目的了解昆陛乙型肝炎患者生活质量现状,并对其生活质量的影响因素进行分析。方法采用整群抽样方法,以世界卫生组织生活质量调查表(WHOQOL-BREF)及自制量表为调查工具,对258例慢陛乙型肝炎患者(病例组)和205名正常人(对照组)进行病例对照研究。用独立样本成组f检验比较两组各项得分的差异,多元线性逐步回归法和单因素方差分析及多重比较分析其影响因素。结果病例组生活质量总分、生理领域得分、心理领域得分、社会关系领域得分、环境领域得分、QOL自评得分和健康自评得分分别为(62.88±8.22)、(64.71±15.05)、(64.35±14.71)、(67.20±12.98)、(59.58±13.23)、(60.75±21.54)、(58.13±19.15)分,均低于对照组相应得分[(67.31±5.82)、(73.21±11.26)、(58.94±10.13)、(59.83±8.65)、(63.97±10.24)、(66.90±17.57)、(76.26土14.27)分],差异均有统计学意义(P值均〈0.05)。多元线性逐步回归分析结果显示:抑郁、病隋较重、自费、对收入有无明显影响、食欲较差、乏力和担心传染是影响生理领域得分的危险因素,治疗信心是保护因素(P值均〈0.05);抑郁和复发是影响心理领域得分的危险因素,治疗信心和男性是保护因素(P值均〈0.05);抑郁、对周围人的态度不满意、复发和高龄是影响社会关系领域得分的危险因素,社会支持和治疗信心是保护因素垆值均〈0.05),不同职业者之间社会关系领域得分差异有统计学意义(P〈0.01);抑郁、对周围人的态度不满意、居住在乡村和复发是影响环境领域得分的危险因素(P值均〈0.05)。结论在临床医疗护理过程中,重视有抑郁症状患者的早期治疗,加强患者心理健康护理,加强医患沟通,提高患者的社会支持水平,利于提高?
Objecjive To survey patients with chronic hepatitis B (CHB) to determine their perceptions of CHB-related quality of life (QOF) and to determine the factors influencing this measure. Methods A total of 268 patients with CHB (disease group) and 205 healthy individuals (control group) completed the World Health Organization (WHO)QOL-BREF life assessment survey and a self-designed questionnaire of health and QOL. The groups' responses were comparatively analyzed by the cluster sampling method and the independent samples t-test. The strength of influence of each factor on the patients' perceptions of QOL was determined by multiple stepwise regression and one-way ANOVA. Results The disease group had significantly lower scores than the control group for overall QOL (62.88 ± 8.22 vs. 67.31 ± 5.82), the physiological area (PHYS: 64.71 ± 15.05 vs. 73.21 ± 11.26), the psychological area (PSYCH: 64.35± 14.71 vs. 68.94± 10.13), the social relations area (SOCIL: 67.20± 12.98 vs. 69.83 ± 8.65), the environmental area (ENVIR: 59.58 ± 13.23 vs. 63.97± 10.24), the QOL self-assessment (60.75±21.54 vs. 66.90± 17.57) and the health self-assessment (58.13± 19.15 vs. 76.26± 14.27) (all, P 〈 0.05). Multiple stepwise regression analysis identified the following parameters as risk factors of PHYS: depression (P〈 0.001), perception of being seriously ill 0a〈0.001), self-payment for treatment 0±=0.003), CHB significant impact on income (P = 0.002), poor appetite (P= 0.002), languor (P〈0.001), and fear of infecting others (P=0.022). Confidence of treatment was a protective factor of PHYS (P=0.001). The risk factors of PSYCH wcrc depression (P〈 0.001) and recurrence (P〈 0.001), and the protective factors were confidence of trcatrncnt (P = 0.003) and male sex (P= 0.014). The risk factors of SOCIL were depression (P〈 0.001, dissatisfaction with the attitude of the people around (P=0.001), recurrence ?