Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-02-19 Cooperative journals: 《中国全科医学》
Abstract： Background Chronic diseases have become a major public health problem affecting the health of the population，and the number of patients with chronic diseases in China continues to increase，as well as the increasing number of deaths due to chronic disease by year，and the increasing burden of disease on patients gradually. Understanding the changes in the burden of chronic diseases is of great importance for the prevention and control of chronic diseases. However，there is a lack of research on the changes in the burden of common chronic diseases in rural Yunnan Province. Objective To examine the changes in the disease burden of five common chronic diseases［hypertension，coronary heart disease（CHD），stroke，asthma，and chronic obstructive pulmonary disease（COPD）］among rural residents in Yunnan Province in 2011 and 2021. Methods A repeated cross-sectional design was used to select 8 400 and 7 700 rural residents aged ≥ 35 years in Yunnan Province using multistage stratified random sampling method in 2011 and 2021 as the research subjects，respectively. Data were collected from on-site questionnaires and physical examinations of study participants，as well as data on the causes of death of five common chronic diseases. Principal component analysis was used to construct a socioeconomic status（SEP）indicator by selecting three variables including education level，annual household income per capita and accessibility to medical services，the coefficients of the variables were used to calculate the SEP composite score，and the SEP was classified into four grades of low，medium#2;low，medium-high and high based on the quartiles of the SEP composite score. Disability-adjusted life year（DALY）was used to measure the magnitude of the disease burden for five chronic diseases. Results Compared with 2011，the overall prevalence of hypertension（25.14% vs. 41.57%），stroke（1.03% vs. 2.52%），and COPD（9.23% vs. 12.60%）in rural Yunnan Province in 2021 increased（P<0.05），as well as the prevalence for males，females，and participants with all SEP grades（P<0.05）； the overall prevalence of CHD（2.02% vs. 2.30%）and asthma（1.36% vs. 1.61%）did not change significantly（P>0.05）， while an increase was found in the prevalence of CHD among males and those with high SEP grade，and in the prevalence of asthma among males and those with medium-high SEP grade（P<0.05）. In 2021，the prevalence of all 5 chronic diseases was higher in males than in females（P<0.05），and there was a decreasing trend in the prevalence of COPD by different grades of SEP in 2021（χ2 trend=6.801，P<0.001）. In addition，an increase was found in DALY per 1 000 population of CHD（10.45 vs. 18.18），stroke（12.80 vs. 23.20），asthma（4.54 vs. 9.10），and COPD（35.99 vs. 49.07），while a decrease was found in DALY per 1 000 population of hypertension（1.38 vs. 1.26）. COPD presents higher DALY per 1 000 population and years of life disability（YLD）per 1 000 population，while stroke presents higher years of life lost（YLL）per 1 000 population among the five chronic diseases. Conclusion The prevalence and disease burden of five common chronic diseases among rural residents in Yunnan Province in 2021 were mainly higher than 2011，and the disease burden of COPD was the heaviest in 2021，with males and those with low SEP grade being the key populations for future prevention and control of chronic diseases. Targeted prevention and control strategies should be adopted to reduce its harm to the health of population.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-10-07 Cooperative journals: 《中国全科医学》
Abstract： Background Successful aging can help to alleviate the aging process，but may be affected by household income. Objective To explore the impact of household income on successful aging and provide fundamental data for improving health equity for the elderly in China. Methods Data from the 2018 China Health and Retirement Longitudinal Study （CHARLS）were used to select participants aged 60 and above. The older adults were categorized into the high-income（≤33.33%），middle-income（33.34%-66.66%），and low-income（≥66.67%） groups based on the annual household income levels within each province. Successful aging was measured based on the Rowe and Kahn models and the multivariate Logistic regression was conducted to identify the effects of different levels of household income on successful aging. Results A total of 7 741 subjects were finally included with 2192（28.32%），2680（34.62%） and 2869（37.06%） in the low-income group，middle income group and high-income group，respectively. The proportion of successful aging was 15.55% （1 204/7 741） among Chinese older adults in 2018，with 21.02% （603/2 869） for