Zhongguo quanke yixue (Nov 2023)
Health-related Quality of Life and Its Influencing Factors in Patients with Prevention of Disease in Traditionnal Chinese Medicine based on EQ-5D-5L Scale
Abstract
Background Prevention of disease in Traditionnal Chinese Medicine (TCM) is a distinguishing advantage of TCM health management services, however, the holistic health state of the patients remains to be elucidated and evaluated. Objective To evaluate the health-related quality of life (HRQoL) and its influencing factors in patients with prevention of disease in TCM. Methods From May to June 2022, a stratified cluster sampling method was used to randomly select a district-level TCM hospital from each of the four administrative regions of Guangzhou (Liwan District, Tianhe District, Baiyun District, Huadu District) as the research site. The EQ-5D-5L scale was used to investigate the patients with prevention of disease in TCM by questionnaire in primary care, and the health utility value was calculated according to the Chinese EQ-5D utility score system. The influencing factors of health utility value and EQ-VAS score were analyzed by using optimal scale regression analysis. Results A total of 660 questionnaires were completed in this survey, including 630 valid questionnaires, with a effective recovery rate of 95.45%. Among the 630 investigated patients with prevention of disease in TCM, 185 patients (29.4%) visited for daily health care, 242 patients (38.4%) visited at the initial stage of disease for discomfort, 218 patients (34.6%) visited for avoiding exacerbation of current illness, 67 patients (10.6%) visited for post-illness rehabilitation physiotherapy. The top three conditions for prevention of disease in TCM were insomnia disorder, epigastric pain and arthralgia. The EQ-5D-5L health utility value for the investigated patients was 0.942 (0.893, 1.000), and the EQ-VAS score was 80 (70, 90). All five dimensions based on the ranking of difficulties frequency were pain/discomfort (50.2%), anxiety/depression (46.9%), daily activities (14.4%), mobility (9.9%) and self-care (6.0%). The influencing factors of health utility value based on the ranking of importance were the main causes of most recent prevention of disease in TCM (0.366), age (0.281), comorbidities of TCM conditions (0.145), occupation (0.111) and education level (0.098). The influencing factors of EQ-VAS score based on the ranking of importance were marital status (0.378), understanding of prevention of disease in TCM (0.353), age (0.176) and monthly income (0.092) . Conclusion The HRQoL of patients with prevention of disease in TCM in primary care in Guangzhou is at a medium level. The health utility values were relatively low in patients suffered from TCM conditions such as lung cancer, stroke, chronic obstructive pulmonary disease, osteoporosis and breast cancer, aged 60 and above, comorbid with 2 or more TCM conditions, with manual labour and lower education level. The self-rated health status was relatively poor in patients absence from marriage, unaware of prevention of disease in TCM, aged 60 and above, with higher monthly income. HRQoL should be applied reasonably as an important outcome indicator. Attention should be paid to the population with poor HRQoL among patients with prevention of disease in TCM, the promotion and dissemination of the concept and connotation of prevention of disease in TCM should be strengthened.
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