Functional impairment associated with psychological distress and medical severity in rural primary care patients
Functional impairment associated with psychological distress and medical severity in rural primary care patients
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DOI：
10.1176/ps.49.7.951
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发表时间：
1998-07-01
影响因子：
3.8
通讯作者：
Hollifield, M
中科院分区：
文献类型：
--
作者：
Thurston-Hicks, A;Paine, S;Hollifield, M
目的：本研究调查了农村初级保健人群中与心理困扰和疾病严重程度相关的功能损害，并探讨了心理困扰和慢性疾病对功能损害的影响。方法：从三个农村初级保健诊所招募的58名患者完成了36项简明健康调查表（SF-36）和精神痛苦类型学（PsyDis），慢性病评分，衡量慢性医学疾病的严重程度，根据6个月内使用处方药的数据计算。T检验用于确定与不同程度的心理困扰和医学疾病相关的功能障碍水平。回归分析被用来确定解释的心理困扰和严重程度的医疗疾病的损害的方差的比例。结果如下：高水平的心理困扰解释了SF-36测量的几个领域的损伤差异，包括一般健康，社会功能，情感角色和心理健康，而高水平的慢性疾病严重程度解释了身体功能损伤的差异。高心理困扰和慢性疾病的严重程度高解释了活力受损的方差，没有变量解释了身体作用或身体疼痛受损的方差。结论：在这个农村门诊初级保健人群中，功能障碍更多地被解释为心理困扰，而不是医疗疾病的严重程度。减少初级保健患者的心理困扰负担可能会改善功能。
Objective: The study examined functional impairment associated with psychological distress and severity of medical illness in a rural primary care population and explored ho rv functional impairment varied with psychological distress and chronic medical illness. methods: Fifty-eight patients recruited from three rural primary care clinics completed the 36-item Short Form Health Survey (SF-36) and the Typology of Psychic Distress (PsyDis), The chronic disease score, a measure of the severity of chronic medical illness, was calculated from data on use of prescription medications over a six-month period. T tests were used to determine the level of functional impairment associated with various levels of psychological distress and medical illness. Regression analyses were used to determine the proportion of variance in impairment that was explained by level of psychological distress and severity of medical illness. Results: High levels of psychological distress explained the variance in impairment in several domains measured by the SF-36, including general health, social functioning, emotional role, and mental health, whereas a high level of severity of chronic medical illness explained the variance in impairment in physical functioning. Both high psychological distress and high severity of chronic medical illness explained the variance in impairment in vitality, and neither variable explained variance in impairment in physical role or bodily pain. Conclusions: In this rural outpatient primary care population, functional impairment was explained more by psychological distress than by severity of medical illness. Decreasing the burden of psychological distress among primary care patients may improve functioning.