Division of Vascular Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.
Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill.
J Vasc Surg. 2022 Apr;75(4):1358-1368.e5. doi: 10.1016/j.jvs.2021.11.036. Epub 2021 Nov 15.
An individual's understanding of disease risk factors and outcomes is important for the ability to make healthy lifestyle choices and decisions about disease treatment. Peripheral artery disease (PAD) is a condition with increasing global prevalence and high risk of adverse patient outcomes. This study seeks to understand the adequacy of disease understanding in patients with PAD.
This was an observational study of patients with PAD recruited from vascular surgery outpatient clinic and PAD clinical studies at a single academic medical center over an 8-month period. A 44-item paper survey assessed demographic and socioeconomic information, knowledge of personal medical history, PAD risk factors, consequences of PAD, and health education preferences. Patients with documented presence of PAD were offered the survey. Patients unable to complete the survey or provide informed consent were not considered eligible. Disease "awareness" was defined as correct acknowledgement of the presence or absence of a disease, including PAD, in the personal medical history. "PAD knowledge score" was the percentage of correct responses to questions on general PAD risk factors and consequences. Of 126 eligible patients, 109 participated. Bivariate analysis was used to study factors associated with awareness of PAD diagnosis. Factors associated with the PAD knowledge score were studied using the Pearson correlation coefficient, two-sample t test, or one-way analysis of variance. P value < .05 was considered statistically significant.
The mean participant age was 69.4 ± 11.0 years, and 39.4% (n = 43) were female. Most participants (78.9%; n = 86) had critical limb-threatening ischemia. Only 65.4% (n = 70) of participants were aware of a diagnosis of PAD, which was less than their awareness of related comorbidities. Factors positively associated with PAD diagnosis awareness were female sex (81.4% vs 54.7%; P = .004) and history of percutaneous leg revascularization (78.6% vs 47.9%; P = .001). Among 17 patients who had undergone major leg amputation, 35% (n = 6) were unaware of a diagnosis of PAD. PAD knowledge scores correlated positively with an awareness of PAD diagnosis (59.1% vs 48.7%; P = .02) and negatively with a history of hypertension (53.4% vs 68.1%; P = .001). Most participants (86.5%; n = 90) expressed a desire to be further educated on PAD. The most popular education topics were dietary recommendations, causes, and treatment for PAD.
Patients with PAD have deficits in their awareness of this diagnosis and general knowledge about PAD. Future research priorities should further define these deficits and their causes in order to inform new strategies that foster information-seeking behavior and effective educational programs for PAD.
个体对疾病风险因素和结果的理解能力对于做出健康的生活方式选择以及治疗疾病的决策至关重要。外周动脉疾病（PAD）是一种在全球范围内发病率不断上升且患者预后不良风险较高的疾病。本研究旨在了解 PAD 患者对疾病的理解程度。
这是一项观察性研究，对象为在一家学术医疗中心的血管外科门诊和 PAD 临床研究中招募的 PAD 患者，研究时间为 8 个月。一份 44 项的纸质调查问卷评估了人口统计学和社会经济学信息、个人病史知识、PAD 风险因素、PAD 后果以及健康教育偏好。有记录的 PAD 患者被提供了该调查问卷。无法完成调查或无法提供知情同意的患者不被认为符合条件。“疾病意识”定义为正确识别个人病史中是否存在疾病，包括 PAD。“PAD 知识得分”是对一般 PAD 风险因素和后果问题的正确回答的百分比。在 126 名符合条件的患者中，有 109 名参与了研究。使用双变量分析研究与 PAD 诊断意识相关的因素。使用 Pearson 相关系数、两样本 t 检验或单因素方差分析研究与 PAD 知识得分相关的因素。P 值<.05 被认为具有统计学意义。
参与者的平均年龄为 69.4±11.0 岁，39.4%（n=43）为女性。大多数参与者（78.9%；n=86）患有严重肢体缺血。只有 65.4%（n=70）的参与者意识到自己患有 PAD，这低于他们对相关合并症的意识。与 PAD 诊断意识呈正相关的因素是女性（81.4%比 54.7%；P=.004）和经皮腿部血运重建史（78.6%比 47.9%；P=.001）。在 17 名接受了主要腿部截肢的患者中，有 35%（n=6）不知道自己患有 PAD。PAD 知识得分与 PAD 诊断意识呈正相关（59.1%比 48.7%；P=.02），与高血压史呈负相关（53.4%比 68.1%；P=.001）。大多数参与者（86.5%；n=90）表示希望进一步了解 PAD。最受欢迎的教育主题是饮食建议、PAD 的病因和治疗。
PAD 患者在对该诊断的认识和对 PAD 一般知识的了解方面存在不足。未来的研究重点应进一步确定这些缺陷及其原因，以便为促进信息寻求行为和 PAD 有效教育计划提供信息。
