社区老年人关节僵硬与健康相关生活质量的关系研究

doi:10.12114/j.issn.1007-9572.2019.00.607

摘要/Abstract

摘要： 背景　关节僵硬在老年人群中发病率较高，可能影响生活质量，严重者引起残疾，导致生活不能自理，引发一系列并发症。不同关节僵硬部位、数量、时间对患者生活质量的影响可能不同。目的　探讨社区老年人关节僵硬与健康相关生活质量（HRQOL）之间的关系。方法　于2017年5—11月，在海南省海口市招募年龄≥65岁的社区老年人586例。采用问卷调查的形式评估其颈部、背部、肩部、肘部、手或手腕、臀部、膝盖、脚踝或脚是否存在关节僵硬，以及僵硬持续时间；采用12条简明健康状况调查问卷（SF-12）和欧洲五维健康量表（EQ-5D）联合评估其HRQOL。采用多因素Logistic回归分析关节僵硬数量、持续时间、部位对HRQOL的影响。结果　最终回收有效问卷530份（90.4%），社区老年人的关节僵硬患病率为54.0%（286/530）。关节僵硬数量≥3个者的平均SF-12和EQ-5D得分分别为（88.3±3.4）、（8.5±0.6）分，持续时间>60 min者的平均SF-12和EQ-5D得分分别为（88.9±3.7）、（8.6±0.6）分，二者的生活质量处于中等水平。多因素Logistic回归分析结果显示：关节僵硬数量、持续时间是社区老年人HRQOL的影响因素（P<0.05）；肘关节、膝关节、踝关节僵硬是社区老年人HRQOL的影响因素（P<0.05）。结论　社区老年人的关节僵硬患病率较高；关节僵硬会影响其生活质量，僵硬关节数量越多、关节僵硬时间越长社区老年人的HRQOL越低，存在肘关节、膝关节、踝关节僵硬社区老年人的HRQOL较低。

关键词: 关节疾病, 关节僵硬, 生活质量, 健康相关生活质量, 老年人, 社区卫生服务, 老年人保健服务

Abstract: Background　Joint stiffness has a high incidence in the elderly population，which may affect the quality of life and even cause disability in severe cases leading to inability to take care of oneself and a series of complications.The different stiff locations，number of stiff joints and duration of stiffness may affect differently on patients' quality of life.Objective　To explore the relationship between joint stiffness and health-related quality of life（HRQOL） in elderly people in community.Methods　A total of 586 elderly people aged 65 and over were recruited in Haikou City of Hainan Province from May to November in 2017.Questionnaires were used to assess whether there was stiffness in the neck，back，shoulder，elbow，hand or wrist，hip，knee，and ankle or foot.The duration of stiffness was obtained.HRQOL was assessed by 12 Concise Health Status Questionnaire（SF-12） and European Quality of Life Five-dimensional Scale（EQ-5D）.Multivariate Logistic regression was used to analyze the effects of the number of stiff joints，duration and locations of joint stiffness on HRQOL.Results　A total of 530（90.4%） valid questionnaires were collected and the prevalence of joint stiffness was 54.0%（286/530） among the elderly in the community.The average SF-12 and EQ-5D scores of patients with more than three locations of joint stiffness were（88.3±3.4） and（8.5±0.6），while those with joint stiffness lasting more than 60 minutes had average SF-12 and EQ-5D scores of（88.9±3.7） and（8.6±0.6）.The quality of life of the two groups was at a moderate level.Multivariate Logistic regression analysis showed that the number of stiff joints and duration of joint stiffness were the influencing factors of HRQOL among the elderly in the community（P<0.05）；elbow stiffness，knee stiffness and ankle stiffness were the influencing factors of HRQOL among the elderly in the community（P<0.05）.Conclusion　The prevalence of joint stiffness is high in the elderly in community，and joint stiffness will affect their quality of life.The more the number of stiff joints and the longer the duration of stiffness，the lower the HRQOL of the elderly in community.The elderly in community with elbow stiffness，knee stiffness and ankle stiffness have the lower HRQOL.

Key words: Joint diseases, Joint stiffness, Quality of life, Health-related quality of life, Aged, Community health services, Health services for the aged

王再生,韩坤元,李秋敏,等. 社区老年人关节僵硬与健康相关生活质量的关系研究[J]. 中国全科医学, 2020, 23(1): 75-79. DOI: 10.12114/j.issn.1007-9572.2019.00.607.
WANG Zaisheng,HAN Kunyuan,LI Qiumin, et al. Association between Joint Stiffness and Health-related Quality of Life in Community Elderly People　[J]. Chinese General Practice, 2020, 23(1): 75-79. DOI: 10.12114/j.issn.1007-9572.2019.00.607.

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