Park Yeeun, Park Kyong
Department of Food and Nutrition, Yeungnam University, Gyeongsan, Gyeongbuk, Republic of Korea.
Front Psychol. 2023 Feb 9;14:1117369. doi: 10.3389/fpsyg.2023.1117369. eCollection 2023.
The unprecedented coronavirus disease 2019 (COVID-19) outbreak has resulted in a global crisis that negatively impacted physical well-being and mental health. Our goal was to investigate the impact of the COVID-19 pandemic on health-related quality of life (HRQoL) and depressive symptoms in patients with chronic diseases and the general population in Korea.
Data from 8341 patients with chronic diseases and 12,395 general population aged ≥20 years who participated in the Korea National Health and Nutrition Examination Survey (2017-2020) were analyzed. Patients with hypertension, dyslipidemia, diabetes, cerebrovascular disease (stroke), heart disease (myocardial infarction or angina pectoris), or cancer were classified as patients with chronic diseases. The general population was defined as those not suffering from corresponding chronic diseases. A modified EuroQol-5 Dimensions (EQ-5D), with three levels (0: extreme problems; 0.5: some problems; 1: no problems) for each dimension in EQ-5D, was used to assess HRQoL. To analyze depressive symptoms among patients with chronic diseases and the general population, we used the Patient Health Questionnaire-9 (PHQ-9) and defined a PHQ-9 score ≥ 10 as having a depressive symptom. Multivariate linear and logistic regression analyses were used to analyze HRQoL and depressive symptoms before and during the COVID-19 pandemic.
The HRQoL level was significantly lower in patients with chronic diseases compared to the general population on all dimensions both before and during the COVID-19 pandemic (all value of < 0.05). Patients with chronic diseases had significantly lower HRQoL levels associated with the anxiety/depression dimension during the COVID-19 pandemic than in the pre-pandemic period (0.940 ± 0.002 vs. 0.929 ± 0.004, value of = 0.041). In addition, patients with chronic diseases were more likely to report depressive symptoms during the COVID-19 pandemic than in the pre-pandemic period (Odds ratio (OR): 1.755, 95% confidence interval (CI): 1.209-2.546, value of = 0.003). However, this association was not observed in the general population (OR: 1.275, 95% CI: 0.933-1.742, value of = 0.13).
The COVID-19 pandemic affected the HRQoL and psychological health in patients with chronic diseases with higher anxiety/depression during the pandemic than in the pre-pandemic period. These results suggest that it is urgent to establish continuous management guidelines, including psychosocial management for high-risk groups, and to improve the existing healthcare system.
2019年新型冠状病毒病（COVID-19）的爆发引发了一场全球危机，对身体健康和心理健康产生了负面影响。我们的目标是调查COVID-19大流行对韩国慢性病患者和普通人群健康相关生活质量（HRQoL）及抑郁症状的影响。
分析了参与韩国国家健康与营养检查调查（2017 - 2020年）的8341例慢性病患者和12395名年龄≥20岁的普通人群的数据。患有高血压、血脂异常、糖尿病、脑血管疾病（中风）、心脏病（心肌梗死或心绞痛）或癌症的患者被归类为慢性病患者。普通人群定义为未患有相应慢性病的人群。使用改良的欧洲五维健康量表（EQ - 5D），其中EQ - 5D的每个维度有三个级别（0：极端问题；0.5：有些问题；1：没有问题）来评估HRQoL。为了分析慢性病患者和普通人群中的抑郁症状，我们使用了患者健康问卷 - 9（PHQ - 9），并将PHQ - 9评分≥10定义为有抑郁症状。采用多变量线性和逻辑回归分析来分析COVID - 19大流行之前和期间的HRQoL及抑郁症状。
在COVID - 19大流行之前和期间，慢性病患者在所有维度上的HRQoL水平均显著低于普通人群（所有 值<0.05）。与大流行前相比，慢性病患者在COVID - 19大流行期间与焦虑/抑郁维度相关的HRQoL水平显著降低（0.940±0.002 vs. 0.929±0.004， 值 = 0.041）。此外，与大流行前相比，慢性病患者在COVID - 19大流行期间更有可能报告抑郁症状（优势比（OR）：1.755，95%置信区间（CI）：1.209 - 2.546， 值 = 0.003）。然而，在普通人群中未观察到这种关联（OR：1.275，95% CI：0.933 - 1.742， 值 = 0.13）。
COVID - 19大流行影响了慢性病患者的HRQoL和心理健康，大流行期间的焦虑/抑郁程度高于大流行前。这些结果表明，迫切需要建立持续管理指南，包括对高危人群的心理社会管理，并改善现有的医疗保健系统。
