甲状腺疾病患者自我健康评价不佳的相关因素：来自印度老年纵向调查第一轮的结果
Factors linked to poor self-rated health in thyroid disorder patients: findings from LASI Wave-I.
作者信息
Kumar Pawan, Sen Arunima, Priyanshu Priyanshu, Khatib Mahalaqua Nazli, Roopashree R, Kaur Mandeep, Srivastava Manish, Barwal Amit, Siva Prasad G V, Rajput Pranchal, Shabil Muhammed, Syed Rukshar, Sharma Gajendra, Gaidhane Abhay M, Jena Diptismita, Bushi Ganesh, Mehta Rachana, Verma Amit, Serhan Hashem Abu, Neyazi Ahmad, Satapathy Prakasini
机构信息
Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Global Center for Evidence Synthesis, Chandigarh, India.
出版信息
Thyroid Res. 2025 May 13;18(1):21. doi: 10.1186/s13044-025-00229-8.
BACKGROUND
Thyroid disorders affect the physical, behavioural, and psychological aspects of an individual, leading to poor self-rated health (SRH). Hence, we aimed to determine the prevalence of poor SRH and the factors associated with it among thyroid disorder patients.
METHODS
This is an observational study consisting of 2336 thyroid disorder patients from LASI, 2017-19. Descriptive statistics were employed to calculate prevalence. The association between poor SRH and socio-demographic variables was evaluated using regression analysis, with results expressed as (AOR) and 95% CI.
RESULTS
The findings showed poor self-rated health predictors among thyroid disorder patients, where 25% rated their health as poor. Significant predictors included older age, with patients aged ≥ 75 years having a higher likelihood of reporting poor health (aOR = 2.36, 95% CI = 1.32-4.22, p = 0.004), and rural residence (aOR = 1.34, 95% CI = 1.07-1.67, p = 0.011). Belonging to the OBC caste (aOR = 1.57, 95% CI = 1.23-2.00, p < 0.001) and practicing Christianity (aOR = 1.90, 95% CI = 1.25-2.89, p = 0.003) were also associated with increased odds of poor SRH. Previous employment (aOR = 1.65, 95% CI = 1.20-2.25, p = 0.002), co-morbidities (aOR = 2.59, 95% CI = 1.88-3.59, p < 0.001), and lower education levels (aOR = 1.50, 95% CI = 1.06-2.13, p = 0.022) were significant. Limitations in activities of daily living and instrumental activities of daily living were linked to poorer health outcomes (aOR = 1.76, 95% CI = 1.33-2.31, p < 0.001; IADL: aOR = 1.41, 95% CI = 1.11-1.79, p = 0.004). Depression (aOR = 1.84, 95% CI = 1.32-2.56, p < 0.001) and healthcare utilization in the past year (aOR = 1.86, 95% CI = 1.33-2.58, p < 0.001) also predicted poor SRH, with most healthcare utilization (79.8%) occurring in private facilities.
CONCLUSION
The study highlights a high prevalence of poor SRH among patients, with significant associations observed with age, residence, comorbidity, and healthcare utilization. Targeted interventions focusing on healthcare access, physical activity, and mental health support are crucial to improve SRH.
背景
甲状腺疾病会影响个体的身体、行为和心理方面，导致自我健康评价较差（SRH）。因此，我们旨在确定甲状腺疾病患者中自我健康评价较差的患病率及其相关因素。
方法
这是一项观察性研究，纳入了2017 - 19年来自LASI的2336名甲状腺疾病患者。采用描述性统计来计算患病率。使用回归分析评估自我健康评价较差与社会人口学变量之间的关联，结果以调整后比值比（AOR）和95%置信区间表示。
结果
研究结果显示甲状腺疾病患者中存在自我健康评价较差的预测因素，其中25%的患者将自己的健康评为较差。显著的预测因素包括年龄较大，≥75岁的患者报告健康状况较差的可能性更高（调整后比值比 = 2.36，95%置信区间 = 1.32 - 4.22，p = 0.004），以及农村居住（调整后比值比 = 1.34，95%置信区间 = 1.07 - 1.67，p = 0.011）。属于其他落后阶层（调整后比值比 = 1.57，95%置信区间 = 1.23 - 2.00，p < 0.001）和信奉基督教（调整后比值比 = 1.90，95%置信区间 = 1.25 - 2.89，p = 0.003）也与自我健康评价较差的几率增加有关。以前有工作（调整后比值比 = 1.65，95%置信区间 = 1.20 - 2.25，p = 0.002）、合并症（调整后比值比 = 2.59，95%置信区间 = 1.88 - 3.59，p < 0.001）和较低的教育水平（调整后比值比 = 1.50，95%置信区间 = 1.06 - 2.13，p = 0.022）具有显著性。日常生活活动和工具性日常生活活动受限与较差的健康结果相关（调整后比值比 = 1.76，95%置信区间 = 1.33 - 2.31，p < 0.001；工具性日常生活活动：调整后比值比 = 1.41，95%置信区间 = 1.11 - 1.79，p = 0.004）。抑郁（调整后比值比 = 1.84，95%置信区间 = 1.32 - 2.56，p < 0.001）和过去一年的医疗服务利用情况（调整后比值比 = 1.86，95%置信区间 = 1.33 - 2.58，p < 0.001）也预测了自我健康评价较差，大多数医疗服务利用（79.8%）发生在私立医疗机构。
结论
该研究突出了患者中自我健康评价较差的高患病率，观察到其与年龄、居住、合并症和医疗服务利用存在显著关联。针对医疗服务可及性、身体活动和心理健康支持的有针对性干预对于改善自我健康评价至关重要。
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