Aile sağlığı merkezlerine başvuran kişilerde kronik hastalık, multimorbidite ve yaşam kalitesi ilişkisinin değerlendirilmesi

Abstract

Amaç: Kronik hastalık ve multimorbiditenin uzun süreli tedavi ve takip gerektirmesi,hastaların yönetilmesi ve izleminde yaşam kalitesinin değerlendirilmesini gündeme getirmiştir. Çalışmada yetişkinlerde kronik hastalık ve multimorbiditenin yaşam kalitesi ile ilişkisinin değerlendirilmesi amaçlandı.

Yöntem: Çalışma, Eskişehir’de hizmet veren Aile Sağlığı Merkezleri(ASM)’ne başvuran yetişkinde gerçekleştirilen kesitsel tipte araştırmadır. Çalışma verileri, sosyodemografik özellikler, riskli sağlık davranışları ve hekim tanılı kronik hastalık varlığını sorgulayan sorular ile Dünya Sağlık Örgütü Yaşam Kalitesi Anketi-8(EUROHİS-OQL-8) ölçeğinden oluşan anket formuyla elde edildi. Verilerin analizinde Mann-Whitney U, Kruskal Wallis ve Çoklu Lineer Regresyon Analizi kullanıldı.

Bulgular: Çalışmaya katılan 2324 kişi arasında en sık bildirilen hekim tanılı kronik hastalık hipertansiyon (%33.3) idi. Yapılan çoklu lineer regresyon modelinde yaşam kalitesiyle ilişkili faktörler kontrol edildiğinde, yaşam kalitesinin para ve yaşanılan evin koşulları dışındaki alt boyutların kronik hastalık varlığıyla negatif yönde ilişkili olduğu bulundu. Hiperlipidemi dışında belirtilen kronik hastalıkların tümünde, yaşam kalitesinin negatif yönde değişim gösterdiği saptandı.

Sonuç: Kronik hastalık ve multimorbiditenin yaşam kalitesini azaltan önemli bir sorun olduğu bulundu. Aile sağlığı merkezlerinde kronik hastalık yönetim ve takibinde, yaşam kalitesinin de ele alınmasının önemli olduğu sonucuna ulaşıldı.

Keywords

• Kronik Hastalık
• yaşam kalitesi
• multimorbidite
• aile sağlığı merkezi

Evaluation of the relationship of chronic disease, multimorbidity and quality of life at primary health care centers

Abstract

Objective: Since chronic diseases and multimorbidity require long-term treatment and follow-up, it brought up the evaluation of the quality of life in the management and follow-up of patients. The aim of the study was to evaluate the relationship between chronic disease and multimorbidity and quality of life in adults.

Method: The study is a cross-sectional type of research conducted in adults who applied to the Family Health Centers (FHC) in Eskisehir. The study data were obtained through questions of sociodemographic characteristics, risky health behaviors and the presence of chronic diseases diagnosed by physicians and a questionnaire consisting of the World Health Organization Quality of Life Questionnaire-8 (EUROHİS-OQL-8) scale. Mann-Whitney U, Kruskal Wallis and Multiple Linear Regression Analysis were used to analyze the data.

Results: Among the 2324 people who participated in the study, the most frequently reported physician-diagnosed chronic disease was hypertension (33.3%). After adjusting for the effect of factors related to the quality of life in the multiple linear regression, it was found that except for the subdomain money and the conditions of the living place the quality of life was negatively related to the presence of chronic disease. The quality of life was also negatively affected in all of the chronic diseases mentioned excluding hyperlipidemia.

Conclusion: It was found that chronic disease and multimorbidity are an important problem that reduces the quality of life. It was concluded that it is important to consider quality of life in chronic disease management and follow-up in primary health care institutions.

Keywords

• Chronic disease
• quality of life
• multimorbidity
• primary health care services

