住院糖尿病性视网膜病变患者生存质量现状及影响因素分析

发布时间：2018-09-12 20:37

【摘要】：目的:通过对住院糖尿病性视网膜病变(DR,diabetic retinopathy)患者生存质量的分析,探讨不同人口学特征的住院糖尿病性视网膜病变患者生存质量的现状;探讨影响其生存质量的相关因素,为提高糖尿病性视网膜病变患者生存质量提供理论依据。方法:采用一般情况调查表、视功能相关生命质量量表NEI-VFQ-25中文版对住院糖尿病性视网膜病变患者及糖尿病未患糖尿病性视网膜病变患者进行面对面问卷调查。采用便利抽样确定调查对象。调查内容包括受访对象的一般情况(性别、年龄、患病病程、职业、文化程度、婚姻状况、其他慢性病、家族史等)、视功能相关生命质量量表NEI-VFQ-25中文版。采用Epidata3.2软件建立数据库并进行数据录入,SPSS16.0统计软件包进行数据处理与分析;应用均数、标准差和构成比对数据进行统计描述;采用方差分析、t检验、相关性分析和线性回归对数据进行统计分析。结果:本研究共完成调查问卷395份,其中糖尿病未患糖尿病性视网膜病变患者136人,占总人数的34.43%;糖尿病性视网膜病变患者共259人,其中单纯型DR患者188人,占DR患者人数的72.59%;增殖型DR患者71人,占DR患者人数的27.41%。本次研究发放调查问卷400份,回收400份,回收率为100%。对所有问卷进行质量控制,剔除问卷中缺失值超过20%的5份问卷,问卷有效率达98.75%。在NEI-VFQ-25量表的信度方面,量表总体的Cronbach’α系数为0.840,各维度的Cronbach’α系数均大于0.7,表明NEI-VFQ-25量表在糖尿病性视网膜病变患者中有较好的内部一致性;量表的分半信度为0896,各维度均在0.6以上,表明NEI-VFQ-25量表在糖尿病性视网膜病变患者中的分半信度良好。同时,该量表在糖尿病性视网膜病变患者中有较好的内容效度及结构效度,各维度及其相关条目系数均大于0.6,P0.001。NEI-VFQ-25量表的研究结果表明,糖尿病未伴糖尿病性视网膜病变患者的生存质量得分高于DR患者;同时,单纯型DR患者的生存质量得分高于增殖型DR患者。性别、婚姻状况、文化程度、职业及家庭收入对DR患者的生存质量得分无影响(P0.05),但在糖尿病病程、是否接受胰岛素治疗、是否患其他慢性病方面,各维度的得分差异均有显著性意义(P0.05)。通过线性回归分析,结果表明空腹血糖水平、入院时收缩压、糖化血红蛋白、是否患有其他慢性病及是否注射胰岛素是影响糖尿病性视网膜病变患者生存质量的因素。结论:1、视功能相关生命质量量表NEI-VFQ-25中文版有良好的可行性、信度和效度,可用于糖尿病性视网膜病变患者的生存质量的测评。2、糖尿病性视网膜病变患者的生存质量最低,明显低于糖尿病未患视网膜病变患者。3、糖尿病性视网膜病变患者在不同性别、年龄、婚姻状况、文化程度、职业、家庭收入方面的生存质量得分差异无统计学意义;在糖尿病病程、是否接受胰岛素治疗、是否患其他慢性病方面,各维度的得分差异均有显著性意义。多因素分析结果表明,空腹血糖水平、入院时收缩压、糖化血红蛋白、是否患有其他慢性病及是否注射胰岛素是影响糖尿病性视网膜病变患者生存质量的因素。
[Abstract]:Objective: To analyze the quality of life of inpatients with diabetic retinopathy (DR) and explore the status quo of quality of life of inpatients with diabetic retinopathy with different demographic characteristics, and to explore the related factors affecting the quality of life so as to provide a basis for improving the quality of life of patients with diabetic retinopathy. METHODS: A face-to-face questionnaire survey was conducted on inpatients with diabetic retinopathy and diabetic patients without diabetic retinopathy by using the General Situation Questionnaire and the Chinese version of the Visual Function Related Quality of Life Questionnaire NEI-VFQ-25. Status (gender, age, course of disease, occupation, educational level, marital status, other chronic diseases, family history, etc.), Chinese version of visual function-related quality of life scale NEI-VFQ-25. Results: A total of 395 questionnaires were completed, including 136 diabetic patients without diabetic retinopathy (34.43%) and 259 diabetic patients with diabetic retinopathy (DR). 188 patients, accounting for 72.59% of the DR patients; 71 patients with proliferative DR, accounting for 27.41% of the DR patients. This study issued 400 questionnaires, 400 were recovered, the recovery rate was 100%. Quality control of all questionnaires, excluding five questionnaires with more than 20% missing value, the validity of the questionnaires was 98.75%. In terms of the reliability of NEI-VFQ-25, the quantity of the questionnaires was measured. The overall Cronbach'a coefficient of the table was 0.840, and the Cronbach'a coefficient of each dimension was greater than 0.7, indicating that the NEI-VFQ-25 scale had good internal consistency in patients with diabetic retinopathy; the half-reliability of the scale was 0.896, and all the dimensions were above 0.6, indicating that the NEI-VFQ-25 scale had a half-score in patients with diabetic retinopathy. At the same time, the scale had good content validity and structure validity in patients with diabetic retinopathy, and the coefficients of each dimension and related items were all greater than 0.6, P 0.001.NEI-VFQ-25 scale showed that the quality of life score of diabetic patients without diabetic retinopathy was higher than that of DR patients. The quality of life score of DR patients was higher than that of proliferative DR patients. Gender, marital status, education level, occupation and family income had no effect on the quality of life score of DR patients (P 0.05). However, there were significant differences in the course of diabetes, insulin treatment and other chronic diseases (P 0.05). Sexual regression analysis showed that fasting blood glucose level, systolic blood pressure at admission, glycosylated hemoglobin, other chronic diseases and insulin injection were the factors affecting the quality of life in patients with diabetic retinopathy. It can be used to evaluate the quality of life of patients with diabetic retinopathy. 2. The quality of life of patients with diabetic retinopathy is the lowest, significantly lower than that of patients without diabetic retinopathy. 3. The quality of life of patients with diabetic retinopathy in terms of gender, age, marital status, educational level, occupation and family income. There was no significant difference in the score between the two groups; there was significant difference in the course of diabetes, insulin treatment and other chronic diseases. Multivariate analysis showed that fasting blood glucose level, systolic blood pressure at admission, glycosylated hemoglobin, other chronic diseases and insulin injection were the main factors. Factors influencing quality of life in patients with diabetic retinopathy.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R587.2;R774.1

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