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中国藏族人群的健康相关生命质量及其变化:基于 2013 年和 2018 年国家卫生服务调查。

Health-related quality of life and its changes of the Tibetan population in China: based on the 2013 and 2018 National Health Services Surveys.

机构信息

Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.

NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.

出版信息

BMJ Open. 2023 Nov 19;13(11):e072854. doi: 10.1136/bmjopen-2023-072854.

Abstract

OBJECTIVE

Health-related quality of life (HRQoL) was an important health outcome measure for evaluating an individual's overall health status. However, there was limited in the literature on HRQoL and its long-term changes of the Tibetan population. This study aimed to assess HRQoL of Tibetan and its changes over time, and explore the differences in HRQoL for residents at different altitudes.

DESIGN

Data for the cross-sectional study were extracted from the fifth and sixth waves of the National Health Services Surveys which were conducted in 2013 and 2018. A multistage stratified cluster random sampling strategy was used to select representative participants.

SETTING

Tibet Autonomous Region in China.

PARTICIPANTS

This study recruited 14 752 participants in 2013 and 13 106 participants in 2018, and after excluding observations with missing values for key variables, 10 247 in 2013 and 6436 in 2018 were included in the study analysis.

PRIMARY AND SECONDARY OUTCOME MEASURES

The EQ-5D-3L was used to measure participants' HRQoL.

RESULTS

The mean health state utility scores of the participants were 0.969±0.078 and 0.966±0.077 in 2013 and 2018, respectively. Pain/discomfort was the most frequently prevalent issue reported in 18.1% and 17.9% of the participants in 2013 and 2018, respectively. Tibetans living 3500-4000 m altitude had the best HRQoL. Age, sex, employment status, educational attainment, chronic disease and weekly physical exercise were influencing factors associated with HRQoL.

CONCLUSIONS

The HRQoL of the Tibetan population was lower than the general Chinese population, and decreased over time between 5 years. There were differences in HRQoL among Tibetan at different altitudes, with residents living at 3500-4000 m having the best quality of life. More attention should be paid to those Tibetans who are older, female, unemployed and without formal education.

摘要

目的

健康相关生活质量(HRQoL)是评估个体整体健康状况的重要健康结果衡量标准。然而,有关藏人群体的 HRQoL 及其长期变化的文献有限。本研究旨在评估藏人群体的 HRQoL 及其随时间的变化,并探讨不同海拔地区居民 HRQoL 的差异。

设计

这项横断面研究的数据来自于 2013 年和 2018 年进行的第五次和第六次国家卫生服务调查。采用多阶段分层聚类随机抽样策略选择具有代表性的参与者。

地点

中国西藏自治区。

参与者

本研究于 2013 年招募了 14752 名参与者,于 2018 年招募了 13106 名参与者,在排除关键变量缺失值的观察值后,2013 年有 10247 名参与者和 2018 年有 6436 名参与者纳入研究分析。

主要和次要结果测量

使用 EQ-5D-3L 衡量参与者的 HRQoL。

结果

参与者的平均健康状态效用评分在 2013 年和 2018 年分别为 0.969±0.078 和 0.966±0.077。疼痛/不适在 2013 年和 2018 年分别有 18.1%和 17.9%的参与者最常报告。生活在 3500-4000 米海拔的藏民拥有最佳的 HRQoL。年龄、性别、就业状况、教育程度、慢性病和每周体育锻炼是与 HRQoL 相关的影响因素。

结论

藏人群体的 HRQoL 低于一般中国人群,并且在 5 年内随时间推移而下降。不同海拔地区的藏民 HRQoL 存在差异,生活在 3500-4000 米的居民生活质量最佳。应更加关注年龄较大、女性、失业和未受过正规教育的藏民。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13dd/10660197/3e35731c60bc/bmjopen-2023-072854f01.jpg

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