期刊论文详细信息
BMC Cardiovascular Disorders
Gender differences and determinants of health related quality of life in coronary patients: a follow-up study
Inmaculada Failde1  Roque Arana2  Carmen Ramirez1  María Dueñas1 
[1] Área de Medicina Preventiva y Salud Pública. Universidad de Cádiz. Spain;Servicio de Cardiologia, Hospital Universitario "Puerta del Mar". Spain
关键词: Coronary patients;    SF-36;    HRQL;    Gender;   
Others  :  1086027
DOI  :  10.1186/1471-2261-11-24
 received in 2010-11-02, accepted in 2011-05-27,  发布年份 2011
PDF
【 摘 要 】

Background

The role of gender differences in Health Related Quality Life (HRQL) in coronary patients is controversial, so understanding the specific determinants of HRQL in men and women might be of clinical importance. The aim of this study was to know the gender differences in the evolution of HRQL at 3 and 6 months after a coronary event, and to identify the key clinical, demographic and psychological characteristics of each gender associated with these changes.

Methods

A follow-up study was carried out, and 175 patients (112 men and 63 women) with acute myocardial infarction (AMI) or unstable angina were studied. The SF-36v1 health questionnaire was used to assess HRQL, and the GHQ-28 (General Health Questionnaire) to measure mental health during follow-up. To study the variables related to changes in HRQL, generalized estimating equation (GEE) models were performed.

Results

Follow-up data were available for 55 men and 25 women at 3 months, and for 35 men and 12 women at 6 months. Observations included: a) Revascularization was performed later in women. b) The frequency of rehospitalization between months 3 and 6 of follow-up was higher in women c) Women had lower baseline scores in the SF-36. d) Men had progressed favourably in most of the physical dimensions of the SF-36 at 6 months, while at the same time women's scores had only improved for Physical Component Summary, Role Physical and Social Functioning; e) the variables determining the decrease in HRQL in men were: worse mental health and angina frequency; and in women: worse mental health, history of the disease, revascularization, and angina frequency.

Conclusions

There are differences in the evolution of HRQL, between men and women after a coronary attack. Mental health is the determinant most frequently associated with HRQL in both genders. However, other clinical determinants of HRQL differed with gender, emphasizing the importance of individualizing the intervention and the content of rehabilitation programs. Likewise, the recognition and treatment of mental disorders in these patients could be crucial.

