【摘要】：目的:通過對住院糖尿病性視網(wǎng)膜病變(DR,diabetic retinopathy)患者生存質(zhì)量的分析,探討不同人口學(xué)特征的住院糖尿病性視網(wǎng)膜病變患者生存質(zhì)量的現(xiàn)狀;探討影響其生存質(zhì)量的相關(guān)因素,為提高糖尿病性視網(wǎng)膜病變患者生存質(zhì)量提供理論依據(jù)。方法:采用一般情況調(diào)查表、視功能相關(guān)生命質(zhì)量量表NEI-VFQ-25中文版對住院糖尿病性視網(wǎng)膜病變患者及糖尿病未患糖尿病性視網(wǎng)膜病變患者進(jìn)行面對面問卷調(diào)查。采用便利抽樣確定調(diào)查對象。調(diào)查內(nèi)容包括受訪對象的一般情況(性別、年齡、患病病程、職業(yè)、文化程度、婚姻狀況、其他慢性病、家族史等)、視功能相關(guān)生命質(zhì)量量表NEI-VFQ-25中文版。采用Epidata3.2軟件建立數(shù)據(jù)庫并進(jìn)行數(shù)據(jù)錄入,SPSS16.0統(tǒng)計軟件包進(jìn)行數(shù)據(jù)處理與分析;應(yīng)用均數(shù)、標(biāo)準(zhǔn)差和構(gòu)成比對數(shù)據(jù)進(jìn)行統(tǒng)計描述;采用方差分析、t檢驗(yàn)、相關(guān)性分析和線性回歸對數(shù)據(jù)進(jìn)行統(tǒng)計分析。結(jié)果:本研究共完成調(diào)查問卷395份,其中糖尿病未患糖尿病性視網(wǎng)膜病變患者136人,占總?cè)藬?shù)的34.43%;糖尿病性視網(wǎng)膜病變患者共259人,其中單純型DR患者188人,占DR患者人數(shù)的72.59%;增殖型DR患者71人,占DR患者人數(shù)的27.41%。本次研究發(fā)放調(diào)查問卷400份,回收400份,回收率為100%。對所有問卷進(jìn)行質(zhì)量控制,剔除問卷中缺失值超過20%的5份問卷,問卷有效率達(dá)98.75%。在NEI-VFQ-25量表的信度方面,量表總體的Cronbach’α系數(shù)為0.840,各維度的Cronbach’α系數(shù)均大于0.7,表明NEI-VFQ-25量表在糖尿病性視網(wǎng)膜病變患者中有較好的內(nèi)部一致性;量表的分半信度為0896,各維度均在0.6以上,表明NEI-VFQ-25量表在糖尿病性視網(wǎng)膜病變患者中的分半信度良好。同時,該量表在糖尿病性視網(wǎng)膜病變患者中有較好的內(nèi)容效度及結(jié)構(gòu)效度,各維度及其相關(guān)條目系數(shù)均大于0.6,P0.001。NEI-VFQ-25量表的研究結(jié)果表明,糖尿病未伴糖尿病性視網(wǎng)膜病變患者的生存質(zhì)量得分高于DR患者;同時,單純型DR患者的生存質(zhì)量得分高于增殖型DR患者。性別、婚姻狀況、文化程度、職業(yè)及家庭收入對DR患者的生存質(zhì)量得分無影響(P0.05),但在糖尿病病程、是否接受胰島素治療、是否患其他慢性病方面,各維度的得分差異均有顯著性意義(P0.05)。通過線性回歸分析,結(jié)果表明空腹血糖水平、入院時收縮壓、糖化血紅蛋白、是否患有其他慢性病及是否注射胰島素是影響糖尿病性視網(wǎng)膜病變患者生存質(zhì)量的因素。結(jié)論:1、視功能相關(guān)生命質(zhì)量量表NEI-VFQ-25中文版有良好的可行性、信度和效度,可用于糖尿病性視網(wǎng)膜病變患者的生存質(zhì)量的測評。2、糖尿病性視網(wǎng)膜病變患者的生存質(zhì)量最低,明顯低于糖尿病未患視網(wǎng)膜病變患者。3、糖尿病性視網(wǎng)膜病變患者在不同性別、年齡、婚姻狀況、文化程度、職業(yè)、家庭收入方面的生存質(zhì)量得分差異無統(tǒng)計學(xué)意義;在糖尿病病程、是否接受胰島素治療、是否患其他慢性病方面,各維度的得分差異均有顯著性意義。多因素分析結(jié)果表明,空腹血糖水平、入院時收縮壓、糖化血紅蛋白、是否患有其他慢性病及是否注射胰島素是影響糖尿病性視網(wǎng)膜病變患者生存質(zhì)量的因素。
[Abstract]:Objective: To analyze the quality of life of inpatients with diabetic retinopathy (DR) and explore the status quo of quality of life of inpatients with diabetic retinopathy with different demographic characteristics, and to explore the related factors affecting the quality of life so as to provide a basis for improving the quality of life of patients with diabetic retinopathy. METHODS: A face-to-face questionnaire survey was conducted on inpatients with diabetic retinopathy and diabetic patients without diabetic retinopathy by using the General Situation Questionnaire and the Chinese version of the Visual Function Related Quality of Life Questionnaire NEI-VFQ-25. Status (gender, age, course of disease, occupation, educational level, marital status, other chronic diseases, family history, etc.), Chinese version of visual function-related quality of life scale NEI-VFQ-25. Results: A total of 395 questionnaires were completed, including 136 diabetic patients without diabetic retinopathy (34.43%) and 259 diabetic patients with diabetic retinopathy (DR). 