晚期血吸虫病患者生存质量及其影响因素

目的 目的 评估青浦区晚期血吸虫病 （晚血） 患者生存质量, 了解其影响因素。方法 方法 采用WHOQOL?BREF量表进行问卷调查, 同时收集调查对象人口学特征、 家庭背景、 患病情况、 健康状况及医疗服务利用等信息。结果 结果 217例晚血患者男女性别比为2 ∶5, 平均年龄75.33±6.94岁, 农民占89.86%, 文盲半文盲占75.58%, 巨脾型占88.94%。患者生存质量和健康状况总体评价得分中等以上的分别为61.29%和45.16%, 两者得分差异有统计学意义 （t = 7.804, P＜0.01）; 生存质量各领域得分均数差异有统计学意义 （χ2=23.46, P＜0.01）。在不同诊断年份、 不同临床分型间生存质量各领域评分差异均无统计学意义 （P均＞0.05）。Logistic回归多元分析显示定期参加体育锻炼或体力劳动对4领域评分均有影响, 近2周疾病急性发作、 长期服用治疗性药物、 婚姻状态和年龄等因素对相应领域评分有影响。总体生存质量及生理、 心理、 社会关系和环境4个领域评分为中等及以上水平, 但生理领域评分低于其他3个领域。结论 结论 青浦区晚血患者的生存质量尚可。为患者提供有效的社区卫生服务和鼓励参加适度的体育、 体力活动, 是提高生存质量的重要途径。

Quality of life and its influencing factors of advanced schistosomiasis patients in Qingpu District,Shanghai

Objective To assess the quality of life （QOL） of advanced schistosomiasis patients, and understand its influencing factors. Methods A questionnaire survey was carried out by using WHOQOL-BREF, and the information of demography, family, illness, health status, and health service was collected. Results Among the 217 advanced patients, the average age was （75.33＋6.94） years, the ratio of male to female was 2：5, 89.86% of them were farmers, 75.58% were illiterate or semilliterate, and 88.94% belonged to the splenomegaly type. Totally 61.29% of the cases had the scores over average for the overall QOL, but the scores for the health and well-being were lower. There were a significant difference among the average scores of different do- mains of QOL （ X2 = 23.46, P 〈 0.01 ）. Both the year of being diagnosed and clinical classification was not associated with the scores of QOL. Regularly taking physical activities was significantly associated with each of all the 4 domains. The factors such as onset of acute disease in 2 weeks, taking therapeutic pills daily, marital status, age, etc. impacted the specific domains of QOL. The overall QOL and the 4 domains of the patients were at medium level; meanwhile, the score of physiological domain was lower than the scores of the other 3 domains. Conclusions The QOL（s） of advanced schistosomiasis patients in Qingpu District are relatively good. It is important to provide effective community health services and encourage the patients to take part in tempered sports or physical activities in order to keep their normal activities of daily living.