Background
Methods
Study design
Data collection tools
Hepatitis B Quality of Life Instrument version 1.0-HBQOL
Medical outcomes scale 36 item short form health survey-SF 36
Ethics
Statistical analysis
Results
Sociodemographic characteristics of patients
Variable | Group-1 (n = 1529) | Group-2 (n = 1721) | Group-3 (n = 1007) |
p value* | All patients (n = 4257) | |
---|---|---|---|---|---|---|
Gendera
| Male | 805 (52,6) | 1095 (63,6) | 659 (65,4) | <0,001 | 2559 (60,1) |
Age (years) b
| 42 (32;52) | 42 (32;52) | 34 (25; 44) | <0,001 | 40 (30;50) | |
Marriage statusa
| Married | 1256 (82,1) | 1359 (79) | 664 (65,9) | <0,001 | 3279 (77) |
Education levela
| Elementary school graduate and under | 654 (42,8) | 672 (39) | 359 (35,7) | 0,002 | 1685 (39,6) |
Middle school graduate | 239 (15,6) | 314 (18,2) | 186 (18,5) | 739 (17,4) | ||
High school graduate | 366 (23,9) | 376 (21,8) | 250 (24,8) | 992 (23,3) | ||
University graduate or higher | 270 (17,7) | 359 (20,9) | 212 (21,1) | 841 (19,8) | ||
Regular incomea
| Present | 893 (58,4) | 1149 (66,8) | 568 (56,4) | <0,001 | 2610 (61,3) |
Any family member(s) with hepatitis Ba
| Present | 740 (48,4) | 983 (57,1) | 606 (60,2) | <0,001 | 2329 (54,7) |
Other chronic diseasea
| Present | 373 (24,4) | 484 (28,1) | 196 (19,5) | <0,001 | 1053 (24,7) |
Hospital typea
| Training hospital | 725 (47,4) | 752 (43,7) | 425 (42,2) | <0,001 | 1902 (44,7) |
University hospital | 491 (32,1) | 655 (38,1) | 291 (28,9) | 1437 (33,8) | ||
Other | 313 (20,5) | 314 (18,2) | 291 (28,9) | 918 (21,6) | ||
Duration of diagnosis (months)b
| 84 (36;144) | 84 (48;156) | 72 (24;132) | <0,001 | 84 (36;144) | |
Period of therapy (months)b
| N/A | 36 (1–312, 12;60) | N/A | 36 (1–312, 12;60) | ||
ALT (U/L)b
| 21 (16;27) | 26 (19;36) | 34 (22;61) | <0,001 | 25 (18;36) | |
HBV DNA (IU/ml)b
| 80 (0;462,5) | 0 (0;117) | 7600 (2001;13 × 104) | <0,001 | 76 (0;1700) | |
HBeAg statusa
| Positive | 0 | 358 (20,8) | 242 (24) | 0,049 | 600 (14,1) |
SF-36 results
SF-36 results according to patient properties
Variable | Physical functioning | Role physical | Role emotional | Vitality | Mental health | Social functioning | Bodily pain | General health | Physical component score | Mental component score |
---|---|---|---|---|---|---|---|---|---|---|
Gender |
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
Male | 90 (70;100) | 100 (50;100) | 100 (33,3;100) | 55 (45;75) | 72 (56;84) | 87,5 (62,5;100) | 100 (77,5;100) | 65 (50;75) | 79 (61,5;86) | 74 (54,9;82,3) |
Female | 80 (55;100) | 100 (25;100) | 100 (0;100) | 50 (35;65) | 64 (48;80) | 87,5 (50;100) | 80 (55;100) | 60 (40;70) | 68,5 (47;84) | 64,1 (44,6;80,8) |
Marriage status |
p:0,376 |
p:0,069 |
p
:0,005
|
p:0,292 |
p
:<0,001
|
p
:<0,001
|
p:0,378 |
p:0,073 |
p:0,725 |
p
:0,009
|
Married | 90 (65;100) | 100 (50;100) | 100 (33,3;100) | 50 (40;70) | 68 (52;84) | 87,5 (62,5;100) | 90 (67,5;100) | 65 (45;75) | 76 (55,5;84) | 71 (51,5;80,8) |
Single | 90 (65;100) | 100 (43,7;100) | 100 (33,3;100) | 55 (40;75) | 66 (48;80) | 87,5 (50;100) | 90 (67,5;100) | 60 (40;75) | 75 (54,5;86) | 67,9 (46,9;81,2) |
