Survey of patients with chronic hepatitis B to identify factors that influence quality of life / 中华肝脏病杂志

ABSTRACT

<p><b>OBJECTIVE</b>To survey patients with chronic hepatitis B (CHB) to determine their perceptions of CHB-related quality of life (QOF) and to determine the factors influencing this measure.</p><p><b>METHODS</b>A total of 268 patients with CHB (disease group) and 205 healthy individuals (control group) completed the World Health Organization (WHO)QOL-BREF life assessment survey and a self-designed questionnaire of health and QOL. The groups' responses were comparatively analyzed by the cluster sampling method and the independent samples t-test. The strength of influence of each factor on the patients' perceptions of QOL was determined by multiple stepwise regression and one-way ANOVA.</p><p><b>RESULTS</b>The disease group had significantly lower scores than the control group for overall QOL (62.88 ± 8.22 vs. 67.31 ± 5.82), the physiological area (PHYS 64.71 ± 15.05 vs. 73.21 ± 11.26), the psychological area (PSYCH 64.35 ± 14.71 vs. 68.94 ± 10.13), the social relations area (SOCIL 67.20 ± 12.98 vs. 69.83 ± 8.65), the environmental area (ENVIR 59.58 ± 13.23 vs. 63.97 ± 10.24), the QOL self-assessment (60.75 ± 21.54 vs. 66.90 ± 17.57) and the health self-assessment (58.13 ± 19.15 vs. 76.26+/-14.27) (all, P less than 0.05). Multiple stepwise regression analysis identified the following parameters as risk factors of PHYS depression (P less than 0.001), perception of being seriously ill (P less than 0.001), self-payment for treatment (P = 0.003), CHB significant impact on income (P = 0.002), poor appetite (P = 0.002), langur (P less than 0.001), and fear of infecting others (P = 0.022). Confidence of treatment was a protective factor of PHYS (P = 0.001). The risk factors of PSYCH were depression (P less than 0.001) and recurrence (P less than 0.001), and the protective factors were confidence of treatment (P = 0.003) and male sex (P = 0.014). The risk factors of SOCIL were depression (P less than 0.001, dissatisfaction with the attitude of the people around (P = 0.001), recurrence (P = 0.008), and advanced age (P = 0.009), and the protective factors were social support (P less than 0.001) and confidence of treatment (P = 0.015); however, the scores were significantly different for different occupations (P = 0.008). The risk factors of ENVIR were depression (P less than 0.001), dissatisfaction with the attitude of the people around (P less than 0.001), living in rural area (P = 0.007), and recurrence (P = 0.016).</p><p><b>CONCLUSION</b>Patients should be monitored for depressive symptoms during the course of clinical medical care for CHB so that psychological care may be initiated in a timely manner. It is important to strengthen communication between healthcare professionals and patients in order to improve the patient's perception of social support and quality of life.</p>