三峡库区就地移民类风湿关节炎患者健康相关生命质量与影响因素调查研究

Study on the health related quality of life and influencing factors in emigrants with rheumatoid arthritis in Three-Gorge Reservoir area

目的分析三峡库区就地移民类风湿关节炎(RA)患者健康相关生命质量(HRQOL)结果,并研究其影响因素。方法使用抑郁自评量表(SDS)评估三峡库区就地移民RA患者抑郁状况,使用简明健康调查问卷(SF-36)测量HRQOL分数,并对HRQOL的影响因素进行分析。结果 SDS评分结果显示抑郁症状110例(67.5%),其中轻度抑郁58例(35.6%),中度抑郁39例(23.9%),重度抑郁13例(8.0%)。统计结果显示SDS评分、DAS-28分级、年龄、性别、治疗处理、文化程度、职业、锻炼情况、经济收入、医疗保障、饮酒状况可影响HRQOL评分,其中DAS-28分级、经济收入、医疗保障、性别、治疗处理是主要影响因素,偏回归系数分别为-39.211、31.512、25.866、-42.348、-51.235。结论三峡库区就地移民RA患者大部分有抑郁症状,整体HRQOL不容乐观。应加强年龄偏大、低收入、女性、文化程度低、DAS-28高分级、无稳定职业患者的防治;积极接收治疗、重视心理治疗、戒酒、加强锻炼、扩大居民医保范围可以改善患者HRQOL。

Objective To analysis the health related quality of life （HRQOL）in emigrants with rheumatoid arthritis（RA） in Three‐Gorge Reservoir area ,and to study the influencing factors on HRQOL .Methods Self‐rating depression scale（SDS） was used to assess degree of depression in emigrants with rheumatoid arthritis in Three‐Gorge Reservoir area ,and SF‐36 scalec was used to assess the HRQOL of these patients .The one‐way ANOVA and stepwise regression analysis were used to study the influence fac‐tors of HRQOL .Results SDS scores showed that there were 110 peoples with depressive symptoms （67 .5% ） ,including mild de‐pression 58 cases（35 .6% ） ,moderate depression 39 cases（23 .9% ） ,severe depression 13 cases（8 .0% ） .Stepwise regression analysis showed that ：SDS score ,DAS‐28 classification ,age ,sex ,treatment ,education ,occupation ,physical exercis ,economic income ,health insurance and alcohol consumption influenced the HRQOL scores of patients with IBS .DAS‐28 classification ,economic income , health insurance ,sex ,treatment were the main influencing factors ,with the unstandardized partial coefficients of -39 .211 ,31 .512 , 25 .866 ,-42 .348 ,-51 .235 .Conclusion Most of emigrants with RA in Three‐Gorge Reservoir area suffering from depressive symptoms ,and the HRQOL scores of them is not optimistic .The results suggested that more attention must be paid to the elderly , low‐income ,women ,low education ,DAS‐28 classification and no occupation .Quiting drinking ,receiving treatment ,psychological treatment ,strengthen exercise and expanding the scope of medical insurance all can improve patients′health related quality of life .