Education level |
p
:<0,001
|
p
:<0,001
|
p
:0,011
|
p
:<0,001
|
p
:<0,001
|
p
:0,013
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
Elementery school and under | 85 (55;100) | 100 (25;100) | 100 (33,3;100) | 50 (40;65) | 68 (52;84) | 87,5 (62,5;100) | 90 (65;100) | 60 (45;70) | 71,5 (52;84) | 68,5 (48,8;80,8) |
Middle school | 85 (60;100) | 100 (25;100) | 100 (33,3;100) | 55 (40;70) | 68 (52;80) | 75 (62,5;100) | 90 (67,5;100) | 60 (40;70) | 72 (52;84) | 68,4 (48,8;80,8) |
High school | 90 (70;100) | 100 (50;100) | 100 (33,3;100) | 55 (40;75) | 68 (52;80) | 87,5 (62,5;100) | 100 (67,5;100) | 60 (45;75) | 78 (56;86) | 72,3 (50,5;81,9) |
University | 95 (80;100) | 100 (75;100) | 100 (33,3;100) | 60 (45;75) | 72 (56;84) | 87,5 (62,5;100) | 100 (77,5;100) | 65 (50;75) | 80 (66;87) | 74,6 (56,6;83,3) |
Regular income |
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
Yes | 95 (70;100) | 100 (50;100) | 100 (66,7;100) | 55 (45;75) | 72 (56;84) | 87,5 (62,5;100) | 100 (77,5;100) | 65 (50;75) | 80 (62;86) | 74,8 (56,8;82) |
No | 80 (50;95) | 75 (25;100) | 66,7 (0;100) | 50 (35;65) | 64 (48;80) | 75 (50;100) | 77,5 (55;100) | 55 (40;70) | 67,5 (45;83) | 62 (43,1;78,6) |
Family members with hepatitis B |
p
:0,003
|
p
:0,003
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
Present | 85 (60;100) | 100 (25;100) | 100 (33,3;100) | 50 (40;70) | 68 (52;80) | 87,5 (62,5;100) | 90 (67,5;100) | 60 (45,70) | 73,5 (53,5;84) | 68,3 (48,6;80,8) |
Not | 90 (70;100) | 100 (50;100) | 100 (33,3;100) | 55 (40;70) | 70 (52;84) | 87,5 (62,5;100) | 100 (67,5;100) | 65 (45;75) | 78 (57;86) | 72,6 (52,8;82,1) |
Received treatment for hepatitis B |
p
:<0,001
|
p
:0,001
|
p
:0,016
|
p:0,164 |
p:0,481 |
p:0,763 |
p:0,712 |
p
:0,006
|
p
:<0,001
|
p
:0,012
|
Yes | 85 (60;100) | 100 (25;100) | 100 (33,3;100) | 55 (40;70) | 68 (52;80) | 87,5 (62,5;100) | 90 (67,5;100) | 60 (45;70) | 74 (54,5;84) | 69,4 (50;80,8) |
No | 90 (65;100) | 100 (50;100) | 100 (33,3;100) | 50 (40;70) | 68 (52;84) | 87,5 (62,5;100) | 90 (67,5;100) | 65 (45;75) | 77 56,5;85,8) | 71,5 (50,5;81,4) |
Other chronic disease |
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
Present | 75 (50;95) | 75 (0;100) | 66,7 (0;100) | 50 (35;60) | 64 (48;80) | 75 (50;100) | 77,5 (55;100) | 55 (35;70) | 64,5 (43;82) | 63,3 (41,2;79,2) |
Not | 90 (70;100) | 100 (50;100) | 100 (33,3;100) | 55 (45;75) | 68 (52;84) | 87,5 (62,5;100) | 100 (77,5;100) | 65 (50;75) | 78 (60;86) | 72,8 (53,6;82) |
Hospital |
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p:0,291 |
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
Training hospital | 95 (73,7;100) | 100 (75;100) | 100 (66,7;100) | 50 (45;70) | 72 (56;84) | 100 (62,5;100) | 100 (77,5;100) | 65 (50;75) | 80,5 (62,5;85) | 75,7 (57,6;81,2) |
University hospital | 85 (60;100) | 100 (25;100) | 100 (33,3;100) | 55 (40;70) | 64 (52;80) | 87,5 (62,5;100) | 90 (67,5;100) | 60 (45;75) | 73 (52,7;84) | 67,6 (48,8;80) |
