我国农村地区老年人生命质量调查与分析

目的：了解我国农村地区老年人的健康相关生命质量,探索其与社会经济、人群健康行为之间的关系。方法：应用欧洲五维度健康量表及直观式健康量表开展老年人生命质量的测量与分析。结果：农村地区老年人总体生命质量明显低于一般人群,配偶健在、有亲友同住、家庭收入水平较好情况下,均有较高的生命质量,低龄老人健康优于75岁以上高龄老人,有慢性病的老年人生命质量较差。结论与建议：农村老年人生命质量的提高需要家庭、政府、社会等多方的共同努力,尤其要关注高龄老人、独居及丧偶老人的身心健康;政府部门除了要加大对低收入老年人的医疗和生活救助外,还要重视老年保健服务,最大限度地提高老年人群的生命质量。     

杭州市居民健康相关生命质量评价及影响因素分析

目的 评价杭州市居民的健康相关生命质量并分析可能影响健康的因素,为提高居民健康水平提供有效的对策建议。方法 于2019年通过多阶段分层随机抽样,对杭州市8个区（县）共5 816名杭州户籍居民开展问卷调查。应用欧洲五维健康量表（EQ-5D）评价调查对象健康相关生命质量。采用R 3.6.2和Stata 15.0软件进行统计学分析。基于中国人群的效用积分体系,将量表评分转换成个体健康效用值,通过Tobit右截断回归模型分析可能影响健康相关生命质量的因素。结果 EQ-5D量表的5个维度自评中,身体疼痛或不适对健康自评影响最大,男性疼痛或不适的比例为11.33%,女性为12.28%。女性焦虑或抑郁的比例（4.85%）高于男性（3.97%）,差异有统计学意义（P<0.05）。市区居民在行动能力、日常活动、身体疼痛或不适的健康自评情况方面好于郊县居民,差异均有统计学意义（P<0.05,P<0.01）。调查对象的自评健康效用值范围为-0.15～1.00,有82.82%调查对象的自评健康效用值得分为1.00。Tobit右截断回归模型回归分析结果表明,女性（β=-0.011,95%CI:...     

基于欧洲五维健康量表的深圳市中老年社区居民生命质量现状及影响因素研究

目的 运用欧洲五维健康量表(European quality of life　5-dimensions,EQ-5D)研究深圳市坪山区中老年人健康相关生命质量(health-related quality of life,HRQOL)及其影响因素。 方法 对研究对象进行问卷调查,采用多重线性回归分析HRQOL的影响因素。 结果 共纳入942名中老年社区居民,回收有效问卷932份,EQ-5D指数和EQ-VAS得分分别为(0.81±0.06)和(77.49±13.93)。多重线性回归分析结果显示,自身或一级亲属未患慢性病、男性、参加体育锻炼、饮食习惯未改变、年龄≥70岁、脑力劳动、每日睡眠时间≥6 h者EQ-5D指数较高,β分别为-0.019、-0.011、0.010、0.014、-0.015、-0.016、0.014和0.011;自身未患慢性疾病、参加体育锻炼、有饮茶史、饮食习惯未改变、每日睡眠时间≥8 h、城镇居民基本医疗保险者EQ-VAS得分较高,β分别为-6.199、3.533、2.600、-2.898、2.578、2.909,P均<0.05。 结论 深圳市坪山区中老年人的HRQOL总体较好,应对患慢性病、女性、不参加体育锻炼、不饮茶、饮食习惯已发生改变、年龄超过70岁、从事体力劳动和睡眠时间小于6 h的中老年人给予更多的关注和照料,以提高中老年人的HRQOL。     

基于EQ-5D的江苏省某贫困县中老年健康相关生命质量评价研究

目的 探讨贫困县弱势中老年人群的健康相关生命质量现况及其影响因素,为精准健康扶贫及改善慢性病管理水平提供证据.方法 基于欧洲五维健康评定量表(EQ-5D)和自设问卷,于2019年7月采用多阶段随机抽样的方法抽取江苏省丰县445名中老年人展开调查.运用秩和检验、CLAD回归模型等进行数据统计分析.结果 丰县贫困人群健康相...     