References

1. 1. Rowbotham S, Astell-Burt T, Barakat T, Hawe P. 30+ years of media analysis of relevance to chronic disease: a scoping review. BMC public health. 2020;20(1):1-21.
2. 2. Fortin M, Lapointe L, Hudon C, Vanasse A, Ntetu AL, Maltais D. Multimorbidity and quality of life in primary care: a systematic review. Health and Quality of life Outcomes. 2004;2(1):51.
3. 3. Sağlık İstatistik Yıllığı 2018, Erişim adresi: https://www.saglik.gov.tr/ TR,62400/saglik-istatistikleri-yilligi2018-yayinlanmistir.html. Erişim Tarihi:15.02.2020
4. 4. Netuveli G, Blane D. Quality of life in older ages. British medical bulletin. 2008;85(1):113-26.
5. 5. Hekmatpou D, Shamsi M, Zamani M. The effect of a healthy lifestyle program on the elderly’s health in Arak. Indian journal of medical sciences. 2013;67(3/4):70.
6. 6. WHO, Health statistics and information systems, Projections of mortality and causes of death, 2015 and 2030 Erişim adresi: https://www.who.int/ healthinfo/global_burden_disease/ projections2015_2030/en/. Erişim tarihi: 07.01.2020
7. 7. Noncommunicable diseases country profiles 2014, Turkey, Erişim adresi: https://www.who.int/nmh/ countries/2014/tur_en.pdf Erişim tarihi: 16.02.2020
8. 8. Boyd CM, Fortin M. Future of multimorbidity research: how should understanding of multimorbidity inform health system design, Public health reviews. 2010;32(2):451.