Other | 80 (55;100) | 75 (25;100) | 66,7 (0;100) | 55 (35;70) | 64 (48;80) | 75 (50;100) | 77,5 (55;100) | 60 (40;70) | 67 (47,4;83) | 61,2 (43,1;80) |
HBeAg status |
p:0,877 |
p:0,079 |
p
:0,034
|
p:0,135 |
p:0,357 |
p
:0,014
|
p:0,466 |
p
:0,014
|
p:0,082 |
p
:0,010
|
Positive | 90 (65;100) | 100 (25;100) | 100 (33,3;100) | 50 (40;70) | 68 (52;80) | 87,5 (50;100) | 90 (67,5;100) | 60 (45;70) | 74 (54,5;84) | 68,6 (48,7;80,8) |
Negative | 90 (65;100) | 100 (50;100) | 100 (33,3;100) | 55 (40;70) | 68 (52;84) | 87,5 (62,5;100) | 90 (67,5;100) | 60 (45;75) | 76 (55,5;85) | 70,8 (50,8; 81) |
Subscale | Age (years) | Duration of diagnosis (months) | Period of therapy (months) | ALT (U(L) | HBV DNA (IU(ml) |
---|---|---|---|---|---|
SF-36 | |||||
Physical functioning | −0,087/<0,001 | 0,009/0,553 | −0,019/0,210 | −0,037/0,015 | −0,038/0,014 |
Role physical, | −0,018/0,235 | 0,002/0,906 | 0,013/0,382 | −0,045/0,003 | −0,035/0,024 |
Role emotional | 0,052/0,001 | 0,002/0,895 | 0,016/0,303 | −0,042/0,006 | −0,043/0,005 |
Vitality | 0,01/0,521 | −0,034/0,025 | 0,013/0,399 | −0,020/0,187 | −0,028/0,068 |
Mental health | 0,107/<0,001 | 0,004/0,781 | 0,024/0,123 | −0,042/0,006 | −0,051/0,001 |
Social functioning | 0,062/<0,001 | −0,019/0,216 | 0,027/0,076 | −0,076/<0,001 | −0,042/0,006 |
Bodily pain | −0,008/0,580 | −0,003/0,844 | 0,035/0,023 | −0,068/<0,001 | −0,055/<0,001 |
General health | 0,029/0,061 | 0,002/0,873 | 0,012/0,421 | −0,044/0,004 | −0,052/0,001 |
Physical component score | 0,013/0,401 | 0,009/0,557 | 0,013/0,384 | −0,044/0,004 | −0,022/0,153 |
Mental component score | 0,013/0,393 | 0,004/0,802 | 0,023/0,136 | −0,032/0,038 | −0,021/0,181 |
HBQOL | |||||
Psychological Well-Being | 0,010/0,526 | 0,004/0,771 | 0,020/0,195 | −0,051/0,001 | −0,012/0,421 |
Anticipation anxiety | 0,106/<0,001 | −0,003/0,827 | −0,011/0,471 | −0,043/0,005 | −0,049/0,001 |
Vitality | 0,063/<0,001 | 0,009/0,578 | −0,010/0,514 | −0,045/0,003 | 0,608/<0,001 |
Stigma | 0,124/<0,001 | 0,050/0,001 | 0,003/0,843 | −0,049/0,001 | −0,052/0,001 |
Vulnerability | 0,091/<0,001 | 0,004/0,789 | −0,011/0,488 | −0,048/0,002 | −0,046/0,003 |
Total score | 0,009/0,568 | 0,003/0,870 | 0,015/0,343 | −0,049/0,001 | −0,024/0,125 |
SF-36 results according to patient groups
Group-1 (n = 1529) | Group-2 (n = 1721) | Group-3 (n = 1007) |
p value | All patients (n = 4257) | |
---|---|---|---|---|---|
SF-36 | |||||
Physical functioning | 90 (70;100) | 85 (60;100) | 90 (65;100) |
<0,001
┼, ╪,0,203§
| 90 (65;100) |
Role physical, | 100 (50;100) | 100 (25;100) | 100 (25;100) |
<0,001
┼, ╪,0,721§
| 100 (50;100) |
Role emotional | 100 (33,3;100) | 100 (33,3;100) | 100 (33,3;100) |
0,001
┼,0,004
╪, 0,859§
| 100 (33,3;100) |
Vitality | 50 (45;70) | 55 (45;70) | 55 (40;70) | 0,060┼,0,167╪,0,819§
| 55 (40;70) |
Mental health | 72 (52;84) | 68 (52;80) | 68 (52;80) |
0,005
┼,<0,001
╪, 0,016
§
| 68 (52;84) |
Social functioning | 87,5 (62,5;100) | 87,5 (62,5;100) | 87,5 (50;100) |
0,012
┼,<0,001
╪,0,006
§
| 87,5 (62,5;100) |
Bodily pain | 100 (67,5;100) | 90 (67,5;100) | 90 (65;100) | 0,185┼, <0,001
╪,0,013