内蒙古地区中老年糖尿病患者生命质量及其影响因素分析

目的 评价内蒙古地区中老年糖尿病患者生命质量现状及其影响因素,以期为改进内蒙古地区糖尿病的预防与控制措施提供科学依据,改善糖尿病患者生命质量。方法 采用多阶段整群抽样方法于2015年7月至2017年6月期间在内蒙古自治区调查6个项目点的年龄为45～75岁间既往被诊断为糖尿病的居民。采用欧洲五维生命质量量表（European quality of life 5-dimensions, EQ-5D）、中国 EQ-5D量表测算时间权衡法（TTO）效用值换算表对糖尿病患者生命质量进行评分。采用Mann-Whitney秩和检验、Tobit回归分析中老年糖尿病患者生命质量的影响因素。结果 内蒙古地区糖尿病患者的控制率11.67%,EQ-5D效用值为1的占57.96%,其中是否有心血管病史（Z=-5.423, P<0.001）、是否服用降糖药（Z=-2.758, P=0.006）、文化程度不同（Z=6.296, P=0.043）的糖尿病患者生命质量评分比较,差异有统计学意义,且有心血管病史（t=-5.574, P<0.001）和具有小学及以下的文化水平（t=2.387, P=0.017）是糖尿病患者生命质量的危险因素。结论 医疗服务机构应着重根据有关影响因素采取相应控制措施,加强基层糖尿病患者健康管理,以改善其生命质量。     

健康相关生命质量简介及其国际应用

健康相关生命质量(HRQOL)是近年来发展起来的一种全新的医学概念,在国外已得到广泛的应用.本文综述健康相关生命质量的定义、量表及其应用.     

新医改十年甘肃省糖尿病患者健康相关生命质量及其影响因素研究

目的:调查新医改前后甘肃省糖尿病患者健康相关生命质量（HRQoL）并分析其影响因素,为提高糖尿病患者HRQoL提供科学依据。方法:利用新医改前（2008年）及医改后（2018年）在甘肃省开展的第四次、第六次国家卫生服务入户调查数据,采用基于我国的欧洲五维健康量表（EQ-5D）效应值积分体系计算EQ-5D健康效用指数。结...     

基于欧洲五维健康量表的2型糖尿病患者健康相关生命质量研究

目的 评价山东省潍坊市2型糖尿病患者生命质量并探讨其影响因素。方法 采用分层随机抽样的方法,于2022年7～9月对潍坊市4所医疗机构内分泌门诊患者进行调查,调查内容包括一般情况、EQ-5D-5L量表多维度评价生命质量,计算健康效用值,采用Tobit回归模型分析影响因素。结果 纳入2型糖尿病患者397人,健康效用值(0.82±0.21分)、视觉刻度尺(visual analogue scale, VAS)得分(79.47±12.81分)。研究对象人群疼痛或不舒服、焦虑或沮丧问题较为突出。年龄、糖尿病并发症、BMI、日常需要照顾、社会支持、日常血糖控制水平是2型糖尿病患者健康相关生命质量的影响因素。结论 在实际治疗过程中,应重点保护老年2型糖尿病患者,预防与控制糖尿病并发症的发生发展,做好日常血糖控制,以进一步提高居民健康相关生命质量。     

上海市社区老年居民健康相关生命质量及影响因素分析

【目的】了解上海市社区老年居民健康相关生命质量及其影响因素,为提高上海市居民整体健康水平提供依据。【方法】于2021年4—6月在上海市宝山、闵行、松江以及浦东新区的5家社区卫生服务中心采用整群抽样的方法开展调查,以在调查时间内接受体格检查的≥65岁老年人为研究对象,借助欧洲五维健康评定量表（EQ-5D-5L）进行面对面问卷调查。采用SPSS 26.0和Stata 16软件进行统计分析。分别采用二元logistic回归、多重线性回归、Tobit回归分析EQ-5D-5L量表各维度问题发生情况、视觉模拟评分（EQ-VAS）、健康效用值的影响因素。【结果】研究共纳入1 302名老年居民,EQ-5D-5L量表5个维度存在问题比例从高到低依次是疼痛/不适（13.9%）、行动能力（9.1%）、日常活动能力（5.8%）、自我照顾能力（4.8%）和焦虑/沮丧（3.6%）,而年龄是各个维度存在问题的相关因素。EQ-VAS平均得分为（84.28±10.32）分,基于中国人群转换后的健康效用值平均为（0.97±0.08）,高于国内其他地区。Tobit回归结果显示,女性（t=-3.96,P<0.001）、...     

Deteriorating health status in Stockholm 1998–2002: results from repeated population surveys using the EQ-5D

Rationale, aim and methodology In order to measure the change in health status in Sweden, the generic health-related quality of life instrument, the EQ-5D, was included in the 1998 (n = 4,950) and 2002 (n = 49,914) cross-sectional postal Public Health Surveys, a representative sample (21–84 years) of the Stockholm County population, with response rates about 63% in both years. The EQ-5D provides data on five dimensions of health as well as an overall index value (1 = full health; 0 = dead). Results Over time the health index decreased statistically significantly from 0.858 to 0.841 for men and from 0.833 to 0.797 for women. Women had significantly more health problems in 2002 in four out of the five dimensions, with the largest increase in the dimensions anxiety/depression (33–43%) and pain/discomfort (47–53%). The health index was significantly lower in all age-groups for women. Men had significantly more health problems 2002 in two dimensions, and the largest increase in anxiety/depression (24–31%). The health index decreased significantly over time for younger men. Conclusion The observed deterioration in health status over time gives reason for concern. Investigation of reasons for the declining health status should be a research priority. The 1998 and 2002 Public Health Surveys in Stockholm County     