188 patients, accounting for 72.59% of the DR patients; 71 patients with proliferative DR, accounting for 27.41% of the DR patients. This study issued 400 questionnaires, 400 were recovered, the recovery rate was 100%. Quality control of all questionnaires, excluding five questionnaires with more than 20% missing value, the validity of the questionnaires was 98.75%. In terms of the reliability of NEI-VFQ-25, the quantity of the questionnaires was measured. The overall Cronbach'a coefficient of the table was 0.840, and the Cronbach'a coefficient of each dimension was greater than 0.7, indicating that the NEI-VFQ-25 scale had good internal consistency in patients with diabetic retinopathy; the half-reliability of the scale was 0.896, and all the dimensions were above 0.6, indicating that the NEI-VFQ-25 scale had a half-score in patients with diabetic retinopathy. At the same time, the scale had good content validity and structure validity in patients with diabetic retinopathy, and the coefficients of each dimension and related items were all greater than 0.6, P 0.001.NEI-VFQ-25 scale showed that the quality of life score of diabetic patients without diabetic retinopathy was higher than that of DR patients. The quality of life score of DR patients was higher than that of proliferative DR patients. Gender, marital status, education level, occupation and family income had no effect on the quality of life score of DR patients (P 0.05). However, there were significant differences in the course of diabetes, insulin treatment and other chronic diseases (P 0.05). Sexual regression analysis showed that fasting blood glucose level, systolic blood pressure at admission, glycosylated hemoglobin, other chronic diseases and insulin injection were the factors affecting the quality of life in patients with diabetic retinopathy. It can be used to evaluate the quality of life of patients with diabetic retinopathy. 2. The quality of life of patients with diabetic retinopathy is the lowest, significantly lower than that of patients without diabetic retinopathy. 3. The quality of life of patients with diabetic retinopathy in terms of gender, age, marital status, educational level, occupation and family income. There was no significant difference in the score between the two groups; there was significant difference in the course of diabetes, insulin treatment and other chronic diseases. Multivariate analysis showed that fasting blood glucose level, systolic blood pressure at admission, glycosylated hemoglobin, other chronic diseases and insulin injection were the main factors. Factors influencing quality of life in patients with diabetic retinopathy.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R587.2;R774.1

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