9. 9. Van Nispen RM, de Boer MR, Hoeijmakers JG, Ringens PJ, van Rens GH. Co-morbidity and visual acuity are risk factors for health-related quality of life decline: five-month follow-up EQ-5D data of visually impaired older patients. Health and quality of life outcomes. 2009;7(1):18.
10. 10. Hunger M, Thorand B, Schunk M, Döring A, Menn P, Peters A, et al. Multimorbidity and health-related quality of life in the older population: results from the German KORA age study. Health and quality of life outcomes. 2011;9(1):53.
11. 11. WHOQOL: Measuring Quality of Life, Introducing the WHOQOL instruments Erişim adresi: https://www.who.int/ healthinfo/survey/whoqol-qualityoflife/en/. Erişim tarihi: 13.02.2020
12. 12. Wang H-M, Beyer M, Gensichen J, Gerlach FM. Health-related quality of life among general practice patients with differing chronic diseases in Germany: cross sectional survey. BMC Public Health. 2008;8(1):246.
13. 13. Grumbach K. Chronic illness, comorbidities, and the need for medical generalism. Annals Family Med; 2003.
14. 14. Türkiye İstatistik Kurumu. Adrese Dayalı Nüfus Kayıt Sistemi Sonuçları Erişim adresi: https://biruni.tuik.gov.tr/ medas/?kn=95&locale=tr, Erişim tarihi: 23.01.2018
15. 15. T.C. Sağlık Bakanlığı Eskişehir İl Sağlık Müdürlüğü Aile Sağlığı Merkezleri Erişim adresi: https://eskisehirism. saglik.gov.tr/TR,39889/aile-sagligimerkezleri.html. Erişim Tarihi: 24.01.2018
16. 16. Dalstra JA, Kunst AE, Borrell C, Breeze E, Cambois E, Costa G, et al. Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries. International journal of epidemiology. 2005;34(2):316-26
17. 17. Centers For Disease Control And Prevention. Behavioral Risk Factor Surveillance System Erişim adresi: https://www.cdc.gov/brfss/questionnaires/pdf-ques/2018_BRFSS_ English_Questionnaire.pdf. Erişim tarihi: 23.01.2018
18. 18. Eser E, Lağarlı T, Baydur H, Akkurt V, Akkuş H, Arslan E, et al. EUROHIS (WHOQOL-8. Tr) Türkçe sürümünün Türk toplumundaki psikometrik özellikleri. Türkiye Halk Sağlığı Dergisi. 2010;8(3):136-52.
19. 19. Höfelmann DA, Gonzalez-Chica DA, Peres KG, Boing AF, Peres MA. Chronic diseases and socioeconomic inequalities in quality of life among Brazilian adults: findings from a population-based study in Southern Brazil. The European Journal of Public Health. 2018;28(4):603-10.
20. 20. Tolonen H, Wolf H, Jakovljevic D, Kuulasmaa K. The European health risk monitoring project. Review of surveys for risk factors of major chronic diseases and comparability of the results. European Health Risk Monitoring (EHRM) Project. 2002.
21. 21. T.C. Sağlık Bakanlığı Halk sağlığı Genel Müdürlüğü. Fiziksel Aktivite.Yetişkinlerde Fiziksel Aktivite, Erişim Adresi: https://hsgm.saglik.gov.tr/depo/birimler/saglikli-beslenmehareketli-hayat-db/Fiziksel-Aktivite/yas-gruplarinda-fiziksel-aktivite/Yetiskinlerde-Fiziksel-Aktivite.pdf. Erişim tarihi: 05.04.2020
22. 22. World Health Organization. Body mass index Erişim adresi: http://www.euro.who.int/en/health-topics/diseaseprevention/nutrition/a-healthylifestyle/body-mass-index-bmi. Erişim tarihi: 23.01.2018
23. 23. Foley D, Ancoli-Israel S, Britz P, Walsh JJJopr. Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey. 2004;56(5):497-502.
24. 24. Marengoni A, Winblad B, Karp A, Fratiglioni LJAjoph. Prevalence of chronic diseases and multimorbidity among the elderly population in Sweden. 2008;98(7):1198-200.
25. 25. Roberts K, Rao D, Bennett T, Loukine L, Jayaraman GJHp, chronic disease prevention in Canada: research p, et al. Prevalence and patterns of chronic disease multimorbidity and associated determinants in Canada. 2015;35(6):87.
26. 26. Rennert G, Peterburg Y. Prevalence of selected chronic diseases in Israel. Hypertension. 2001;10(8.8):11.2.
27. 27. Tüzün H, Aycan S, Ilhan MN. Impact of comorbidity and socioeconomic status on quality of life in patients with chronic diseases who attend primary health care centres. Cent Eur J Public Health. 2015;23(3):188-94.
28. 28. Arslantas D, Ünsal A, Metintas S, Koc F, Arslantas A. Life quality and daily life activities of elderly people in rural areas, Eskişehir (Turkey). Archives of gerontology and geriatrics. 2009;48(2):127-31.
29. 29. Arokiasamy P, Uttamacharya U, Jain K, Biritwum RB, Yawson AE, Wu F, et al. The impact of multimorbidity on adult physical and mental health in low-and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal? BMC medicine. 2015;13(1):178.
30. 30. Lubetkin EI, Jia H, Franks P, Gold MR. Relationship among sociodemographic factors, clinical conditions, and healthrelated quality of life: examining the EQ5D in the US general population. Quality of Life Research. 2005;14(10):2187-96.
31. 31. Schweikert B, Hunger M, Meisinger C, König H-H, Gapp O, Holle R. Quality of life several years after myocardial infarction: comparing the MONICA/ KORA registry to the general population. European heart journal. 2008;30(4):436-43.
32. 32. Michelson H, Bolund C, Brandberg Y. Multiple chronic health problems are negatively associated with health related quality of life (HRQoL) irrespective of age. Quality of Life Research. 2000;9(10):1093-104.
33. 33. Heyworth IT, Hazell ML, Linehan MF, Frank TL. How do common chronic conditions affect healthrelated quality of life? Br J Gen Pract. 2009;59(568):e353-e8.
34. 34. Pengpid S, Peltzer K. The impact of chronic diseases on the quality of life of primary care patients in Cambodia, Myanmar and Vietnam. Iranian journal of public health. 2018;47(9):1308.
35. 35. Altay B, Çavuşoğlu F, Çal A. Yaşlıların sağlık algısı, yaşam kalitesi ve sağlıkla ilgili yaşam kalitesini etkileyen faktörler. TAF Preventive Medicine Bulletin.2016;15(3):181-9.
36. 36. Mielck A, Vogelmann M, Leidl R. Healthrelated quality of life and socioeconomic status: inequalities among adults with a chronic disease. Health and quality of life outcomes. 2014;12(1):58.
37. 37. Sathvik B, Parthasarathi G, Narahari M, Gurudev K. An assessment of the quality of life in hemodialysis patients using the WHOQOL-BREF questionnaire. Indian journal of nephrology. 2008;18(4):141.
38. 38. Ahangari M, Kamali M, Arjmand Hesabi M. The study of quality of life in the elderly with hypertension who are member of Tehran Senile Culture House Clubs. Iranian Journal of Ageing. 2008;3(1):26-32.
39. 39. Eljedi A, Mikolajczyk RT, Kraemer A, Laaser U. Health-related quality of life in diabetic patients and controls without diabetes in refugee camps in the Gaza strip: a cross-sectional study. BMC public health. 2006;6(1):268.
40. 40. Arnold R, Ranchor A, Sanderman R, Kempen G, Ormel J, Suurmeijer T. The relative contribution of domains of quality of life to overall quality of life for different chronic diseases. Quality of life Research. 2004;13(5):883-96.