我国农村地区高血压患者生命质量评价

目的:分析我国农村高血压患者生命质量及影响因素,为提高其健康水平、制定我国农村高血压病管理提供参考。方法:使用EQ-5D量表测量生命质量,数据使用SPSS16.0进行统计分析。结果:高血压病降低生命质量;对日常活动影响最大;高血压病对女性和中青年生命质量影响大。结论:应重视农村高血压病管理,在制定防制措施时,重点关注女性、中青年群体。     

Variation in Chinese population health related quality of life: Results from a EuroQol study in Beijing,China

The purpose of this study is to measure Chinese population health related quality of life (HRQoL) using European quality of life (EQ-5D) instrument, to examine the validity of EQ-5D in measuring Chinese population HRQoL, to explore the relationships between EQ-5D and other health determinants, and to display the similarities and differences of HRQoL between the Chinese population and the populations of other countries. The data used in this study includes 2994 respondents whose age are 12 years and older, which is from the 2000 Beijing Household Health Survey. Univariate and bivariate analyses have been used to examine the level of HRQoL and the relationships between HRQoL and other variables. Multi-variate analyses have been used to explore the relationships between the EQ-5D Visual Analogue Scale (VAS) and the EQ-5D five dimension indicators. There are four principal findings from this study. First, the EQ-5D instrument is a valid measure for Chinese HRQoL, but with a significant ceiling effect. Second, Pain/Discomfort and Anxiety/Depression are the major Chinese HRQoL problems and the extents of these problems differ in subgroup populations. Third, typically mean scores are lower for older age group; this is observed at lower ages in the Chinese population than in populations from developed countries. Fourth, Chinese HRQoL has strong association relationship with population socio-economic status (SES), which might imply that issues brought on by the rapid economic transition have both positive and negative impacts on Chinese HRQoL.     

Socioeconomic variation in the impact of obesity on health-related quality of life

There is evidence that obesity has a negative impact on health-related quality of life (HRQL). However, little attention has been paid to variations in this impact between population groups. This study investigates the relationship between HRQL and obesity, and whether or not this relationship varies by socioeconomic status (SES). Data were taken from four rounds of the Health Survey for England (2003-2006; n = 33,716) for persons aged 16 and above. Banded total annual household income is regressed against a comprehensive set of SES indicators using interval regression. We use the equivalised predicted values from this model, categorised into quartiles, as our measure of SES. We regress EQ-5D scores against interactions between body mass index and SES categories. Obesity is negatively correlated with HRQL. The negative impact of obesity is greater in people from lower SES groups. Overweight and obese people in lower SES groups have lower HRQL than those of normal weight in the same SES group, and have lower HRQL than those in higher SES groups of the same weight. This trend is also observed after controlling for individual and household characteristics, although the statistical significance and magnitude of effects is diminished.     

四川省空巢老人生命质量及影响因素研究

目的 了解四川省空巢老人的生命质量现状并探讨其影响因素,为提高空巢老人生命质量提供参考依据。 方法 本资料来源于2018年国家第六次卫生服务调查四川省调查数据,健康相关生命质量用EQ-5D效用值和EQ-VAS得分进行衡量。采用两水平方差成分模型探索空巢老人生命质量的影响因素。结果 共调查4587名空巢老人, EQ-5D 效用值平均为(74.05±1.39) 分,VAS评分平均为(66.54±0.278) 分。年龄较小、文化程度较高、就业状态为在业、12个月内未饮酒、经常参加体育锻炼、无高血压和糖尿病的空巢老人EQ-5D效用值较高。结论 空巢老人的生命质量整体偏低。可通过倡导健康行为、提高健康意识、加强慢性病防控等途径来提高空巢老人生命质量。     

