Health-related quality of life among general practice patients with differing chronic diseases in Germany: cross sectional survey.
Health-related quality of life among general practice patients with differing chronic diseases in Germany: cross sectional survey.
复制标题
德国患有不同慢性疾病的全科医生的健康相关生活质量：横断面调查
DOI：
10.1186/1471-2458-8-246
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发表时间：
2008-07-21
影响因子：
4.5
通讯作者：
Gerlach FM
中科院分区：
文献类型：
--
作者：
Wang HM;Beyer M;Gensichen J;Gerlach FM
本研究旨在比较不同慢性病的全科患者与非慢性病患者的HRQL，评估德国全科患者的HRQL与一般人群的HRQL，并探讨不同慢性病对患者HRQL的影响，不受多个混杂变量的影响。方法采用横断面问卷调查，包括SF-36、EQ-5D和人口统计学问题。连续1009名年龄在15-89岁的患者参加。比较不同慢性病的全科患者与非慢性病患者的SF-36量表得分。分析患者与一般人群在SF-36量表/总分及情商-5D维度的比例上的差异。用多元线性回归和多项式回归模型分析慢性疾病和人口统计学变量对HRQL的独立影响。结果与无慢性病的对照组相比，有不同慢性病的全科患者的HRQL有更多的躯体健康损害。在德国，全科患者的SF-36得分明显低于普通人群(P<；0.001)，而在除自我护理维度(P<；0.001)之外的所有EQ-5D维度上，问题的比例都显著高于普通人群。全科患者的平均情商VAS低于普通人群(69.2vs77.4P<；0.001)。德国全科患者的生活质量受抑郁、背痛、膝骨性关节炎、癌症等疾病的影响比受高血压和糖尿病的影响更大。结论德国患有不同慢性病的全科患者的生活质量受损，尤其是身体健康。对HRQOL的独立影响因慢性病的类型而异。这项研究的发现可能有助于卫生专业人员从患者的角度关注初级保健中更有影响力的疾病。
BackgroundThis study was carried out to compare the HRQoL of patients in general practice with differing chronic diseases with the HRQoL of patients without chronic conditions, to evaluate the HRQoL of general practice patients in Germany compared with the HRQoL of the general population, and to explore the influence of different chronic diseases on patients' HRQoL, independently of the effects of multiple confounding variables.MethodsA cross-sectional questionnaire survey including the SF-36, the EQ-5D and demographic questions was conducted in 20 general practices in Germany. 1009 consecutive patients aged 15–89 participated. The SF-36 scale scores of general practice patients with differing chronic diseases were compared with those of patients without chronic conditions. Differences in the SF-36 scale/summary scores and proportions in the EQ-5D dimensions between patients and the general population were analyzed. Independent effects of chronic conditions and demographic variables on the HRQoL were analyzed using multivariable linear regression and polynomial regression models.ResultsThe HRQoL for general practice patients with differing chronic diseases tended to show more physical than mental health impairments compared with the reference group of patients without. Patients in general practice in Germany had considerably lower SF-36 scores than the general population (P< 0.001 for all) and showed significantly higher proportions of problems in all EQ-5D dimensions except for the self-care dimension (P< 0.001 for all). The mean EQ VAS for general practice patients was lower than that for the general population (69.2 versus 77.4,P< 0.001). The HRQoL for general practice patients in Germany seemed to be more strongly affected by diseases like depression, back pain, OA of the knee, and cancer than by hypertension and diabetes.ConclusionGeneral practice patients with differing chronic diseases in Germany had impaired quality of life, especially in terms of physical health. The independent impacts on the HRQoL were different depending on the type of chronic disease. Findings from this study might help health professionals to concern more influential diseases in primary care from the patient's perspective.