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先天性心脏病患者生活质量评估:一项观察性病例对照研究。

Evaluation of quality of life in patients with congenital heart disease: an observational case control study.

作者信息

Martínez-Quintana Efrén, Estupiñán-León Hiurma, Rojas-Brito Ana Beatriz, Déniz-Déniz Liuva, Barreto-Martín Alejandro, Rodríguez-González Fayna

机构信息

Cardiology Service Complejo Hospitalario Universitario Insular-Materno Infantil Las Palmas de Gran Canaria, Spain.

Department of Medical and Surgical Sciences, Faculty of Health Sciences, Universidad de Las Palmas de Gran Canaria Las Palmas de Gran Canaria, Spain.

出版信息

Am J Cardiovasc Dis. 2021 Feb 15;11(1):73-79. eCollection 2021.

Abstract

Quality of life (QoL) has become an important issue in patients with congenital heart disease (CHD). Accordingly, the focus has shifted from mere survival to a better QoL. The objective of this study is to assess QoL, by examining the World Health Organization QoL-bref (WHOQoL-BREF) questionnaire, in patients with CHD and a control population of a same geographic area matched for age, sex, cardiovascular risk factors and educational level. 154 patients with CHD recruited from a single hospital outpatient clinic and 250 healthy controls were studied between October 2018 and April 2019. Median age in patients with CHD was 27 (20-34) years and 62% were male. 32, 90 and 32 patients with CHD showed mild, moderate, and complex defects, respectively. 131 (53%) controls referred having felt or experienced negative feelings such as bad mood, despair, stress, or depression compared to 53 (34%) patients in the CHD group (P<0.001). Despite needing more medical treatment (P<0.001), patients with CHD enjoyed more their lives (P<0.001), felt their lives made more sense (P<0.001), were happier with themselves (P=0.006) and with their personal relationships (P=0.020), had a greater support from friends (P=0.031) and felt safer in their daily lives (P=0.004) than patients in the control group. Similarly, patient with CHD felt their environment was healthier, had more opportunities for leisure and were happier with their access to healthcare system (P<0.005) than controls. On the contrary, except the need for more medical treatment in patients with great CHD defects (P=0.019), no significant differences were seen in the WHOQoL-BREF survey according to the anatomical complexity. In conclusion, overall patients with CHD scored better in the WHOQoL-BREF questionnaire, especially in the psychological and environment domains, than patients in the control group.

摘要

生活质量(QoL)已成为先天性心脏病(CHD)患者的一个重要问题。因此,关注点已从单纯的生存转移到更好的生活质量。本研究的目的是通过检查世界卫生组织生活质量简表(WHOQoL - BREF)问卷,评估先天性心脏病患者以及年龄、性别、心血管危险因素和教育水平相匹配的同一地理区域对照人群的生活质量。2018年10月至2019年4月期间,对从一家医院门诊招募的154例先天性心脏病患者和250名健康对照者进行了研究。先天性心脏病患者的中位年龄为27(20 - 34)岁,62%为男性。32例、90例和32例先天性心脏病患者分别表现为轻度、中度和复杂缺陷。与先天性心脏病组的53例(34%)患者相比,131例(53%)对照者表示曾感到或经历过诸如情绪低落、绝望、压力或抑郁等负面情绪(P<0.001)。尽管先天性心脏病患者需要更多的医疗治疗(P<0.001),但他们比对照组患者更享受生活(P<0.001),觉得自己的生活更有意义(P<0.001),对自己(P = 0.006)和个人关系(P = 0.020)更满意,从朋友那里得到更多支持(P = 0.031),并且在日常生活中感觉更安全(P = 0.004)。同样,先天性心脏病患者感觉他们的环境更健康,有更多休闲机会,并且对获得医疗保健系统更满意(P<0.005)。相反,除了患有严重先天性心脏病缺陷的患者需要更多医疗治疗(P = 0.019)外,根据解剖复杂性,在WHOQoL - BREF调查中未发现显著差异。总之,总体而言,先天性心脏病患者在WHOQoL - BREF问卷中的得分比对照组患者更高,尤其是在心理和环境领域。

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