基于EQ-5D量表的连云港农村地区高血压患者生命质量评价

发布时间：2018-04-02 13:28

本文选题：高血压　切入点：生命质量　出处：《安徽医科大学》2017年硕士论文

【摘要】：目的:以欧洲五维健康量表为工具,调查连云港市东海县农村地区高血压患者生理、心理等不同维度的生命质量情况,探讨影响生命质量的因素,为当地农村高血压患者的健康管理提供依据。方法:2016年7月至9月期间,在连云港市5个乡镇(石榴街道、青湖镇、洪庄镇、温泉镇、张湾乡)抽取2125名高血压患者作为研究对象,组织到当地乡镇卫生院进行血压测量、体格检查和问卷调查,收集患者的一般情况及血压情况,应用欧洲生存质量测定量表评价患者的生命质量。Epidata3.1建立数据库,将原始数据双录入,确保正确性,采用SPSS16.0软件对数据进行描述,分析生命质量的影响因素。EQ-5D评分采用英国TTO效用值换算表法。结果:(1)本次调查研究对象的收缩压和舒张压平均水平分别是(146.66±12.69)mm Hg、(94.37±12.01)mm Hg。降压药物服用率达到63.0%,血压控制率13.1%。(2)EQ-5D量表五个维度:行动能力报告有困难者327人(15.3%);自理能力报告有困难者103人(4.8%);日常生活能力报告有困难者211人(9.9%);疼痛/不适报告有困难者960人(45.1%);焦虑/抑郁报告有困难者358人(16.9%)。本次调查研究对象的主要生命质量问题是在疼痛/不适以及焦虑/抑郁两个维度。利用英国的TTO换算表得出的EQ-5D总评分(0.839±0.217),评分范围(-0.349~1)。行动能力(0.011±0.026),自理能力(0.005±0.025),日常生活能力(0.004±0.014),疼痛/不适(0.066±0.089),焦虑/抑郁(0.015±0.041)。(3)不同乡镇高血压患者EQ-5D各个维度出现困难的比例有差异,石榴街道的患者在除行动能力之外的维度出现困难的比例都最高。血压正常组在行动能力、日常生活能力两个维度出现困难的比例均比血压异常组高。单纯收缩期高血压在行动能力维度出现困难的比例最高。(4)行动能力出现困难的保护因素是:受教育程度、月平均收入,危险因素是:年龄、高血压病程;自理能力出现困难的保护因素是:性别、月平均收入,危险因素是:职业;日常生活能力出现困难的保护因素是:月平均收入、血压等级,危险因素是:职业、高血压病程;疼痛/不适出现困难的保护因素是:月平均收入,危险因素是:性别、婚姻状况、高血压病程;焦虑/抑郁出现困难的保护因素是:年龄、月平均收入,危险因素是:性别、受教育程度。(5)EQ-5D指数总评分(0.839±0.217)较高,EQ-VAS平均(70.06±19.04)分,患者健康状态自我感觉良好。EQ-5D总评分与EQ-VAS评分具有相关性。(6)EQ-5D总评分的影响因素有性别、月平均收入、婚姻状况、高血压病程,EQ-VAS评分的影响因素有性别、BMI、月平均收入、高血压病程、是否服用高血压药。结论:本次调查地区高血压患者生命质量较好,不同乡镇间患者生命质量不同,政府仍需加大投入力度,保障居民的生命质量,患者本身也要加强高血压管理,改变不合理的行为生活方式,增强高血压危险意识,定期测量血压,按时按量服药,提高自身生命质量。
[Abstract]:Objective: to investigate the quality of life (QOL) of hypertensive patients in rural areas of Donghai County, Lianyungang City by using the European five dimensional Health scale (E5-DHS), and to explore the factors affecting the quality of life (QOL).To provide the basis for the health management of hypertension patients in rural areas.Methods: from July to September 2016, 2125 patients with hypertension were selected from five townships of Lianyungang (Pomegranate Street, Qinghu Town, Hongzhuang Town, Hot Springs Town, Zhangwan Township) as study subjects, and blood pressure was measured in local township health centers.Physical examination and questionnaire survey were conducted to collect the general situation and blood pressure of the patients. The quality of life (QOL) of patients was evaluated by European quality of Life scale (EQOL). Epidata 3.1 was used to establish a database to record the original data to ensure the accuracy.SPSS16.0 software was used to describe the data, and the influencing factors of quality of life were analyzed. EQ-5D score was calculated by the conversion table of TTO utility value in England.Results the mean levels of systolic and diastolic blood pressure were 146.66 卤12.69)mm Hg and 94.37 卤12.01)mm Hg, respectively.The blood pressure control rate of 13.1%.(2)EQ-5D scale is as high as 63.0. The five dimensions of the scale are as follows: there are 327 people with dysphoria reported by mobility ability; 103 people with difficulties reported by self-care ability; 211 people with daily living ability who have difficulty; 211 people with daily life who have difficulties; and those with pain / discomfort.960 people were reported to have difficulties and 45.1% were reported to have difficulties, while 358 / 358 persons with anxiety / depression reported difficulties were found to be 16.9% of the total.The main QOL issues were pain / discomfort and anxiety / depression.The total score of EQ-5D obtained from the TTO conversion table of the United Kingdom was 0.839 卤0.217g, and the score range was -0.349U ~ (-1).There were significant differences in the proportion of difficulty in different dimensions of EQ-5D in patients with hypertension in different towns, such as mobility 0.011 卤0.026, self-care 0.005 卤0.025, daily life 0.004 卤0.014, pain / discomfort 0.066 卤0.089, anxiety / depression 0.015 卤0.041.Pomegranate street patients had the highest incidence of difficulty in dimensions other than mobility.The proportion of difficulty in the two dimensions of normal blood pressure group was higher than that of abnormal blood pressure group.Simple systolic hypertension has the highest proportion of difficulty in the dimension of movement ability. The protective factors of difficulty of movement ability are: education level, average monthly income, risk factors: age, course of hypertension;The protective factors of difficulty in self-care ability are: sex, average monthly income, risk factors: occupation, the protective factors of difficulty in daily life ability are: monthly average income, blood pressure grade, risk factors: occupation, course of hypertension;The protective factors of pain / discomfort difficulty were: average monthly income, risk factors: sex, marital status, course of hypertension; protective factors of anxiety / depression difficulties were age, average monthly income, risk factors: sex,The influencing factors of EQ-VAS score were gender BMI, monthly average income, course of hypertension, whether to take hypertension drugs or not.Conclusion: the quality of life of patients with hypertension in this investigation area is better, and the quality of life of patients in different villages and towns is different. The government still needs to increase investment to ensure the quality of life of residents, and the patients themselves should strengthen the management of hypertension.Change unreasonable behavior life style, enhance hypertension risk consciousness, measure blood pressure regularly, take medicine on time, improve life quality of oneself.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.1

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