糖尿病视网膜病变患者健康素养、应对方式与生活质量的相关性研究

Correlation between health literacy,coping style and quality of life in patients with diabetic retinopathy

目的探讨糖尿病视网膜病变(DR)患者生活质量现状及影响因素,并分析生活质量、医学应对方式及健康素养三者之间的相关性。方法采用便利抽样法,选取2021年11月—2022年8月在承德市3所三级甲等医院眼科门诊就诊的300例DR患者作为研究对象。采用一般资料调查表、中文版糖尿病健康素养量表(HLS)、医学应对方式问卷(MCMQ)、视功能损害眼病患者生存质量量表(VQOL-DVI)进行横断面调查。结果研究对象HLS得分为(35.36±6.38)分,MCMQ总分为(52.52±7.75)分,VQOL-DVI总分为(110.36±27.49)分。Pearson相关分析结果显示:DR患者VQOL-DVI总分与HLS总分、MCMQ总分均呈正相关(r=0.434,0.227;P<0.05)。单因素分析结果显示:不同年龄、文化程度、家庭月收入、饮酒情况、DR确诊时间、DR类型、甘油三酯情况、身体质量指数研究对象VQOL-DVI得分的差异均有统计学意义(P<0.05)。多重线性回归分析结果显示:年龄、DR类型、饮酒情况(目前饮酒)、甘油三酯水平、健康素养、医学应对方式(面对、回避、屈服)是DR患者生活质量的影响因素(P<0.05),可解释患者生活质量总变异的49.5%。结论DR患者生活质量水平较低,可通过提高其健康素养水平、鼓励患者采取积极的应对方式等,以减缓视网膜病变进展,进而提高患者生活质量。

Objective This study aimed to investigate the status quo of quality of life(QOL)and its influencing factors in patients with diabetic retinopathy(DR),and to analyze the correlation between QOL,medical coping style and health literacy.Methods A total of 300 patients with DR who visited the ophthalmology clinic of class A tertiary hospitals in Chengde from November 2021 to August 2022 were selected by convenience sampling.A cross-sectional survey was conducted using a general data questionnaire,the Chinese version of the Health Literacy Scale(HLS)for Diabetes,the Medical Coping Modes Questionnaire(MCMQ),and the vision-related quality of life for diseases with visual impairment(VQOL-DVI)scale.Results The HLS,MCMQ and VQOL-DVI scores were 35.36±6.38,52.52±7.75 and 110.36±27.49,respectively.The results of Pearson correlation analysis showed that the total VQOL-DVI score was positively correlated with the total HLS score and the total MCMQ score in DR patients(r=0.434,0.227;P<0.05).Univariate analysis indicated that there were significant differences in VQOL-DVI scores among participants with different ages,education levels,monthly family income,alcohol consumption,time to diagnosis of DR,type of DR,triglyceride status,and body mass index(P<0.05).The results of multiple linear regression analysis showed that age,type of DR,alcohol consumption(current alcohol consumption),triglyceride level,health literacy,and different medical coping styles(confrontation,avoidance,and resignation)were the influencing factors of quality of life in DR patients(P<0.05),which could account for 49.5%of the total variation of quality of life in patients.Conclusion The quality of life of patients with DR remains low,which can slow down the progression of retinopathy and raise the quality of life of patients by improving their health literacy level and encouraging patients to adopt an active coping style.