Health-related quality of life and its related factors in coronary heart disease patients: results from the Henan Rural Cohort study

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Abstract

The aims were to identify the possible influencing factors of health-related quality of life (HRQoL) and its domain-specific scores in patients with coronary heart disease (CHD). A total of 1247 patients with CHD from the Henan Rural Cohort Study (n = 39,259) were included in this study. The Chinese version of the European Quality of Life Five Dimension Five level scale (EQ-5D-5L) and Visual Analogue Scale (VAS) were used to evaluate HRQoL in patients with CHD. Tobit regression, generalized linear models and binary logistic regression were applied to determine the potential factors influencing the EQ-5D utility, as well as each domain, and the VAS. CHD patients had lower per capita monthly actual income, and higher rates of diabetes mellitus, stroke, anxiety and poor sleep quality, which significantly decreased EQ-5D index and VAS scores. In addition, sex, older age, education, not having a spouse, ever drinking alcohol, a high-fat diet, physical activity, hypertension and depression affected the various domain-specific EQ-5D scores in CHD patients. CHD patients in rural areas have a lower HRQoL. Factors associated with the EQ-5D index, including each domain, and the VAS need attention. CHD patients in rural areas need to be managed systematically.

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Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Maigeng Zhou, Haidong Wang, Xinying Zeng … (2019)

Summary Background Public health is a priority for the Chinese Government. Evidence-based decision making for health at the province level in China, which is home to a fifth of the global population, is of paramount importance. This analysis uses data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to help inform decision making and monitor progress on health at the province level. Methods We used the methods in GBD 2017 to analyse health patterns in the 34 province-level administrative units in China from 1990 to 2017. We estimated all-cause and cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), summary exposure values (SEVs), and attributable risk. We compared the observed results with expected values estimated based on the Socio-demographic Index (SDI). Findings Stroke and ischaemic heart disease were the leading causes of death and DALYs at the national level in China in 2017. Age-standardised DALYs per 100 000 population decreased by 33·1% (95% uncertainty interval [UI] 29·8 to 37·4) for stroke and increased by 4·6% (–3·3 to 10·7) for ischaemic heart disease from 1990 to 2017. Age-standardised stroke, ischaemic heart disease, lung cancer, chronic obstructive pulmonary disease, and liver cancer were the five leading causes of YLLs in 2017. Musculoskeletal disorders, mental health disorders, and sense organ diseases were the three leading causes of YLDs in 2017, and high systolic blood pressure, smoking, high-sodium diet, and ambient particulate matter pollution were among the leading four risk factors contributing to deaths and DALYs. All provinces had higher than expected DALYs per 100 000 population for liver cancer, with the observed to expected ratio ranging from 2·04 to 6·88. The all-cause age-standardised DALYs per 100 000 population were lower than expected in all provinces in 2017, and among the top 20 level 3 causes were lower than expected for ischaemic heart disease, Alzheimer's disease, headache disorder, and low back pain. The largest percentage change at the national level in age-standardised SEVs among the top ten leading risk factors was in high body-mass index (185%, 95% UI 113·1 to 247·7]), followed by ambient particulate matter pollution (88·5%, 66·4 to 116·4). Interpretation China has made substantial progress in reducing the burden of many diseases and disabilities. Strategies targeting chronic diseases, particularly in the elderly, should be prioritised in the expanding Chinese health-care system. Funding China National Key Research and Development Program and Bill & Melinda Gates Foundation.

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The Patient Health Questionnaire-2: validity of a two-item depression screener.

Kurt Kroenke, Robert L Spitzer, Janet B W Williams (2003)

A number of self-administered questionnaires are available for assessing depression severity, including the 9-item Patient Health Questionnaire depression module (PHQ-9). Because even briefer measures might be desirable for use in busy clinical settings or as part of comprehensive health questionnaires, we evaluated a 2-item version of the PHQ depression module, the PHQ-2. The PHQ-2 inquires about the frequency of depressed mood and anhedonia over the past 2 weeks, scoring each as 0 ("not at all") to 3 ("nearly every day"). The PHQ-2 was completed by 6000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-2 depression severity increased from 0 to 6, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and healthcare utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-2 score > or =3 had a sensitivity of 83% and a specificity of 92% for major depression. Likelihood ratio and receiver operator characteristic analysis identified a PHQ-2 score of 3 as the optimal cutpoint for screening purposes. Results were similar in the primary care and obstetrics-gynecology samples. The construct and criterion validity of the PHQ-2 make it an attractive measure for depression screening.

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Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection.