high-income group，13.62%（365/2680）for middle-income group，and 10.77%（236/2 192） for low-income group （P<0.05）. Older adults in the low-income group performed worse than those in the middle-income and high-income groups in daily function loss，cognitive function，no depression，and active social participation （P<0.05）.However，there was no statistically significant difference in the prevalence of major chronic diseases among the three groups（P>0.05）. The results of multivariate Logistic regression analysis showed that after controlling for demographic characteristics（age，gender，ethnicity，education level，and region of residence），the proportion of successful aging in the middle-income and high-income groups was 1.226 times （OR=1.226，95%CI=1.028-1.463） and 1.721 times （OR=1.721，95%CI=1.450-2.044） as high as those in the low-income group；after controlling for health status and behavioral factors（night sleep duration，accidental falls，hospitalization in the past year，hearing，and masticatory function），the proportion of successful aging in the high-income group was 1.559 times higher than that in the low-income group（OR=1.559，95%CI=1.028-1.463）；after controlling for home living environment（bathing facilities，home hygiene），the proportion of successful aging in the high-income group was 1.461 times higher than that in the low-income group（OR=1.461，95%CI=1.207-1.770）. Conclusion The proportion of successful aging in China is low，and the level of household income is an independent influencing factor for successful aging. Focus on the improvement of physical and mental health and function，increasing the social participation of older adults might be important measures to promote the construction of Healthy China and active responding to population aging.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-07-18 Cooperative journals: 《中国全科医学》
Abstract： Background The reported outcome level of patients with inflammatory bowel disease（IBD） has received attention. There are few mature outcome scales with Chinese cultural characteristics for patients with IBD，and the developed scales need strict evaluation. Objective To analyze and evaluate the measurement properties of the Inflammatory Bowel Disease Patient-Reported Outcome Measurement Scale〔PROISCD-IBD（V1.0）〕，to provide basis for scientific evaluation of reported outcomes in patients with IBD. Methods From October 2020 to January 2022，PROISCD-IBD（V1.0） was used to detect 274 IBD patients who were treated in the outpatient and inpatient departments of Gastroenterology in the FirstAffiliated Hospital of Kunming Medical University and the Affiliated Hospital of Guangdong Medical University. PROISCD IBD（V1.0） consisted of 1 commonality module and 1 IBD specific module. The commonality module had 30 items，which were divided into 4 domains of physical health，mental health，social health，and spiritual/belief health. TIBD covered four aspects of digestive system symptoms（DSS），extraintestinal symptom（EXS），special psychological symptoms（SPP），and treatment side effects（TSE）. Cronbach's α coefficient and split-half coefficient were used to test the reliability. Correlation coefficient method，exploratory factor analysis and structural equation model were used to analyze the structural validity. Clinical validity of each domain was analyzed using t test. Results The Cronbach's α coefficients of physical health，mental health，social health，spiritual/belief health and specific module of PROISCD-IBD（V1.0） were 0.732，0.838，0.781，0.673 and 0.884，respectively. Cronbach's α coefficient of total scale was 0.932. The half-score coefficients of physical health，mental health，social health，spiritual/faith health and specific module were 0.669，0.859，0.610，0.494 and 0.795，respectively，and the half-score reliability of the total scale was 0.879. Correlation analysis showed that the phase coefficients of PHD，MHD，SHD and SBD scores and commonality module score were all >0.6（P<0.05）. Three principal components were extracted from exploratory factor analysis，and the cumulative variance contribution rate was 58.05%. Structural equation model showed that（χ2/df=2.568，root-mean-square error of approximation（RMSEA）=0.076，normed fit index（NFI）=0.677，non-normed fit index（NNFI）=0.774，comparative fit index（CFI）=0.772，incremental fit index（IFI）=0.774，SRMR=0.1031. IBD patients were divided into active stage（n=90） and remission stage（n=184） according to clinical stages. The total scores of various domains，common modules，specific modules and scale in remission stage were higher than those in active stage（P<0.05）. Conclusion PROISCD-IBD（V1.0） has good reliability and validity for reporting outcome measures in patients with IBD.
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