Department of Social Medicine, Faculty of Health, Medicine and Life sciences, Care and Public Health Research Institute Maastricht University, Maastricht 6200 MD, Limburg, Netherlands.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Nutrition and Translational Research in Metabolism, Maastricht 6200 MD, Limburg, Netherlands.
World J Gastroenterol. 2024 Jul 28;30(28):3418-3427. doi: 10.3748/wjg.v30.i28.3418.
The concept of positive health (PH) supports an integrated approach for patients by taking into account six dimensions of health. This approach is especially relevant for patients with chronic disorders. Chronic gastrointestinal and hepato-pancreatico-biliary (GI-HPB) disorders are among the top-6 of the most prevalent chronically affected organ systems. The impact of chronic GI-HPB disorders on individuals may be disproportionally high because: (1) The affected organ system frequently contributes to a malnourished state; and (2) persons with chronic GI-HPB disorders are often younger than persons with chronic diseases in other organ systems.
To describe and quantify the dimensions of PH in patients with chronic GI-HPB disorders.
Prospective, observational questionnaire study performed between 2019 and 2021 in 235 patients with a chronic GI-HPB disorder attending the Outpatient Department of the Maastricht University Medical Center. Validated questionnaires and data from patient files were used to quantify the six dimensions of PH. Internal consistency was tested with McDonald's Omega. Zero-order Pearson correlations and -tests were used to assess associations and differences. A value < 0.05 was considered significant.
The GI-HPB patients scored significantly worse in all dimensions of PH compared to control data or norm scores from the general population. Regarding quality of life, participation and daily functioning, GI-HPB patients scored in the same range as patients with chronic disorders in other organ systems, but depressive symptoms (in 35%) and malnutrition (in 45%) were more frequent in patients with chronic GI-HPB disorders. Intercorrelation scores between the six dimensions were only very weak to weak, forcing us to quantify each domain separately.
All six dimensions of PH are impaired in the GI-HPB patients. Malnutrition and depressive symptoms are more prevalent compared to patients with chronic disorders in other organ systems.
积极健康（PH）的概念支持通过考虑健康的六个维度为患者提供综合方法。这种方法对于患有慢性疾病的患者尤其相关。慢性胃肠道和肝胆胰（GI-HPB）疾病是受影响器官系统中最常见的前 6 种疾病之一。慢性 GI-HPB 疾病对个体的影响可能不成比例地高，原因如下：（1）受影响的器官系统经常导致营养不良状态；（2）患有慢性 GI-HPB 疾病的人通常比患有其他器官系统慢性疾病的人年轻。
描述和量化慢性 GI-HPB 疾病患者 PH 的各个维度。
这是一项在 2019 年至 2021 年期间在 235 名患有慢性 GI-HPB 疾病的患者中进行的前瞻性、观察性问卷调查研究，这些患者在马斯特里赫特大学医学中心的门诊部就诊。使用经过验证的问卷和患者档案中的数据来量化 PH 的六个维度。使用 McDonald's Omega 测试内部一致性。使用零阶 Pearson 相关系数和检验来评估关联和差异。值<0.05 被认为具有统计学意义。
与对照数据或一般人群的常模得分相比，GI-HPB 患者在 PH 的所有维度上的得分明显更差。在生活质量、参与度和日常功能方面，GI-HPB 患者的得分与其他器官系统慢性疾病患者相当，但慢性 GI-HPB 疾病患者的抑郁症状（35%）和营养不良（45%）更为常见。六个维度之间的相互关联评分仅非常弱到弱，迫使我们分别量化每个领域。
GI-HPB 患者的 PH 的所有六个维度都受损。与其他器官系统慢性疾病患者相比，营养不良和抑郁症状更为常见。