Kurt Kroenke, Robert L Spitzer, Janet B.W. Williams … (2007)

Anxiety, although as common as depression, has received less attention and is often undetected and undertreated. To determine the current prevalence, impairment, and comorbidity of anxiety disorders in primary care and to evaluate a brief measure for detecting these disorders. Criterion-standard study performed between November 2004 and June 2005. 15 U.S. primary care clinics. 965 randomly sampled patients from consecutive clinic patients who completed a self-report questionnaire and agreed to a follow-up telephone interview. 7-item anxiety measure (Generalized Anxiety Disorder [GAD]-7 scale) in the clinic, followed by a telephone-administered, structured psychiatric interview by a mental health professional who was blinded to the GAD-7 results. Functional status (Medical Outcomes Study Short Form-20), depressive and somatic symptoms, and self-reported disability days and physician visits were also assessed. Of the 965 patients, 19.5% (95% CI, 17.0% to 22.1%) had at least 1 anxiety disorder, 8.6% (CI, 6.9% to 10.6%) had posttraumatic stress disorder, 7.6% (CI, 5.9% to 9.4%) had a generalized anxiety disorder, 6.8% (CI, 5.3% to 8.6%) had a panic disorder, and 6.2% (CI, 4.7% to 7.9%) had a social anxiety disorder. Each disorder was associated with substantial impairment that increased significantly (P < 0.001) as the number of anxiety disorders increased. Many patients (41%) with an anxiety disorder reported no current treatment. Receiver-operating characteristic curve analysis showed that both the GAD-7 scale and its 2 core items (GAD-2) performed well (area under the curve, 0.80 to 0.91) as screening tools for all 4 anxiety disorders. The study included a nonrandom sample of selected primary care practices. Anxiety disorders are prevalent, disabling, and often untreated in primary care. A 2-item screening test may enhance detection.

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Author and article information

Contributors

Dong-bin Yang: dongbinyang@126.com

Chong-jian Wang: tjwcj2005@126.com

Wei-hong Zhang: 18638127788@163.com

Journal

Journal ID (nlm-ta): Sci Rep

Journal ID (iso-abbrev): Sci Rep

Title: Scientific Reports

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2045-2322

Publication date (Electronic): 3 March 2021

Publication date PMC-release: 3 March 2021

Publication date Collection: 2021

Volume: 11

Electronic Location Identifier: 5011

Affiliations

[1 ]GRID grid.207374.5, ISNI 0000 0001 2189 3846, School of Nursing and Health, , Zhengzhou University, ; No. 100 Kexue Road, Zhengzhou, 450001 People’s Republic of China

[2 ]GRID grid.207374.5, ISNI 0000 0001 2189 3846, Department of Epidemiology and Biostatistics, College of Public Health, , Zhengzhou University, ; 100 Kexue Avenue, Zhengzhou, 450001 Henan People’s Republic of China

[3 ]The People’s Hospital of Hebi, 115 Jiuzhou Rd, Hebi, 458000 Henan People’s Republic of China

[4 ]GRID grid.412990.7, ISNI 0000 0004 1808 322X, School of Public Health, , Xinxiang Medical University, ; 601 Jinsui Rd, Xinxiang, 453000 Henan People’s Republic of China

[5 ]GRID grid.265021.2, ISNI 0000 0000 9792 1228, School of Public Health, , Tianjin Medical University, ; 22 Qixiangtai Rd, Heping District, Tianjin, 300070 People’s Republic of China

[6 ]Henan Province General Medical Educations and Research Center, Xinxiang, People’s Republic of China

[7 ]Department of Neurosurgery of Hebi People’s Hospital, Hebi Neuroanatomical Laboratory, Hebi, 458030 People’s Republic of China

Article

Publisher ID: 84554

DOI: 10.1038/s41598-021-84554-6

PMC ID: 7930256

PubMed ID: 33658589

SO-VID: c3cfe2c0-c1f0-4387-a715-f381a884edb4

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 30 April 2020

Date accepted : 8 January 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100002858, China Postdoctoral Science Foundation;

Award ID: 2019M652589

Award Recipient : Yong-xia Mei

Funded by: Foundation of National Key Program of Research and Development of China2016YFC0900803

Award ID: 2016YFC0900803

Award Recipient : Chong-jian Wang

Funded by: National Natural Science Foundation of China

Award ID: 81573243

Award ID: U1304821

Award Recipient : Chong-jian Wang Wei-hong Zhang

Funded by: Henan Natural Science Foundation of China

Award ID: 182300410293

Award Recipient : Chong-jian Wang

Funded by: Science and Technology Foundation for Innovation Talent of Henan Province

Award ID: 164100510021

Award Recipient : Chong-jian Wang

Funded by: Science and Technology Innovation Talents Support Plan of Henan Province Colleges and Universities

Award ID: 14HASTIT035

Award ID: 17HASTIT048

Award Recipient : Chong-jian Wang Wei-hong Zhang

Funded by: High-level Personnel Special Support Project of Zhengzhou University

Award ID: ZDGD13001

Award Recipient : Chong-jian Wang

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ScienceOpen disciplines: Uncategorized

Keywords: cardiology,health care,risk factors

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ScienceOpen disciplines: Uncategorized

Keywords: cardiology, health care, risk factors

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Health-related quality of life and its related factors in coronary heart disease patients: results from the Henan Rural Cohort study

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Cardiovascular Innovations and Applications

Most cited references 41

Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

The Patient Health Questionnaire-2: validity of a two-item depression screener.

Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection.

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