社区脑卒中高危人群生活质量及影响因素

The quality of life and its influencing factors in high risk population of stroke in district

目的了解社区脑卒中高危人群生活质量现状,并对其影响因素进行分析。方法随机选取四家黄浦区社区卫生服务中心,在上海市社区脑卒中筛查及防控项目发现的脑卒中高危人群中,通过方便抽样的方法选择研究对象。使用世界卫生组织生活质量测定简表(World Health Organization quality of life scale-brief form questionnaire,WHOQOL-BREF)、抑郁自评量表(self-rating depression scale,SDS)和焦虑自评量表(self-rating anxiety scale,SAS)作为调查工具,对1200名脑卒中高危对象进行研究。用单样本t检验比较各项得分和全球24中心的数据的差异,多元线性逐步回归法探讨其影响因素。结果脑卒中高危人群的生理领域、心理领域、社会关系领域得分[分别为(13.60±1.86)分、(14.58±1.97)分、(13.72±2.10)分]均低于全球24个中心的一般人群的得分(均P<0.01),环境领域得分[(14.08±1.95)分]高于全球24个中心的一般人群的得分(P<0.01)。多元线性逐步回归分析结果显示,高龄、焦虑、抑郁是影响生理领域得分(β=-0.027,-0.056,-0.051)、心理领域得分(β=-0.019,-0.055,-0.050)和环境领域得分(β=-0.017,-0.040,-0.054)的危险因素;高龄、抑郁是影响社会关系领域得分的危险因素(β=-0.026,-0.067);焦虑、抑郁是影响生活质量自我评估(β=-0.012,-0.014)和健康自我评估(β=-0.012,-0.014,)的危险因素(均P<0.01)。结论脑卒中高危人群生活质量可能与年龄、抑郁和焦虑等心理因素有关。对脑卒中的防治应采取身心并重的措施,对不良心理状况及时进行干预,逐步改善生活质量。

Objective To understand the quality of life of high risk population of stroke in community and analyze the influencing factors.Methods Four community health service centers in Huangpu District were randomly selected,and the subjects were included by using convenient sampling method among the high risk groups of stroke found in the community stroke screening and prevention and control project in Shanghai.The World Health Organization quality of life scale-brief form questionnaire(WHOQOL-BREF),self-rating depression scale(SDS)and self-rating anxiety scale(SAS)were used as the survey tools to study 1200 high-risk stroke subjects.Single sample t-test was used to compare the differences between the scores and the data of 24 centers in the world,and multiple linear stepwise regression were used to analyze the influencing factors.Results The scores of physical field,psychological field and social relationship field((13.60±1.86),(14.58±1.97),(13.72±2.10)respectively)of high-risk population of stroke were lower than the scores of general population of 24 centers in the world(P<0.01),and the scores of environmental field(14.08±1.95)were higher than it(P<0.01),of which the differences were all statistically significant.The results of multiple linear stepwise regression analysis showed that old age,anxiety and depression were the risk factors influencing the scores of physical field(β=-0.027,-0.056,-0.051),psychological field(β=-0.019,-0.055,-0.050)and environmental field(β=-0.017,-0.040,-0.054);old age and depression were the risk factors influencing the scores of social relationship field(β=-0.026,-0.067);anxiety and depression were the risk factors influencing the self-assessment of quality of life and health(β=-0.012,-0.014 for quality of life;-0.012,-0.014 for health,all P<0.01).Conclusion The quality of life of high-risk population of stroke may be related to age,depression,anxiety and other psychological factors.The prevention and treatment of stroke should take both physical and mental measures,take timely intervention for poor psychological status,and gradually improve the quality of life.