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影响下肢截肢者健康相关生活质量的因素:一项双中心横断面研究。

Factors Influencing the Health-Related Quality of Life Among Lower Limb Amputees: A Two-Center Cross-Sectional Study.

作者信息

Hando Deo J, Byomuganyizi Moses J, Ngendahayo John B, Khamisi Ramadhani H, Kivuyo Nashivai E, Kunambi Peter P, Mutajwaha JohnofGod L, Mushi Giliard R, Kitua Daniel W, Mwanga Ally H

机构信息

Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Department of Surgery, Muhimbili National Hospital, Dar es Salaam, Tanzania.

出版信息

East Afr Health Res J. 2023;7(1):121-126. doi: 10.24248/eahrj.v7i1.718. Epub 2023 Jul 12.

Abstract

BACKGROUND

Limb amputation is among the commonly performed surgical procedures known to have a significant impact on health-related quality of life (HRQoL). Nonetheless, factors influencing the HRQoL among amputees have not been extensively explored. We therefore conducted a study aiming at determining factors influencing the HRQoL among lower limb amputees.

METHODS

A cross-sectional study was conducted from May 2021 to December 2021 in two specialized hospitals located in Dar es Salaam, Tanzania. A total of 160 participants who exclusively underwent lower limb amputation(s) were recruited. Data was collected using a checklist incorporating the 36-Item Short Form Survey (SF-36) questionnaire. Multivariable linear regression analysis was performed to identify factors influencing the HRQoL.

RESULTS

The mean age of the study participants was 53.8 (±15.44) years; with males constituting 68.7%. The mean duration since amputation was 19.84 (±12.44) months. A relatively poor physical component summary score (PCS), as opposed to the mental component summary score (MCS) of the SF-36 was observed among the participants (42.0 vs. 59.3, respectively). Factors that positively influenced the PCS included achieving a college/university level of education, absence of stump pain, and the use of a prosthetic device or crutches. Conversely, factors that negatively influenced the PCS included increasing age and the absence of associated comorbid conditions. These factors accounted for 34.1% of the variance in the PCS. With reference to the MCS, post-amputation employment, longer durations since amputation, and the use of prostheses or crutches had a positive influence. However, having no associated comorbidity negatively influenced the MCS. These factors explained 26.5% of the variances in the MCS.

CONCLUSION AND RECOMMENDATIONS

The aforementioned factors should be addressed accordingly in order to ensure a holistic approach in the management of lower limb amputees. Moreover, longitudinal studies are recommended to systematically study the change in HRQoL over time and to assess its determinants.

摘要

背景

肢体截肢是常见的外科手术之一,已知对健康相关生活质量(HRQoL)有重大影响。尽管如此,影响截肢者HRQoL的因素尚未得到广泛探讨。因此,我们开展了一项研究,旨在确定影响下肢截肢者HRQoL的因素。

方法

2021年5月至2021年12月在坦桑尼亚达累斯萨拉姆的两家专科医院进行了一项横断面研究。共招募了160名仅接受过下肢截肢的参与者。使用包含36项简短调查问卷(SF-36)的清单收集数据。进行多变量线性回归分析以确定影响HRQoL的因素。

结果

研究参与者的平均年龄为53.8(±15.44)岁;男性占68.7%。截肢后的平均时长为19.84(±12.44)个月。参与者中观察到SF-36的身体成分总结得分(PCS)相对较差,与心理成分总结得分(MCS)相反(分别为42.0和59.3)。对PCS有积极影响的因素包括达到大专/大学教育水平、无残肢疼痛以及使用假肢或拐杖。相反,对PCS有负面影响的因素包括年龄增长和无相关合并症。这些因素占PCS方差的34.1%。关于MCS,截肢后就业、截肢后时长较长以及使用假肢或拐杖有积极影响。然而,无相关合并症对MCS有负面影响。这些因素解释了MCS方差的26.5%。

结论与建议

应相应地解决上述因素,以确保对下肢截肢者进行全面管理。此外,建议进行纵向研究,以系统地研究HRQoL随时间的变化并评估其决定因素。

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