金华市244例职业性尘肺病患者生存质量调查

Quality of life among 244 patients with occupational pneumoconiosis in Jinhua City

目的了解浙江省金华市职业性尘肺病患者的生存质量,为提升职业性尘肺病患者生存质量提供依据。方法通过国家职业病及健康危害因素监测信息系统检索2009—2021年金华市职业性尘肺病现患病例为调查对象,通过问卷调查收集人口学信息、尘肺病诊断、尘肺病分期、肺功能状况和医疗费用等资料,采用中文版生存质量量表(SF-36)评估生存质量,描述性分析不同疾病分期、肺功能状况、诊疗费用支出和文化程度的职业性尘肺病患者的生存质量。结果调查职业性尘肺病患者244例,其中男性225例,占92.21%;年龄为(75.20±9.42)岁;发病接尘时间为(13.11±9.89)年。生理功能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能和精神健康维度的生存质量评分分别为(64.03±31.22)、(45.14±44.22)、(56.34±26.60)、(40.80±19.80)、(59.14±17.35)、(68.41±19.67)、(47.03±44.08)和(61.15±17.06)分,均低于常模(P<0.05)。Ⅲ期尘肺病患者生理功能、躯体疼痛和精力维度评分[(31.17±23.40)、(45.21±19.50)和(47.00±20.70)分]较低;肺功能重度损伤患者生理功能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能和精神健康维度评分[(32.27±24.24)、(12.88±30.70)、(37.44±20.43)、(14.76±17.17)、(38.79±19.33)、(53.33±17.08)、(9.09±26.71)和(53.21±17.25)分]较低;诊疗费用个人支付占家庭年收入30%及以上的患者生理功能、躯体疼痛、一般健康状况、精力、社会功能和精神健康维度评分[(30.97±27.40)、(37.77±24.34)、(19.10±18.62)、(38.39±23.78)、(55.89±21.00)和(55.35±20.35)分]较低;高中及以上学历患者生理功能和生理职能维度评分[(66.36±17.33)和(59.09±45.10)分]较高(均P<0.05)。结论本次调查的金华市职业性尘肺病患者生存质量较差,疾病分期、肺功能状况、医疗费用和文化程度均会影响患者的生存质量。

Objective To investigate the quality of life among patients with occupational pneumoconiosis in Jinhua City,Zhejiang Province,so as to provide insights into improving the quality of life among patients with occupational pneumoconiosis.Methods Patients with occupational pneumoconiosis in Jinhua City from 2009 to 2021 were retrieved from the National Occupational Disease and Health Risk Factors Monitoring Information System.Participants'demographics,diagnosis of pneumoconiosis,stage of pneumoconiosis,pulmonary function and medical expense were collected through questionnaire surveys,and the quality of life was measured using a Chinese version of the Short-Form Health Survey(SF-36).The quality of life was descriptively analyzed among patients with occupational pneumoconiosis by disease stage,pulmonary function,expense for disease diagnosis and treatment and educational level.Results A total of 244 patients with occupational pneumoconiosis were enrolled,including 225 men(92.21%).The participants had a mean age of(75.20±9.42)years,and mean duration from dust contact to pneumoconiosis onset of(13.11±9.89)years.The scores for physical functioning,role-physical,bodily pain,general health,vitality,social functioning,role-emotional,and mental health were(64.03±31.22),(45.14±44.22),(56.34±26.60),(40.80±19.80),(59.14±17.35),(68.41±19.67),(47.03±44.08)and(61.15±17.06)points among patients with occupational pneumoconiosis,which were all lower than the national constant(P<0.05).Lower scores were measured for physical functioning[(31.17±23.40)points],bodily pain[(45.21±19.50)points]and vitality[(47.00±20.70)points]among patients with stage Ⅲ occupational pneumoconiosis,for physical functioning[(32.27±24.24)points],role-physical[(12.88±30.70)points],bodily pain[(37.44±20.43)points],general health[(14.76±17.17)points],vitality[(38.79±19.33)points],social functioning[(53.33±17.08)points],role-emotional[(9.09±26.71)points],and mental health[(53.21±17.25)points]among occupational pneumoconiosis patients with severe pulmonary function damages,and for physical functioning[(30.97±27.40)points],bodily pain[(37.77±24.34)points],general health[(19.10±18.62)points],vitality[(38.39±23.78)points],social functioning[(55.89±21.00)points]and mental health[(55.35±20.35)points]among occupational pneumoconiosis patients that had personal payments for pneumoconiosis diagnosis and treatment expenses exceeding 30% of annual household incomes,while higher scores were measured for physical functioning[(66.36±17.33)points]and role-physical[(59.09±45.10)points]among occupational pneumoconiosis patients with an educational level of high school and above(all P<0.05).Conclusions The quality of life was low among occupational pneumoconiosis patients in Jinhua City from 2009 to 2021.Stage of pneumoconiosis,pulmonary function,medical expenses and educational level were identified as factors affecting the quality of life among occupational pneumoconiosis patients in Jinhua City.