【 授权许可】

   
2011 Dueñas et al; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150113182628947.pdf 251KB PDF download
Figure 1. 47KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]Brink E, Grankvist G, Karlson BW, Hallberg LR: Health-related quality of life in women and men one year after acute myocardial infarction. Qual Life Res 2005, 14(3):749-757.
  • [2]Smith H, Taylor R, Mitchell A: A comparison of four quality of life instruments in cardiac patients: SF-36, QLI, QLMI, and SEIQoL. Heart 2000, 84(4):390-394.
  • [3]Tunstall-Pedoe H, Vanuzzo D, Hobbs M, Mahonen M, Cepaitis Z, Kuulasmaa K, Keil U: Estimation of contribution of changes in coronary care to improving survival, event rates, and coronary heart disease mortality across the WHO MONICA Project populations. Lancet 2000, 355(9205):688-700.
  • [4]Abbey SE, Stewart DE: Gender and psychosomatic aspects of ischemic heart disease. J Psychosom Res 2000, 48(4-5):417-423.
  • [5]Brink E, Karlson BW, Hallberg LRM: Health experiences of first-time myocardial infarction: Factors influencing women's and men's health-related quality of life after five months. Psychology, Health and Medicine 2002, 7(1):5-16.
  • [6]Ghali WA, Faris PD, Galbraith PD, Norris CM, Curtis MJ, Saunders LD, Dzavik V, Mitchell LB, Knudtson ML, Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) Investigators: Sex differences in access to coronary revascularization after cardiac catheterization: importance of detailed clinical data. Ann Intern Med 2002, 136(10):723-732.
  • [7]Kannel WB, Sorlie P, McNamara PM: Prognosis after initial myocardial infarction: the Framingham study. Am J Cardiol 1979, 44(1):53-59.
  • [8]Schuster PM, Waldron J: Gender differences in cardiac rehabilitation patients. Rehabilitation nursing: the official journal of the Association of Rehabilitation Nurses 1991, 16(5):248-253.
  • [9]O'Callaghan WG, Teo KK, O'Riordan J, Webb H, Dolphin T, Horgan JH: Comparative response of male and female patients with coronary artery disease to exercise rehabilitation. Eur Heart J 1984, 5(8):649-651.
  • [10]Norris CM, Hegadoren K, Pilote L: Depression symptoms have a greater impact on the 1-year health-related quality of life outcomes of women post-myocardial infarction compared to men. Eur J Cardiovasc Nurs 2007, 6(2):92-98.
  • [11]Wiklund I, Herlitz J, Johansson S, Bengtson A, Karlson BW, Persson NG: Subjective symptoms and well-being differ in women and men after myocardial infarction. Eur Heart J 1993, 14(10):1315-1319.
  • [12]Westin L, Carlsson R, Erhardt L, Cantor-Graae E, McNeil T: Differences in quality of life in men and women with ischemic heart disease. A prospective controlled study. Scand Cardiovasc J 1999, 33(3):160-165.
  • [13]Beck CA, Joseph L, Belisle P, Pilote L: Predictors of quality of life 6 months and 1 year after acute myocardial infarction. Am Heart J 2001, 142(2):271-279.
  • [14]Mendes de Leon CF, Dilillo V, Czajkowski S, Norten J, Schaefer J, Catellier D, Blumenthal JA, Enhancing Recovery in Coronary Heart Disease (ENRICHD) Pilot Study: Psychosocial characteristics after acute myocardial infarction: the ENRICHD pilot study. Enhancing Recovery in Coronary Heart Disease. J Cardiopulm Rehabil 2001, 21(6):353-362.
  • [15]Agewall S, Berglund M, Henareh L: Reduced quality of life after myocardial infarction in women compared with men. Clin Cardiol 2004, 27(5):271-274.
  • [16]Shumaker SA, Brooks MM, Schron EB, Hale C, Kellen JC, Inkster M, Wimbush FB, Wiklund I, Morris M: Gender differences in health-related quality of life among postmyocardial infarction patients: brief report. CAST Investigators. Cardiac Arrhythmia Suppression Trials. Womens Health 1997, 3(1):53-60.
  • [17]Emery CF, Frid DJ, Engebretson TO, Alonzo AA, Fish A, Ferketich AK, Reynolds NR, Dujardin JP, Homan JE, Stern SL: Gender differences in quality of life among cardiac patients. Psychosom Med 2004, 66(2):190-197.
  • [18]Pettersen KI, Reikvam A, Rollag A, Stavem K: Understanding sex differences in health-related quality of life following myocardial infarction. Int J Cardiol 2008, 130(3):449-456.
  • [19]Orfila F, Ferrer M, Lamarca R, Tebe C, Domingo-Salvany A, Alonso J: Gender differences in health-related quality of life among the elderly: the role of objective functional capacity and chronic conditions. Soc Sci Med 2006, 63(9):2367-2380.
  • [20]Norris CM, Ghali WA, Galbraith PD, Graham MM, Jensen LA, Knudtson ML, APPROACH Investigators: Women with coronary artery disease report worse health-related quality of life outcomes compared to men. Health Qual Life Outcomes 2004, 2:21. BioMed Central Full Text
  • [21]Dixon T, Lim LL, Powell H, Fisher JD: Psychosocial experiences of cardiac patients in early recovery: a community-based study. J Adv Nurs 2000, 31(6):1368-1375.
  • [22]Verbrugge LM: The twain meet: empirical explanations of sex differences in health and mortality. J Health Soc Behav 1989, 30(3):282-304.
  • [23]Medical Outcomes Trust: Manual de puntuación de la versión española del cuestionario de salud SF-36. Barcelona: Institut Municipal d'nvestigació Mèdica, Unitat de Recerca en Serveis Sanitaris; 2000.
  • [24]Lobo A, Pérez-Echeverría M, Artal J: Validity of the scaled version of the General Health Questionnaire (GHQ-28) in a Spanish population. Psychol Med 1986, 16(1):135-140.
  • [25]Vázquez Barquero J, Ochoteco A, Padierna Acero J, Antón Sainz J, Arenal González A, Peña C: El cuestionario de salud general (GHQ) como instrumento de "screening" de patología psiquiátrica en enfermos cardiológico. Actas Luso Esp Neurol Psiquiatr Cienc Afines 1982, 10(1):21-32.
  • [26]Twisk J, de Vente W: Attrition in longitudinal studies. How to deal with missing data. J Clin Epidemiol 2002, 55(4):329-337.
  • [27]Ballinger GA: Using Generalized Estimating Equations for Longitudinal Data Analysis. Organizational Research Methods 2004, 7(2):127-150.
  • [28]Cui J, Qian G: Selection of working correlation structure and best model in GEE analyses of longitudinal data. Communications in Statistics: Simulation and Computation 2007, 36(5):987-996.
  • [29]Van Jaarsveld C, Sanderman R, Ranchor A, Ormel J, van Veldhuisen D, Kempen G: Gender-specific changes in quality of life following cardiovascular disease: a prospective study. J Clin Epidemiol 2002, 55(11):1105-1112.
  • [30]Hemingway H, McCallum A, Shipley M, Manderbacka K, Martikainen P, Keskimaki I: Incidence and prognostic implications of stable angina pectoris among women and men. JAMA 2006, 295(12):1404-1411.
  • [31]Aguado-Romeo MJ, Marquez-Calderon S, Buzon-Barrera ML, por los investigadores del grupo VPM-IRYSS-Andalucia: Differences between women's and men's access to interventional cardiovascular procedures at public hospitals in Andalusia (Spain). Rev Esp Cardiol 2006, 59(8):785-793.
  • [32]Willingham SA, Kilpatrick ES: Evidence of gender bias when applying the new diagnostic criteria for myocardial infarction. Heart 2005, 91(2):237-238.
  • [33]Phillips Bute B, Mathew J, Blumenthal JA, Welsh-Bohmer K, White WD, Mark D, Landolfo K, Newman MF: Female gender is associated with impaired quality of life 1 year after coronary artery bypass surgery. Psychosom Med 2003, 65(6):944-951.
  • [34]Lane D, Carroll D, Ring C, Beevers DG, Lip GY: Mortality and quality of life 12 months after myocardial infarction: effects of depression and anxiety. Psychosom Med 2001, 63(2):221-230.
  • [35]Nores M, Díaz M: Construcción de Modelos Gee para Variables con Distribución Simétrica. Sociedad Argentina de Estadística 2005, 9:43-63.
  • [36]Twisk JW: Longitudinal data analysis. A comparison between generalized estimating equations and random coefficient analysis. Eur J Epidemiol 2004, 19(8):769-776.
  文献评价指标  
  下载次数:0次 浏览次数:3次