基于EQ-5D量表的子宫颈癌患者生命质量评价

目的:测算子宫颈癌患者生命质量,为临床实践中子宫颈癌治疗方案的选择和子宫颈癌患者生命质量的提高提供参考依据。方法:选取276名子宫颈癌患者为研究对象,所有病例均经病理学确诊。采用欧洲五维度健康量表(EQ-5D)评价子宫颈癌患者生命质量。结果:子宫颈癌CIN2及以下患者量表指数(Index)评分为(0.916 5±0.013 3)分、视觉模拟尺度(VAS)评分为(86.23±11.13)分,接近正常女性人群评分。但随着子宫颈癌病理和临床分期的提高,Index评分逐渐降低,分别由0.916 5分降至0.872 3分和由0.913 8分降至0.868 9分;VAS评分亦逐渐降低,分别由83.09分降至64.97分和86.23分降至65.37分。不同的治疗方法后子宫颈癌患者的生命质量亦有差异。Index得分由低到高依次为:子宫颈癌根治术+化疗、单纯化疗、子宫颈癌根治术、子宫全切术、子宫颈锥切术。VAS得分由低到高依次为:子宫颈癌根治术+化疗、子宫颈癌根治术、单纯化疗、子宫全切术、子宫颈锥切术。除子宫颈癌根治术与单纯化疗略有交叉外,其他治疗方案得分顺序相同。结论:随着子宫颈癌患者病情的加重,生命质量不断降低,提示子宫颈癌早期诊断和治疗可以显著改善子宫颈癌患者的生命质量。实施不同治疗方案的子宫颈癌患者的生命质量不同,提示患者生命质量也应作为临床实践中治疗方案的选择依据。     

The social tariff of EQ-5D is not adequate to assess quality of life in patients with low back pain

Background

We compared the quality of life perceived by patients with non-specific low back pain with that predicted by the social tariff of the Spanish version of EQ-5D questionnaire.

Methods

For each health state of the EQ-5D, an adjusted tariff for patients with back pain was obtained using a linear regression model in which the linear effect of the three levels of response for each of the five domains of the EQ-5D was assumed. These coefficients were compared with those obtained for the general Spanish population. In another model, equal in structure to the standard “Dolan N” model, the linear effect of the five domains was not assumed.

Results

In 633 patients, 93 health states were recorded. Significant differences in the coefficients of self-care (p = 0.003) and the maximum level of severity in any dimension (p < 0.0001) were observed. The social tariff of the healthy population is different from the tariff of low back pain patients, with general population values being lower than those of patients, particularly in the 211 health states in which any dimension is at level 3. Weights of the different EQ-5D dimensions showed a non-linear effect on the patients’ quality of life.

Conclusion

Methods used to develop the social tariff for the Spanish version of EQ-5D were inadequate. In addition, this study shows that values given by the general population are different from those of low back pain patients, further confirming that the social tariff of EQ-5D should not be used with actual patients.     

哈尔滨市农村癫痫患者健康相关生命质量评价研究

目的 评价哈尔滨市农村癫痫患者健康相关生命质量并分析其影响因素。方法 通过简单随机抽样方法,随机选取哈尔滨市236例惊厥型癫痫患者,基于中国人群的EQ-5D效应值积分体系计算癫痫患者健康效应值,采用秩和检验和Tobit回归模型方法对癫痫患者健康水平影响因素进行分析。结果 调查的236名癫痫患者在5个维度有困难者占比排序为:焦虑或沮丧（42.74%）、疼痛或不适（30.77%）、日常活动（28.63%）、自己照顾自己（18.80%）、行动（16.67%）,基于中国积分体系计算癫痫患者健康效应值为0.85,Tobit回归模型结果表明,职业（95%CI = 0.004～0.313,P = 0.045）、体育运动（95%CI = 0.001～0.438,P = 0.049）、最近一次发作时间（95%CI = - 0.316～- 0.020,P = 0.027）、总病程（95%CI = - 0.051～- 0.387,P = 0.011）对癫痫患者的健康效用值得分有统计学差异。结论 癫痫对患者心理方面的影响程度大于生理方面,应加大对癫痫患者心理方面的关注。脑力劳动者、体育运动的癫痫患者健康效用值相对较高,发作时间在0～3个月内、总病程较长的癫痫患者健康效用值相对较低。     

Evaluating podiatry services: Testing a treatment specific measure of health status

This study reports on the preliminary testing of a new measure designed for use alongside EQ-5D in evaluating outcomes in podiatry: the Podiatry Health Questionnaire (PHQ). Individuals aged 18 years or more, receiving podiatry services in clinic or domicilliary locations across four NHS Trusts in Yorkshire and Humberside UK took part in a questionnaire survey. Respondents reported high levels of problems on all six PHQ dimensions. Correlations suggested that the PHQ and EQ-5D were measuring distinct constructs. The levels on each dimension were well defined in terms of self-rated morbidity on the PHQ visual analogue scale (PHQ_vas) and the EQ-5D_vas, although PHQ_vas appeared to be slightly more sensitive to changes in health on the dimensions. There was a strong relationship between clinicians' Podiatry Clinical Score rating and reported symptoms for four out of six PHQ dimensions and PHQ_vas. The PHQ was able to distinguish respondents in terms of their self-reported morbidity in EQ-5D and in terms of their morbidity as assessed by clinicians. It is suggested that the respondent completed PHQ appears to be a useful new measure for assessing foot-related health. However, further investigation of the psychometric properties of the measure is required.