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COVID-19 大流行期间无家可归者健康相关生活质量的决定因素。

Determinants of health-related quality of life among homeless individuals during the COVID-19 pandemic.

机构信息

Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

出版信息

Public Health. 2021 May;194:60-66. doi: 10.1016/j.puhe.2021.02.026. Epub 2021 Mar 6.

Abstract

OBJECTIVE

To clarify which variables are associated with the health-related quality of life (HRQoL) among homeless individuals during the COVID-19 pandemic.

STUDY DESIGN

Cross-sectional research.

METHODS

Data were taken from the Hamburg survey of homeless individuals (n = 151). HRQoL was assessed using the EQ-5D tool. More precisely, the EQ-5D-5L questionnaire was used to quantify problems in five health dimensions (i.e. mobility, self-care, usually activities, pain/discomfort, anxiety/depression), and its visual analog scale (EQ-VAS) was used to record the according self-rated health status. Explanatory variables include sex, age, education, marital status, country of origin, health insurance, and chronic alcohol consumption.

RESULTS

With regard to HRQoL, most frequently, problems were reported as pain/discomfort (47.3%), followed by anxiety/depression (32.4%), mobility (29.7%), usual activities (20.7%) and self-care (4.6%). The mean EQ-VAS score was 75.34 (SD 22.23; range 1-100), and the mean EQ-5D-5L index was 0.84 (SD 0.23; range 0.32-1). Regressions showed increasing problems in mobility and self-care with higher age, whereas EQ-VAS was positively associated with younger age. Furthermore, EQ-5D-5L index was positively associated with younger age and higher education. Summarized, among this cohort, a higher age is associated with a lower HRQoL.

CONCLUSION

Remarkably high EQ-VAS values and rather few problems in the five dimensions investigated here were reported among the homeless individuals during the COVID-19 pandemic particularly compared with the general population. Moreover, study findings particularly stress the link between higher age and lower HRQoL among homeless individuals. This knowledge is important to address homeless individuals at risk of poor HRQoL. Longitudinal studies are required to confirm the given findings.

摘要

目的

厘清在 COVID-19 大流行期间,哪些变量与无家可归者的健康相关生活质量(HRQoL)有关。

研究设计

横断面研究。

方法

数据来自汉堡无家可归者调查(n=151)。使用 EQ-5D 工具评估 HRQoL。更确切地说,使用 EQ-5D-5L 问卷来量化五个健康维度(即行动能力、自理能力、通常活动能力、疼痛/不适、焦虑/抑郁)中的问题,并使用其视觉模拟量表(EQ-VAS)来记录相应的自我报告健康状况。解释变量包括性别、年龄、教育、婚姻状况、原籍国、健康保险和慢性酒精消费。

结果

在 HRQoL 方面,最常见的问题是疼痛/不适(47.3%),其次是焦虑/抑郁(32.4%)、行动能力(29.7%)、通常活动能力(20.7%)和自理能力(4.6%)。EQ-VAS 平均得分为 75.34(SD 22.23;范围 1-100),EQ-5D-5L 平均指数为 0.84(SD 0.23;范围 0.32-1)。回归分析显示,随着年龄的增长,行动能力和自理能力的问题逐渐增多,而 EQ-VAS 则与年龄呈正相关。此外,EQ-5D-5L 指数与年龄和教育程度呈正相关。综上所述,在这一队列中,年龄较大与 HRQoL 较低相关。

结论

在 COVID-19 大流行期间,与一般人群相比,无家可归者报告的 EQ-VAS 值非常高,且五个维度的问题相对较少。此外,研究结果特别强调了年龄与无家可归者 HRQoL 较低之间的联系。这些知识对于关注 HRQoL 较差的无家可归者至关重要。需要进行纵向研究来证实这些发现。

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