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1.
Transplantation ; 68(9): 1331-5, 1999 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-10573072

RESUMO

BACKGROUND: This study had four goals: (1) to evaluate an index of health-related quality of life (HQOL) among renal-transplant recipients in Japan, (2) to compare HQOL of renal-transplant recipients with that of the Japanese population as a whole, and (3,4) to study associations of HQOL with renal function and with the time since transplantation. METHODS: Questionnaires were distributed to 570 subjects. All were outpatients, were 16 years old or older, and were studied at least 1 year after they had received their latest renal transplant. HQOL was assessed with the Short Form 36-item health survey. Subjects' physicians provided data on renal function. Associations of HQOL with serum creatinine concentration and with the time since transplantation were evaluated by logistic regression. RESULTS: The response rate was 83%. Data from patients with diabetes and from those who had had at least two renal transplants were excluded; data from 395 recipients were analyzed. On the physical functioning, general health perception, vitality, and social functioning scales, the patients' scores were significantly lower than the Japanese national-norm scores. General health perception was particularly low. Serum creatinine concentrations were associated with general health perception, vitality, and social functioning. Longer times since transplantation were associated with better social functioning. CONCLUSIONS: Although social and physical functioning may improve after transplant surgery, a low self-rating of general health seemed to remain. The rarity of renal transplantation in Japan and other psychosocial factors may explain the low self-rating of general health in Japanese renal-transplant recipients.


Assuntos
Nível de Saúde , Transplante de Rim/psicologia , Qualidade de Vida , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Seguro Saúde , Japão , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
2.
Am J Kidney Dis ; 37(5): 987-96, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11325681

RESUMO

We used the 36-item Short-Form Health Survey to compare health-related quality of life (HRQOL) between 104 dialysis patients in Seattle, WA, and 2,178 patients in Aichi, JAPAN: Compared with Aichi patients, Seattle patients had lower scores on three scales related to physical HRQOL: Physical Functioning (PF; P = 0.03), Role-Physical (RP; P = 0.004), and Vitality (VT; P < 0.001). However, scores related to mental HRQOL were higher for Seattle patients compared with those of Aichi patients, which included scores for Role-Emotional (RE; P = 0.005) and Mental Health (MH; P < 0.001). Scores for Bodily Pain, General Health Perception, and Social Functioning did not differ significantly between the two groups. These differences persisted even after potential confounding factors were controlled for. However, after taking into account national norm data for the United States and Japan, differences in PF and VT disappeared, whereas differences in RP, RE, and MH persisted. These results suggest that the higher scores for PF and VT in Aichi patients were partly explained by the higher physical HRQOL of the Japanese general population. Although these data may not be representative of the total dialysis populations in the United States and Japan, they suggest potential differences in HRQOL between patients in the two countries. Additional research is needed to confirm these results and understand the factors associated with these differences. The findings suggest the need for further attention to the physical limitations of US dialysis patients and the mental health of Japanese dialysis patients.


Assuntos
Nível de Saúde , Qualidade de Vida , Diálise Renal , Inquéritos e Questionários , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Japão , Falência Renal Crônica/terapia , Pessoa de Meia-Idade , Razão de Chances , Washington
3.
J Am Geriatr Soc ; 47(12): 1425-9, 1999 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-10591236

RESUMO

OBJECTIVES: Minimizing the overuse of prescribed drugs among older people is a goal of geriatricians and healthcare policy makers. Indirect evidence indicates that use of prescribed drugs is more common in Japan than in some Western countries, but the actual situation in Japan is unknown. The first aim of this study was to clarify the use of prescribed drugs among older people in Japan. We also tested the hypothesis that using five or more prescribed drugs is associated with a situation that is modifiable and is relatively common in Japan: not having a regular physician. DESIGN: A cross-sectional survey. PARTICIPANTS: Subjects representing the Japanese general population aged 65 years and older were selected by two-stage stratified sampling; 617 persons were eligible for the study. MEASUREMENTS: Each subject was given a self-report questionnaire about current medications, sociodemographic characteristics, current state of health, health-related quality of life, and whether they had a regular physician. Among users of prescribed drugs, the association between using five or more prescribed drugs and not having a regular physician was assessed by univariate analysis and by stepwise logistic regression. RESULTS: The questionnaire was returned by 491 (80%) of the eligible subjects, 299 (61%) of whom were taking at least one prescribed drug. Nearly 30% of those subjects were taking at least five prescribed drugs. The distribution of the number of prescribed drugs being taken was positively skewed; the minimum was one and the maximum was 17, the middle 50% of the values ranged from two to five, and the median was three. About half of those who were taking at least five prescribed drugs did not have a regular physician. Compared with those who had a regular physician, those who did not were 2.5 times more likely to be taking at least five prescribed drugs (95% confidence interval, 1.4 - 4.6). CONCLUSIONS: Older people in Japan are less likely to be taking many prescribed drugs if they have the continuity of care provided by a regular physician.


Assuntos
Idoso , Prescrições de Medicamentos/estatística & dados numéricos , Uso de Medicamentos/estatística & dados numéricos , Continuidade da Assistência ao Paciente , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Japão , Modelos Logísticos , Masculino , Médicos/estatística & dados numéricos , Autoadministração , Inquéritos e Questionários
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