Sociodemographic, disease status, and illness perceptions predictors of global self-ratings of health and quality of life among those with coronary heart disease - one year follow-up study
Sociodemographic, disease status, and illness perceptions predictors of global self-ratings of health and quality of life among those with coronary heart disease - one year follow-up study
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DOI：
10.1007/s11136-006-0010-3
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发表时间：
2006-10-01
影响因子：
3.5
通讯作者：
Elovainio, Marko
中科院分区：
文献类型：
--
作者：
Aalto, Anna-Mari;Aro, Arja R.;Elovainio, Marko
这项为期一年的随访研究（基线时n = 130，随访时n =2745，年龄45-74岁）检查了患者对冠心病（CHD）和疾病相关因素的感知与总体健康状况和总体生活质量（QOL）评分的关系。独立变量为CHD病史（心肌梗死、血运重建）、CHD严重程度（硝酸盐使用、CHD危险因素和合并症）和疾病认知。在多变量回归分析中，CHD病史和严重程度解释了基线时总体健康状况13%的变异和总体QOL评分8%的变异。疾病感知分别增加了18%和16%的解释方差的份额。在随访中，疾病的看法解释了一个显着的，但适度的份额变化的健康状况和生活质量的基线健康状况和生活质量和冠心病的严重程度进行了调整，更多的症状归因于冠心病，严重的感知后果的冠心病，以及弱信念的可控性冠心病是相关的整体健康状况和生活质量评分。在结构路径模型中，冠心病严重性因素的关联是由疾病感知介导的。疾病严重程度与因变量的关联较弱后，控制疾病的看法。CHD的认知表征有助于整体健康状况和QOL评级，并且它们还介导CHD严重程度和幸福感之间的关联。在疾病认知与健康状况或生活质量评分的相关性方面没有发现性别差异。
This one-year follow-up study (n = 130 at baseline, n =2745 at follow-up, aged 45-74 years) examined the relationship of patients' perceptions of coronary heart disease (CHD) and illness-related factors with global health status and global quality of life (QOL) ratings. The independent variables were CHD history (myocardial infarction, revascularisation), CHD severity (use of nitrates, CHD risk factors and co-morbidities) and illness perceptions. In multivariate regression analysis, CHD history and severity explained 13% of variance in global health status and 8% in global QOL ratings at the baseline. Illness perceptions increased the share of explained variance by 18% and 16% respectively. In the follow-up, illness perceptions explained a significant but modest share of variance in change in health status and QOL when baseline health status and QOL and CHD severity were adjusted for more symptoms being attributed to CHD, severe perceived consequences of CHD, as well as a weak belief in the controllability of CHD were related to poor global health status and QOL ratings. In structural path models associations of CHD severity factors were mediated by illness perceptions. The association of disease severity with dependent variables was weaker after controlling for illness perceptions. Cognitive representations of CHD contribute to both global health status and QOL ratings and they also mediate the associations between CHD severity and well-being. No gender differences were found in associations of illness perceptions with health status or QOL ratings.