Lee Eunmi, Cha Sunkyung, Kim Geun Myun
Department of Nursing, Hoseo University, Asan 31499, Korea.
Department of Nursing Science, Sun Moon University, Asan 31460, Korea.
Healthcare (Basel). 2021 Mar 16;9(3):334. doi: 10.3390/healthcare9030334.
We investigated the effect of predisposing, enabling, need factors, and health behaviors on health-related quality of life (HRQoL) of patients with multimorbidity according to Andersen's model. This study is a secondary analysis of population-based cross-sectional surveys. Data from 328 patients with multimorbidity (≥3 co-occurring chronic diseases) from the 6th/7th Korea National Health and Nutrition Examination Surveys were analyzed using logistic regression. Patients ≥65 years, without private insurance, with poor subjective health, unmet medical needs, and/or limited activity were more likely to experience mobility problems. Self-care problems were more likely among those without private insurance and/or with limited activity. Patients lacking living security, with poor subjective health, limited activity, and/or who smoked were more likely to experience problems performing usual activities. Pain/discomfort was more likely among females, Medicaid beneficiaries, and patients with limited activity and/or with poor subjective health. Patients with poor subjective health, limited activity, and/or unmet medical needs were more likely to experience anxiety/depression. The investigation of HRQoL in multimorbidity should consider predisposing, enabling, need factors, and health behaviors. Interventions addressing movement restrictions and personalized care based on HRQoL domains should be prioritized.
我们根据安德森模型，研究了易患因素、促成因素、需求因素和健康行为对患有多种疾病的患者健康相关生活质量（HRQoL）的影响。本研究是基于人群的横断面调查的二次分析。使用逻辑回归分析了来自第六次/第七次韩国国家健康与营养检查调查的328名患有多种疾病（≥3种同时存在的慢性病）患者的数据。65岁及以上、没有私人保险、主观健康状况差、医疗需求未得到满足和/或活动受限的患者更有可能出现行动不便问题。没有私人保险和/或活动受限的患者更有可能出现自我护理问题。缺乏生活保障、主观健康状况差、活动受限和/或吸烟的患者在进行日常活动时更有可能出现问题。女性、医疗补助受益人以及活动受限和/或主观健康状况差的患者更有可能出现疼痛/不适。主观健康状况差、活动受限和/或医疗需求未得到满足的患者更有可能出现焦虑/抑郁。对患有多种疾病的患者的健康相关生活质量进行调查时应考虑易患因素、促成因素、需求因素和健康行为。应优先采取针对行动限制的干预措施以及基于健康相关生活质量领域的个性化护理。
