埃塞俄比亚亚的斯亚贝巴提克里安巴萨专科医院风湿性心脏病患者的主观幸福感：观察性横断面研究。
Subjective wellbeing among rheumatic heart disease patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: observational cross-sectional study.
机构信息
Department of Pediatrics and Child Health, Cardiology Division, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Internal Medicine, Cardiology Division, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
出版信息
BMC Health Serv Res. 2021 Dec 19;21(1):1354. doi: 10.1186/s12913-021-07378-0.
BACKGROUND
Subjective wellbeing (SWB) is a self-reported positive life judgment and good feeling. RHD, rheumatic heart disease, is a long-term sequel of single or recurrent acute rheumatic fever. There are no studies that assessed SWB in RHD patients. We aimed to assess SWB among RHD subjects enrolled in chronic care at Tikur Anbessa Specialized Hospital (TASH), Ethiopia.
METHODS
This observational cross-sectional study employed a validated Amharic WHO-5 wellbeing index to assess SWB. Sociodemographic and clinical data were collected using structured questionnaire. RHD subjects aged 9 years and above were included. Factors associated with SWB were assessed using logistic regression models.
RESULTS
The study included 384 subjects, females 68.2% (262). Children, < 18 years, constituted one third of study subjects, 32.8% (126). Moderate and severe echocardiographic RHD dominated, 85.9% (330) with no associated comorbidity, 84.4% (324). Only 17.2% (66) had surgical or device intervention. Poor SWB was documented in 9.6% of study subjects (95% CI: 6.88-13.04). On multivariable regression, those with younger age RHD diagnosis, < 20 years, had almost three times higher odds of poor SWB, adjusted odds ratio (aOR) 2.69(95% CI: 1.30-5.58, P 0.008). Those with monthly family income of < 1000 Ethiopian Birr had three times higher odds of poor SWB, aOR 2.97(95% CI: 1.24-7.1, P 0.014). Study subjects who had good medication adherence had reduced odds of poor SWB, aOR 0.37(95% CI: 0.18-0.77, P 0.028). Those who received psychologic support from their families also had reduced odds of poor SWB, aOR 0.26(95% CI: 0.11-0.64, P 0.003).
CONCLUSION
Poor SWB was documented in one-tenth of RHD patients. Family income, younger age at RHD diagnosis, medication adherence and psychological support predicted poor SWB. Poor SWB has to be considered and assessed among RHD patients particularly among those with younger age at RHD diagnosis and poor family income. Further mixed studies are recommended to assess how medication adherence and psychological supports associate with positive SWB among RHD patients.
背景
主观幸福感（SWB）是一种自我报告的积极生活判断和良好感觉。风湿性心脏病（RHD）是单一或复发性急性风湿热的长期后遗症。目前尚无评估 RHD 患者 SWB 的研究。我们旨在评估在埃塞俄比亚提库安贝斯专科医院（TASH）接受慢性护理的 RHD 患者的 SWB。
方法
本观察性横断面研究采用经过验证的阿姆哈拉语 WHO-5 幸福感指数评估 SWB。使用结构化问卷收集社会人口统计学和临床数据。纳入年龄在 9 岁及以上的 RHD 患者。使用逻辑回归模型评估与 SWB 相关的因素。
结果
该研究共纳入 384 名患者，女性占 68.2%（262 名）。儿童，<18 岁，占研究对象的三分之一，为 32.8%（126 名）。中度和重度超声心动图 RHD 为主，占 85.9%（330 名），无相关合并症，占 84.4%（324 名）。仅有 17.2%（66 名）接受了手术或器械干预。研究中有 9.6%（95%CI：6.88-13.04）的患者存在 SWB 较差。在多变量回归中，RHD 诊断年龄较小的患者，<20 岁，SWB 较差的可能性几乎高出三倍，调整后的优势比（aOR）为 2.69（95%CI：1.30-5.58，P<0.008）。家庭月收入<1000 埃塞俄比亚比尔的患者 SWB 较差的可能性高出三倍，aOR 为 2.97（95%CI：1.24-7.1，P=0.014）。药物依从性好的患者 SWB 较差的可能性降低，aOR 为 0.37（95%CI：0.18-0.77，P=0.028）。得到家庭心理支持的患者 SWB 较差的可能性也降低，aOR 为 0.26（95%CI：0.11-0.64，P=0.003）。
结论
RHD 患者中十分之一存在 SWB 较差的情况。家庭收入、RHD 诊断年龄较小、药物依从性和心理支持预测 SWB 较差。特别是在 RHD 诊断年龄较小和家庭收入较低的患者中，必须考虑和评估 SWB 较差的情况。建议进一步开展混合研究，以评估 RHD 患者的药物依从性和心理支持与积极 SWB 之间的关系。
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