Analysis Of Health-related Quality Of Life And Influencing Factors Among Rural Uyghur Residents In Southern Xinjiang Corps

Objective:Based on the social determinants of health model,the study analyzed the health-related quality of life（HRQOL）of rural Uyghur residents in southern Xinjiang Corps,explored the factors affecting the HRQOL and proposed solutions to improve their HRQOL,optimised health behaviours to inform health protection and improve the health status of rural Uyghur residents.Methods:In this study,a multi-stage stratified random sampling method was used to survey the rural Uyghur residents of the 53rd Mission in Tumushuk City,Xinjiang,used the EQ-5D-5L and a self-administered health status questionnaire.Based on the framework of the social determinants of health model,the investigated variables were incorporated into the model,and general statistical descriptive analysis,unconditional dichotomous logistic regression,multiple linear regression and Tobit regression models were used to analyze the basic characteristics,the distribution of the five EQ-5D,and conducted to determine the factors influencing VAS,health utility and health-related quality of life.Result:1.The status of health-related quality of life among rural Uyghur residents in southern Xinjiang Corps.A total of 1019 rural Uyghur residents in Xinjiang were enrolled in this study,426（41.8%）were male and593（58.2%）were female.The total health utility value was 0.59±0.39,P₅₀(P_25,P₇₅)is 0.72（0.30,0.94）,with a range of[-0.391,1].135 residents（13.25%）had no problems in the five dimensions of"mobility""self-care""usual activity""pain/discomfort"."Depression/Anxiety"was the most problematic,with 69.9%of residents having problems in this dimension and the total self-rated health（VAS）was 75.58±19.25.2.In the health-related quality of life single factor analysis of rural Uyghur residents in southern Xinjiang Corps,based on the analysis of the social determinants of health model,the health utility values results shows gender,age,daily oil intake per capita,daily fruit intake per capita,smoking,alcohol consumption,family size,education,income,marital status and distance to the nearest medical instituaion were were statistically significant（P<0.05）.Gender,age,smoking,alcohol consumption,daily fruit intake per capita,family size,and having a chronic disease differences were statistically significant among mobility,self-care,usual activity,pain/discomfort and depression/anxiety.In the self-rated health score（VAS）,biologic factors（gender,age）;personal lifestyle（smoking,alcohol consumption,daily vegetable intake per capita,daily fruit intake per capita）;community network（family size,participation in community activities）;socio-structural factors（education,marital status,occupation,income）and having a chronic disease were statistically significant（P<0.05）.3.A multifactor analysis of health-related quality of life among rural Uyghur residents in southern Xinjiang Corps showed that,tobit regression results of health utility values for rural Uyghur residents in Xinjiang showed that,based on a model of social determinants of health,biological factors:gender（β=0.018,P<0.001）,age≥55 years（β=-0.338,P<0.001）,personal lifestyle:participation in physical exercise（β=0.086,P<0.001）,daily fruit per capita intake（β=0.110,P=0.028）,daily vegetable intake per capita（β=0.220,P<0.001）,community network:participation in community activities（β=0.253,P<0.001）,social structural factors:income（β=0.054,P=0.049）,distance of home from the nearest health facility≥4km（β=0.110,P<0.001）and having a chronic disease（β=-0.182,P<0.001）were significantly associated with health utility values.4.The results of unconditional dichotomous logistic regression in five dimensions,based on the the social determinants of health model,mobility:female,age≥55 years,smoking,participation in community activities,divorce or widowhood,income>10000 and having a chronic illness.Self-care:gender,age≥55years,fruit intake>800g per capita per day,participation in community activities,distance of home from the nearest health facility≥4 km,having a chronic disease was significantly associated with its correlation.In daily activities:age,smoking,family size 4-8 people,participation in community activities,high school education or higher and having a chronic illness its significant association.In pain/discomfort:female,age≥55 years,daily vegetable intake per capita,literacy level,having a chronic illness was significantly associated with it.In depression/anxiety:only smoking,participation in community activities and having a chronic illness were significantly associated with it.5.The results of multiple linear regression of self-rated health scores（VAS）of rural Uyghur residents in southern Xinjiang Corps showed for the biological factors（age）,based on the social determinants of health model,personal lifestyle（per capita daily fruit intake>800 g and per capita daily vegetable intake>200 g）and community network（participation in community activities）differences were associated with it.Conclusion:1.The health-related quality of life of rural Uyghur residents in southern Xinjiang Corps needs to improve,and focus needs to be placed on the health status of the elderly and other groups.2.Based on the social determinants of health model,biological factors,individual lifestyle,community networks,social structural factors and chronic disease status all had varying degrees of influence on the quality of life of rural Uyghur residents.Residents with low levels of vegetable,fruit intake were more prone to problems in pain/discomfort and had lower HRQOL.Having a chronic disease was an important factor influencing the five dimensions of the EQ-5D,self-rated health scores（VAS）and health utility values among rural Uyghur residents.3.The local government and medical institutions should focus on olders and patients HRQOL.Besides,they have to require enhanced publicity on health education and health promotion to guide residents to form good lifestyle and dietary habits,consume more vitamin-rich foods such as vegetables and fruits,reduce the high intake of oil,salt and meat,actively participate in physical exercise and optimise health behaviours.At the same time,we should continue to focus on rural Uyghur residents in areas which out of poverty,prevent them from falling into poverty again due to illness.