Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Chronic Illn. 2023 Dec;19(4):743-757. doi: 10.1177/17423953221124313. Epub 2022 Sep 6.
The impact of various psychosocial factors (sense of coherence, illness perception, patient enablement, self-efficacy, health literacy, personality) is not fully understood across a wide range of chronic diseases, and in particular in patients with multimorbidity. As such, this study assessed the key psychosocial factors associated with impaired health-related quality of life (HRQoL) in patients with one or more chronic diseases based on cross-sectional data collected in Flanders (Belgium).
Cross-sectional data on 544 chronically ill patients were analysed. Multiple linear regression models were built to analyze the key psychosocial factors associated with HRQoL (EQ-5D-5L as dependent factor).
Overall, the strongest independently associated factor with HRQoL was illness perceptions (β = -0.52, P < 0.001). In addition, sense of coherence (β = 0.14, P = < 0.05) was independently positively associated with HRQoL. Moreover, after stratification for multimorbidity, the negative association of illness perceptions with HRQoL was stronger when multimorbidity is present compared to when it is absent (β = -0.62, P < 0.001 vs β = -0.38, P < 0.001).
This study revealed interesting associations of the modifiable psychosocial factors of illness perceptions and sense of coherence with HRQoL in a population of chronically ill persons. Given that the burden of chronic diseases will rise in the next decades, designing and implementing interventions that enhance these psychosocial abilities of patients, especially illness perceptions in multimorbid patients, is needed in order to reduce the burden of chronic diseases in terms of impaired HRQoL.
各种心理社会因素(综合感知、疾病认知、患者赋能、自我效能、健康素养、人格)对广泛的慢性疾病,特别是对患有多种疾病的患者的健康相关生活质量(HRQoL)的影响尚未完全清楚。因此,本研究根据在佛兰德(比利时)收集的横断面数据,评估了与患有一种或多种慢性疾病的患者的 HRQoL 受损相关的关键心理社会因素。
对 544 名慢性疾病患者的横断面数据进行了分析。建立了多个线性回归模型,以分析与 HRQoL(EQ-5D-5L 为因变量)相关的关键心理社会因素。
总体而言,与 HRQoL 最强的独立相关因素是疾病认知(β=-0.52,P<0.001)。此外,综合感知力(β=0.14,P<0.05)与 HRQoL 独立呈正相关。此外,在对多种疾病进行分层后,当存在多种疾病时,疾病认知与 HRQoL 的负相关关系比不存在多种疾病时更强(β=-0.62,P<0.001 与 β=-0.38,P<0.001)。
本研究揭示了可改变的心理社会因素疾病认知和综合感知力与慢性疾病患者 HRQoL 之间的有趣关联。鉴于在未来几十年中慢性疾病的负担将会增加,因此需要设计和实施干预措施,增强患者的这些心理社会能力,特别是在患有多种疾病的患者中增强疾病认知能力,以降低慢性疾病对 HRQoL 受损的负担。