list of 14 chronic conditions. The associations between multimorbidity and the components of the EQ5D were assessed using multivariable regression analyses.
RESULTS
The study included 297 participants, aged 40-64 years, of which 124 (41.7%) had multimorbidity. After adjusting for sociodemographic factors, participants with multimorbidity had significantly lower EQ5D UI, (β-coefficient - 0.064 (C.I -0.125, - 0.003), p = 0.04), but not significantly lower EQ5D VAS, (β-coefficient - 0.045 (C.I 0.102, 0.012), p = 0.12). Additionally, participants with multimorbidity had higher odds (OR = 2.41, p = 0.01) of reporting problems due to pain/discomfort.
CONCLUSION
Multimorbidity was not significantly associated with the overall health state, as measured by the EQ5D VAS, in middle-aged primary care patients. However, it was associated with the EQ5D UI which is a composite measure of five specific domains of HrQoL. Specifically, there was a statistically significant association between multimorbidity and the pain domain. Further studies are required to understand the relationship between multimorbidity and pain to enable physicians to better manage pain and HrQoL in this population.
背景
多病共存的情况越来越普遍，也越来越重要。它与健康相关的生活质量（HrQoL）较差有关，尤其是在老年人群中。尽管中年人群（定义为 40-64 岁之间的人群）中存在大量的多病共存情况，但针对这一人群的多病共存影响的研究却很少。本研究旨在调查新加坡中年初级保健人群中多病共存与 HrQoL 之间的关系。
方法
在新加坡的一个初级保健中心进行了一项横断面研究。使用访谈员管理的问卷收集了参与者的社会人口统计学特征、慢性疾病和 HrQoL 数据，采用 EuroQol 五维 3 级问卷（EQ5D）进行测量。我们将多病共存定义为存在 14 种慢性疾病中的三种或更多种疾病。使用多变量回归分析评估多病共存与 EQ5D 各组成部分之间的关系。
结果
该研究纳入了 297 名年龄在 40-64 岁之间的参与者，其中 124 名（41.7%）患有多病共存。在调整了社会人口统计学因素后，患有多病共存的参与者的 EQ5D UI 显著较低（β 系数-0.064（CI-0.125，-0.003），p=0.04），但 EQ5D VAS 没有显著较低（β 系数-0.045（CI0.102，0.012），p=0.12）。此外，患有多病共存的参与者报告因疼痛/不适而出现问题的可能性更高（OR=2.41，p=0.01）。
结论
在中年初级保健患者中，多病共存与 EQ5D VAS 测量的总体健康状况没有显著关联。然而，它与 EQ5D UI 相关，EQ5D UI 是五个特定 HrQoL 领域的综合测量。具体而言，多病共存与疼痛领域之间存在统计学显著关联。需要进一步的研究来了解多病共存与疼痛之间的关系，以便医生能够更好地管理这一人群的疼痛和 HrQoL。
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