开始血液透析前生活过程中的经济压力对日本老年患者健康结果的影响:一项在日本的回顾性研究

H. Sugisawa, Y. Shimizu, T. Kumagai, K. Shishido, T. Shinoda
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引用次数: 1

摘要

目的本研究分析了开始血液透析前生活过程中的经济压力对日本老年患者健康结果的影响。这项研究仅限于在开始血液透析之前的整个生命过程中的经济压力,以消除因辞职而导致的经济压力的影响。我们研究了四种生命过程模型中的哪一种——途径、潜在、社会流动和积累——适合描述生命过程中经济压力对老年患者健康的影响。患者和方法数据来自对日本各地透析机构6644名门诊患者的横断面调查。我们选择了调查时年龄在60岁及以上的参与者。透析并发症、日常生活能力(ADL)残疾和抑郁症状的数量被选为健康结果。生命历程的基准期分为三个部分:18岁以下(儿童)、18-35岁(年轻人)和35-50岁(中年人)。我们回顾性地衡量了整个人生过程中的财务压力。结果Pathway模型最好地描述了生活过程中的经济压力对三种类型的健康结果的影响。年轻人的经济压力对老年患者的ADL残疾有直接影响。这一结果支持了潜在的模型。社会流动性模型(向上和向下流动性)和累积模型解释了老年患者透析并发症、ADL残疾和抑郁症状的数量。结论这些结果表明,在开始血液透析前的整个生命过程中,社会经济劣势与老年患者的健康结果显著相关。
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Influences of Financial Strains Over the Life Course Before Initiating Hemodialysis on Health Outcomes Among Older Japanese Patients: A Retrospective Study in Japan
Purpose This study analyzed the influence of financial strains over the life course before initiating hemodialysis on the health outcomes of older Japanese patients. This study was limited to financial strains over the life course before initiating hemodialysis to eliminate the influence of financial strains resulting from resignation from paid jobs. We examined which of the four life course models—pathway, latent, social mobility, and accumulation—were appropriate to describe the influences of financial strains over the life course on older patients’ health. Patients and Methods Data were obtained from a cross-sectional survey of 6,644 outpatients in dialysis facilities across Japan. We selected participants aged 60 years and older at the time of the survey. Numbers of dialysis complications, activities of daily living (ADL) disability, and depressive symptoms were selected as health outcomes. Benchmark periods over the life course were constructed in three parts: less than 18 years (childhood), 18–35 years (young adults), and 35–50 years (middle-aged). We retrospectively measured financial strains over the life course. Results Pathway models best described the influence of financial strains over the life course on the three types of health outcomes. Experiences of financial strains as young adults had a direct influence on ADL disability of older patients. This result supports latent models. Social mobility models (upward and downward mobility) and accumulation models explained the number of dialysis complications, ADL disability, and depressive symptoms in older patients. Conclusion These results suggest that socioeconomic disadvantages over the life course before initiating hemodialysis were significantly associated with health outcomes in older patients.
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来源期刊
CiteScore
3.90
自引率
5.00%
发文量
40
审稿时长
16 weeks
期刊介绍: International Journal of Nephrology and Renovascular Disease is an international, peer-reviewed, open-access journal focusing on the pathophysiology of the kidney and vascular supply. Epidemiology, screening, diagnosis, and treatment interventions are covered as well as basic science, biochemical and immunological studies. In particular, emphasis will be given to: -Chronic kidney disease- Complications of renovascular disease- Imaging techniques- Renal hypertension- Renal cancer- Treatment including pharmacological and transplantation- Dialysis and treatment of complications of dialysis and renal disease- Quality of Life- Patient satisfaction and preference- Health economic evaluations. The journal welcomes submitted papers covering original research, basic science, clinical studies, reviews & evaluations, guidelines, expert opinion and commentary, case reports and extended reports. The main focus of the journal will be to publish research and clinical results in humans but preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies and interventions.
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