Die globale Gesundheitseinschätzung bei Männern und Frauen in einer Anästhesieambulanz: In wieweit beeinflussen Faktoren aus den Bereichen Lebensstil, Soziodemographie, physische und psychische Gesundheit die globale Gesundheitseinschätzung?

Abstract

Hintergrund: Verschiedene Studien konnten nachweisen, dass die subjektive Gesundheit ein unabhängiger Prädiktor für die individuelle Mortalität ist. Die Frage nach der globalen Gesundheitseinschätzung mit Hilfe der visuellen Analogskala (VAS) stellte die selbst eingeschätzte Gesundheit gut dar. Sie variierte im internationalen Vergleich und bei Frauen und Männern fanden sich deutliche Unterschiede. Der Einfluss, den verschiedene Faktoren aus den Bereichen „Lebensstil“, „Soziodemographie“, „physische und psychische Gesundheit“ auf die subjektive Gesundheit von Frauen und Männern ausübten, wurde in der Literatur kontrovers diskutiert. Dabei wurde die relative Einflusstärke der verschiedenen Faktoren nicht oder nur zum Teil untersucht.

Introduction: Several studies could prove that subjective health was an independent predictor for individual mortality. The question for global health using a visual analogue scale was able to display well self rated health. Self rated health varied internationally and gender differences could be shown. The influence on subjective health of women and men caused by different factors of the domains lifestyle, social demographics, physical and psychic health was discussed controversially. The relative strength of different factors was only partly examined. Aims: The aim of this study was to show global self rated health of female and male patients in an Anesthesia Preoperative Evaluation Clinic (APEC). Furthermore, it was tried to identify relevant influencing factors of the domains lifestyle, social demographics, physical and psychic health and their relative strength was tried to be determined. Methods: From February 13th to December 20th 2006 3.219 patients from the Anesthesia Preoperative Evaluation Clinic of the Charité – Universitätsmedizin Berlin (Campus Mitte and Virchow-Klinikum) answered a questionnaire that was carried out within the context of a lifestyle survey. To measure global self rated health patients used a visual analogue scale to mark their global health. The visual analogue scale is part of the Euro-Qol questionnaire that was established to record subjective health and that is composed of 5 questions and the visual analogue scale. In addition, questions for the domains lifestyle, social demographics, physical and psychic health were asked. Statistics: For statistical calculations the computer program “The Statistical Package for Social Sciences“ (SPSS 17.0) was used. Data was described. Differences in means of various participants’ global self rated health were calculated. Furthermore, linear regression analysis was executed in several steps to determine the influence of factors and 4 domains. Finally the influence of all factors together on global self rated health was calculated. Influence of 4 confounders (age, sex, high-school diploma and number of primary diseases) was taken into account. Results: The mean value of global self rated health of respondent patients was 67,99 on the visual analogue scale. Men (68,99) estimated their health as to be better then women (66,96). The influence of factors of the domains lifestyle (1,3%) and social demographics (2,6%) was lower then the one of the domains psychic health (9,0%) and physical health (25,1%). All domains together explained 31,3% (women 32,7%, men 31,1%) of the patients’ global self rated health. Discussion: The global self rated health of patients from a Anesthesia Preoperative Evaluation Clinic was worse than global self rated health of a German general population (67,99 versus 77,4). In contrast to prior studies gender differences could be proved. Before this thesis was presented it was only possible to compare patients’ global self rated health with the one of healthy people or the one of patients with a certain disease. The presented data allows comparing patients global self rated health with the one of a group of patients in which different diseases occur. The in this way extended possibilities of comparison enables to more precisely evaluate patients’ health and to identify problem areas within patient groups. Relevant factors influencing global self rated health were identified. They were put in relation to each other. The influence of the domains lifestyle and social demographics was lower than the one of the domains physical and psychic health. In many cases factors influenced the global self rated health of women and men in a different manner. This kind of gender differences should be considered when future prevention measures such as education about risky lifestyle behaviour are planned. Knowing about relevant factors influencing global self rated health can highlight starting points for prevention and health education. Moreover, comparing different factors in terms of their relative strength influencing global self rated health supports a more aimed action in healthcare policy.