老年人糖尿病患者健康相关生活质量轨迹:基于群组的建模方法。

Health-Related Quality of Life Trajectories Among Older Adults With Diabetes Mellitus: A Group-Based Modeling Approach.

机构信息

PhD, RN, Assistant Professor, School of Nursing, Hanyang University, Seoul, Republic of Korea.

PhD, Research Professor, College of Nursing, University of Illinois, Chicago, USA.

出版信息

J Nurs Res. 2022 Mar 2;30(2):e199. doi: 10.1097/jnr.0000000000000480.

Abstract

BACKGROUND

Health-related quality of life (HR-QoL) is an important issue among older adults with diabetes mellitus. However, information on longitudinal changes in HR-QoL over time using the illness trajectory model is limited.

PURPOSE

The purpose of this study was to identify patterns of temporal change in HR-QoL and their predictors using longitudinal data and a group-based modeling approach.

METHODS

European Quality of Life-5 Dimensions data for 440 older adults with diabetes mellitus were drawn from the nationwide Korea Health Panel Survey conducted from 2009 to 2013. Latent class growth analysis and multinomial logistic regression models were used to identify the predictors of HR-QoL trajectories.

RESULTS

Four distinct classes of HR-QoL trajectory were identified: high decrease (n = 46, 10.5%), high stable (n = 232, 52.7%), medium stable (n = 157, 35.7%), and low increase (n = 5, 1.1%). Participants in high decrease" and high-stable" classes tended to be men who were highly educated, physically active, and adherent to their medication regimen. High economic status, few chronic diseases, independence in activities of daily living, and high self-rated health status were also identified as indicators of being in the high-decrease" and high-stable" class group.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE: A salient finding of this study is that HR-QoL trajectories in older adults with diabetes mellitus are not homogeneous but instead diverge into four distinct classes. Most participants showed no major changes in HR-QoL across the 5-year period, regardless of HR-QoL level. To prevent patients with diabetes from experiencing chronically low levels of HR-QoL, comprehensive assessment and individualized care based on HR-QoL are necessary.

摘要

背景

健康相关生活质量(HR-QoL)是老年糖尿病患者的一个重要问题。然而,使用疾病轨迹模型来衡量随时间推移的 HR-QoL 纵向变化的信息有限。

目的

本研究旨在通过纵向数据和基于群组的建模方法,确定 HR-QoL 随时间变化的模式及其预测因素。

方法

从 2009 年至 2013 年进行的全国性韩国健康面板调查中抽取了 440 名患有糖尿病的老年患者的欧洲生活质量-5 维度数据。使用潜在类别增长分析和多项逻辑回归模型来确定 HR-QoL 轨迹的预测因素。

结果

确定了 4 种不同的 HR-QoL 轨迹类别:高下降(n=46,10.5%)、高稳定(n=232,52.7%)、中稳定(n=157,35.7%)和低升高(n=5,1.1%)。“高下降”和“高稳定”类别的参与者往往是受过高等教育、身体活跃且坚持药物治疗方案的男性。高经济地位、较少的慢性疾病、日常生活活动的独立性和较高的自我评估健康状况也被确定为处于“高下降”和“高稳定”类别的指标。

结论/对实践的启示:本研究的一个显著发现是,老年糖尿病患者的 HR-QoL 轨迹并非同质,而是分为四个不同的类别。无论 HR-QoL 水平如何,大多数参与者在 5 年内 HR-QoL 均无明显变化。为了防止糖尿病患者长期 HR-QoL 水平较低,需要基于 HR-QoL 进行全面评估和个体化护理。

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