Evaluation of self-rated health – information on patients’ unmet needs?

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Original scientific articleBackground: Health-related quality of life (HRQoL) is measuring a patient's experience of his health status and represents an outcome of medical interventions. Existing data proves that a healthy lifestyle is positively associated with HRQoL in all age groups. Patients with a high risk for cardiovascular disease typically led an unhealthy lifestyle combined with risk diseases. We aimed to analyse these characteristics and their reflection in HRQoL. Methods:A cross-sectional study in 36 family practices, stratified by location and size. Each practice invited 30 high-risk patients from the register. Data were obtained from medical records and patient questionnaire. The EQ-5D questionnaire and the VAS scale were used for measuring the patient's HRQoL as an independent variable.Results: 871 patients (80.6% response rate) were included in the analysis. 60.0% had 3-4 uncontrolled risk factors for CVD. The average VAS scale was 63.2 (SD 19.4). The correlation of EQ-5D was found in the number of visits in the practice (r=-0.31, p<0.001), the socioeconomic status (r=-0.25, p=0.001), age (r=-0.27, p=0.001) and healthy diet (r=0.20, p=0.006). In a multivariate model, only physical activity among lifestyle characteristics was an independent predictor of HRQoL (p=0.001, t=3.3), along with the frequency of visits (p<0.001, t=-5.3) and age (p=0.025, t=-2.2). Conclusion:This study has been performed on a specific group of patients, not being "really sick", but having less optimal lifestyle in many cases. Encouragement to improve or keep healthy lifestyle, especially physical activity, is important, not only to lower the risk for CVD, but also to improve HRQoL. Izhodišča Metode: Presečna raziskava je bila izvedena v 36 ambulantah družinske medicine, stratificiranih glede na lokacijo (mesto, podeželje) in velikost (do dva oz. več polno zaposlenih zdravnikov na lokaciji). Vsaka ambulanta je k sodelovanju povabila 30 bolnikov iz registra visoko ogroženih za nastanek bolezni srca in ožilja (BSO) po Framinghamski tabeli ogroženosti. Ustrezni podatki so bili pridobljeni iz zdravstvenih kartotek in s pomočjo vprašalnikov za bolnike. Z zdravjem povezana kakovost življenja je bila merjena s petdimenzionalnim EQ-5D vprašalnikom in z VAS lestvico kakovosti življenja, ki sta predstavljala neodvisni spremenljivki.Rezultati: V analizo je bilo vključenih 871 bolnikov (80,6 % vseh vabljenih). Od teh je 60,0 % imelo 3-4 prisotne dejavnike tveganja za nastanek BSO. Povprečna vrednost VAS lestvice je bila 63,2 (SE 0,72). Ugotovljena je bila korelacija med EQ-5D in pogostostjo obiskov bolnika v enem letu v ambulanti (r=-0,31, p<0,001), socialnoekonomskim statusom bolnika (r=-0,25, p=0,001), starostjo bolnika (r=-0,27, p=0,001) in zdravim načinom prehranjevanja (r=0,20, p=0,006). Med vsemi spremenljivkami so bili v multivariatnem modelu neodvisni napovedni dejavniki HRQoL telesna aktivnost (p=0,001, t=3,3), pogostost obiskov bolnika v ambulanti (p<0,001,3) in starost bolnika (p=0,025, t=-2,2 Petek D, Petek-Ster M, Tusek-...

Section: Discussionsupporting

confidence: 62%

Health behavior and health-related quality of life in patients with a high risk of cardiovascular disease

Petek¹,

Petek-Ster²,

Tušek-Bunc³

2018

Self Cite

“…In testing lifestyle characteristics, we found a weak bivariate correlation of HRQoL with a healthy diet and a significant association with physical activity in the multivariate model. Randomised trials of patients with metabolic syndrome showed that an improved lifestyle with a healthy diet and regular physical activity improved HRQoL ( 34 , 35 ) and self-rated health ( 36 ). The results of Imayama on postmenopausal women showed the same ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

Health behavior and health-related quality of life in patients with a high risk of cardiovascular disease

Petek

Petek-Ster

Tušek-Bunc

2018

Self Cite

BackgroundHealth-related quality of life (HRQoL) is measuring a patient’s experience of his health status and represents an outcome of medical interventions. Existing data proves that a healthy lifestyle is positively associated with HRQoL in all age groups. Patients with a high risk for cardiovascular disease typically led an unhealthy lifestyle combined with risk diseases. We aimed to analyse these characteristics and their reflection in HRQoL.MethodsA cross-sectional study in 36 family practices, stratified by location and size. Each practice invited 30 high-risk patients from the register. Data were obtained from medical records and patient questionnaire. The EQ-5D questionnaire and the VAS scale were used for measuring the patient’s HRQoL as an independent variable.Results871 patients (80.6% response rate) were included in the analysis. 60.0% had 3-4 uncontrolled risk factors for CVD. The average VAS scale was 63.2 (SD 19.4). The correlation of EQ-5D was found in the number of visits in the practice (r=-0.31, p<0.001), the socioeconomic status (r=-0.25, p=0.001), age (r=-0.27, p=0.001) and healthy diet (r=0.20, p=0.006). In a multivariate model, only physical activity among lifestyle characteristics was an independent predictor of HRQoL (p=0.001, t=3.3), along with the frequency of visits (p<0.001, t=-5.3) and age (p=0.025, t=-2.2).ConclusionThis study has been performed on a specific group of patients, not being “really sick”, but having less optimal lifestyle in many cases. Encouragement to improve or keep healthy lifestyle, especially physical activity, is important, not only to lower the risk for CVD, but also to improve HRQoL.

“…Most widely used are single-item indicators that differ in the number of available answers, but, in general, they represent a parallel assessment of subjective health ( 10 ). A study in Slovenia using SRH showed that PSRH is associated with multimorbidity and unhealthy life-style ( 17 ). Subjective evaluation of health is used also in econometric analyses and health technology assessment ( 18 ).…”

Section: Introductionmentioning

confidence: 99%

Assessment of the association between dentate status and self-rated general health

Ranfl

Zaletel-Kragelj

2017

ObjectiveAiming at preparing the basis for evidence-based dental public health policy making in Slovenia, the objective of the study was to assess the strength of association between oral health status measured by the number of missing teeth and self-rated health (SRH).MethodsThe study was designed as a pooled individual-level data study from four national cross-sectional studies carried out in the period 2001-2012, based on CINDI Health Monitor methodology. Altogether, 34,412 participants were included. A logistic regression model with poor SRH as observed outcome and the number of teeth as explanatory factor (adjusted for selected biologic, socio-economic and health factors) was proposed.ResultsIn the sample, women represented 55.7% and men 44.3%, median age was 45 years. Persons with more missing teeth more likely rated their health as poor. The association was persistent even when different confounding variables were included in the model. In the group with 1-5 missing teeth, in comparison to the group with none missing teeth, OR was 1.23 (p=0.049), whereas for the group with 6-10 missing teeth, OR was 1.32 (p=0.019); for the group with >10 missing teeth, but not all, OR was 1.77 (p<0.001), and for the group with all missing teeth, OR was 2.19 (p<0.001).Conclusions Study results showed clear association of SRH with dentate status, which confirms the oral-general health connection. This indicates the need for the development of proper dental public health policies for better oral health, and presents a new view on the importance of preserving teeth.