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基于EQ-5D-5L量表研究社会资本对慢性病患者生命质量的影响

Influence of Social Capital on the Life Quality of Patients with Chronic Diseases—A Study Based on EQ-5D-5L Scale

  • 摘要:
      目的  探究社会资本对慢性非传染性疾病患者生命质量的影响。
      方法  本研究采用多阶段分层整群抽样方法抽取调查对象,由经过专业培训的调查员入户面对面进行问卷调查,采用五维五水平生存质量量表(European Quality of Life Five Dimension Five Level Scale Questionnaire, EQ-5D-5L)和自制社会资本量表调查其生命质量和社会资本情况。运用因子分析和Cronbach’s α系数检验自编社会资本量表信效度,χ2检验和Tobit回归模型分析社会资本对慢性非传染性疾病患者生命质量的影响。
      结果  本研究自编的社会资本量表性能良好,Cronbach’s α系数为0.728,KMO值为0.716,Bartlett球形检验的结果为P<0.001,说明该数据适合使用因子分析。4个公因子累计解释了总变异的68.27%。调查对象的健康效用值为(0.869±0.181),能四处走动、自己洗澡穿衣和进行日常活动中完全没问题的调查对象占75.70%、80.10%和74.1%,疼痛或不舒服和焦虑或沮丧自觉没有任何困难的分别占43.40%和58.90%;EQ-5D-5L量表中躯体健康维度的自评健康影响因素为社区安全和人际网络关系,社会功能健康的影响因素为社区安全,精神健康受到社区安全、社区信任和人际网络关系的影响;社区安全提高一个等级,慢性非传染性疾病患者健康效用值增加0.046,人际网络关系增加一个等级,健康效用值增加0.037。
      结论  慢性非传染性疾病患者的生命质量主要问题表现在精神健康维度,在治疗过程中应注重心理疏导,社区安全和人际网络关系是患者自评健康的保护因素,提供安全的社区环境,扩大人际网络改善人际关系有助于提高患者健康水平。

     

    Abstract:
      Objective  To explore the influence of social capital on the quality of life of patients with chronic non-communicable diseases.
      Methods  A multi-phase stratified cluster sampling method was adopted to select the survey respondents. Professionally trained surveyors made home visits in order to conduct face-to-face questionnaire surveys in person. European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) and a self-developed social capital scale were used to investigate the quality of life and social capital of the respondents. Factor analysis and Cronbach’s α coefficient test were done to verify the reliability and validity of the self-developed social capital scale. The χ2 test and robust Tobit regression model were used to analyze the impact of social capital on the quality of life of patients with chronic non-communicable diseases.
      Results  The self-developed social capital scale showed excellent performance. The Cronbach’s α coefficient was 0.728, the KMO value was 0.716, and the result of Bartlett’s test of sphericity was statistically significant (P<0.001), indicating that the data were well suited for factor analysis. The four common factors cumulatively explained 68.27% of the total variation. The health utility value of the survey respondents was 0.869±0.181. Those who could walk around, shower and dress themselves, and perform usual activities without any problem accounted for 75.70%, 80.10%, and 74.1% of the respondents, respectively. Those who had pain or discomfort and anxiety or depression, with no self-perceived problem were 43.40% and 58.90%, respectively. In the EQ-5D-5L scale, the self-rated health influencing factors of the physical health dimension were community safety and interpersonal network relationships. The influencing factors of social function health was community safety and mental health was affected by community safety, community trust and interpersonal network relationships. When community safety improved by one level, the health utility value of patients with chronic non-communicable diseases increased by 0.046, and when interpersonal network relationships improved by an additional level, their health utility value increased by 0.037.
      Conclusion  The main problem of the quality of life of patients with chronic non-communicable diseases was found in the mental health dimension. In the process of treating chronic non-communicable diseases, attention should also be given to psychological counseling. Community safety and interpersonal network relationships are the protective factors for self-rated health status. Providing a safe community environment and expanding interpersonal networks help improve the health of patients.

     

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