功能障碍与自评健康的关联：一项考虑类型、来源和受限程度的巴西人群研究。
Association between impairment and self-rated heath: a brazilian population study considering type, origin, and degree of limitation.
机构信息
Universidade Federal do Rio Grande do Sul Programa de Pós-graduação em Epidemiologia, Rua Ramiro Barcelos 2400, CEP 90035-003, Porto Alegre, Brazil.
出版信息
BMC Public Health. 2023 Mar 28;23(1):580. doi: 10.1186/s12889-023-15445-w.
BACKGROUND
Perceived health is a well-known, low-cost measure in public health, and has been used in several studies on individuals with impairment. Although many studies have related impairment to self-rated health (SRH), few have considered the origin and degree of limitation of the impairment. This study examined whether physical, hearing, or visual impairments-when analyzed according to origin (congenital or acquired) and degree of limitation (with or without)-are associated with the SRH status.
METHODS
This cross-sectional study used data of 43,681 adult individuals from the Brazilian National Health Survey (NHS, 2013). The outcome SRH was dichotomized into poor (including the regular, poor, and very poor responses) or good (including the good and very good responses). Crude and adjusted (for socio-demographic characteristics and chronic diseases history) prevalence ratios (PR) estimates were evaluated using Poisson regression models with the robust variance estimator.
RESULTS
Poor SRH prevalence was estimated at 31.8% (95%CI:31.0-33.0) among the non-impaired population, 65.6% (95%CI:60.6-70.0) among individuals with physical impairment, 50.3% (95%CI:45.0-56.0) for people with hearing impairment, and 55.3% (95%CI:51.8-59.0) for the visually impaired. Individuals with congenital physical impairment-with or without limitations-presented the strongest association with the poorest SRH status. Participants with non-limiting, congenital hearing impairment showed a protective factor to poor SRH (PR = 0.40 95%CI: 0.38-0.52). Individuals with acquired visual impairment with limitations demonstrated the strongest association with poor SRH (PR = 1.48 95%CI:1.47-1.49). Among the impaired population, middle-aged participants showed a stronger association with poor SRH than older adult participants.
CONCLUSIONS
Impairment is associated with poor SRH status, especially among people with physical impairment. The origin and degree of limitation of each type of impairment differently impacts SRH among the impaired population.
背景
感知健康是公共卫生领域中一种广为人知的低成本衡量标准，已被用于多项有关身体残障人士的研究中。尽管许多研究已经将残障与自我报告健康状况（SRH）相关联，但很少有研究考虑到残障的起源和受限程度。本研究旨在检验身体、听力或视力障碍（根据起源（先天或后天）和受限程度（有或无）进行分析）是否与 SRH 状况相关。
方法
本横断面研究使用了巴西国家健康调查（NHS，2013 年）中 43681 名成年个体的数据。结局 SRH 被分为差（包括一般、差和很差）和良好（包括良好和很好）。使用泊松回归模型和稳健方差估计，评估了未经校正和校正（社会人口特征和慢性疾病史）后的粗患病率比（PR）估计值。
结果
在无残障人群中，差的 SRH 患病率估计为 31.8%（95%CI：31.0-33.0），身体残障者为 65.6%（95%CI：60.6-70.0），听力残障者为 50.3%（95%CI：45.0-56.0），视力残障者为 55.3%（95%CI：51.8-59.0）。有或无限制的先天性身体残障者与最差的 SRH 状况关联性最强。非限制的先天性听力障碍者呈现出对差的 SRH 的保护因素（PR=0.40 95%CI：0.38-0.52）。有受限的后天性视力障碍者与差的 SRH 关联性最强（PR=1.48 95%CI：1.47-1.49）。在残障人群中，中年参与者比老年参与者与差的 SRH 状况关联性更强。
结论
残障与差的 SRH 状况相关，尤其是在身体残障者中。每种类型的残障的起源和受限程度对残障人群的 SRH 状况有不同的影响。
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