§
| 90 (67,5;100) |
General health | 65 (45;75) | 60 (45;70) | 60 (45;75) |
<0,001
┼, ╪,0,775§
| 60 (45;75) |
Physical component score | 79 (58,5;86) | 74 (54,5;84) | 74 (54;85) |
<0,001
┼, ╪,0,644§
| 75,5 (55,5;85) |
Mental component score | 74 (52,4;81,8) | 69,4 (50;80) | 67,8 (49;80,8) |
<0,001
┼,╪,0,511§
| 70,6 (50,3;80,8) |
HBQOL | |||||
Psychological Well-Being | 90 (67,5;97,5) | 85 (70;95) | 82,5 (65;95) |
0,019
┼,<0,001
╪,0,090§
| 85 (67,5;95) |
Anticipation anxiety | 80 (56,7;93,3) | 76,6 (53,3;90) | 70 (50;90) |
0,008
┼, <0,001
╪, 0,001
§
| 76,6 (53,3;93,3) |
Vitality | 80 (64;88) | 76 (64;88) | 76 (60;88) |
<0,001
┼,0,001
╪,0,758§
| 80 (64;88) |
Stigma | 93,3 (73,3;100) | 90 (73,3;100) | 90 (70;100) | 0,056┼, 0,001
╪,0,071§
| 90 (73,3;100) |
Vulnerability | 80 (60;93,3) | 80 (60;93,3) | 73,3 (53,3;93,3) |
<0,001
┼,╪,0,300§
| 80 (60;93,3) |
Total score | 85 (67,1;93,6) | 80,7 (66,4;91,4) | 79,3 (63,9;90,7) |
<0,001
┼,╪,0,024
§
| 81,4 (65,7;92,1) |
HBQOL results
HBQOL results according to patient properties
Variable | Psychological Well-Being | Anticipation anxiety | Vitality | Stigma | Vulnerability | Total score |
---|---|---|---|---|---|---|
Gender |
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p:0,921 |
p
:0,003
|
p
:0,001
|
Male | 87,5 (70;97,5) | 76,7 (56,7;93,3) | 80 (64;92) | 90 (73,3;100) | 80 (60;93,3) | 82,8 (67,1;92,8) |
Female | 85 (65;95) | 73,3 (50;93,3) | 76 (60;88) | 90 (73,3; 100) | 80 (60;93,3) | 80 (63,6;91,4) |
Marriage status |
p
:0,001
|
p
:<0,001
|
p:0,341 |
p
:<0,001
|
p
:<0,001
|
p
:0,002
|
Married | 87,5 (70;95) | 76,7 (56,7;93,3) | 80 (64;88) | 90 (73,3;100) | 80 (60;93,3) | 82,1 (67,1;92,8) |
Single | 82,5 (65;95) | 73,3 (50;90) | 76 (60;92) | 86,7 (66,7;100) | 73,3 (53,3;93,3) | 78,6 (62,8;90,7) |
Education level |
p:0,441 |
p
:0,121
|
p
:<0,001
|
p:0,001 |
p:0,089 |
p:0,881 |
Elementery school and under | 87,5 (67,5;95) | 76,7 (53,3;93,3) | 76 (60;88) | 93,3 (73,3;100) | 80 (60;93,3) | 81,4 (65,7;93,6) |
Middle school | 82,5 (68;95) | 73,3 (50;90) | 76 (64;88) | 86,7 (66,7;100) | 80 (53,3;93,3) | 80,7 (62,8;91,4) |
High school | 87,5 (70;95) | 76,7 (54,2;90) | 80 (64;92) | 90 (73,3;100) | 80 (60;93,3) | 82,1 (67,8;92,8) |
University | 85 (70;97,5) | 76,7 (56,6;90) | 80 (68;92) | 90 (73,3;100) | 80 (60;93,3) | 82,1 (67,1;91,4) |
Regular income |
p
:0,005
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p:0,077 |
Yes | 90 (72,5;97,5) | 80 (60;93,3) | 80 (64;92) | 93,3 (76,7;100) | 80 (60;93,3) | 84,3 (70;93,6) |
No | 80 (62,5;95) | 70 (46,7;86,7) | 72 (56; 88) | 86,7 (66,7;100) | 73,3 (53,3;93,3) | 77,1 (60,7;89,3) |
Family members with hepatitis B |
p:0,328 |
p
:0,015
|
p
:<0,001
|
p:0,082 |
p
:0,002
|
p:0,097 |
Present | 85 (67,5;95) | 73,3 (53,3;90) | 76 (60;88) | 90 (73,3;100) | 80 (60;93,3) | 80,7 (65;91,4) |
Not | 87,5 (67,5;97,5) | 76,7 (54,2;93,3) | 80 (64;92) | 90 (73,3;100) | 80 (60;93,3) | 82,9 (67,1;92,8) |
Received treatment for hepatitis B |
p
:0,001
|
p:0,070 |
p:0,179 |
p:0,066 |
p:0,917 |
p
:0,011
|
Yes | 85 (70;95) | 76,7 (53,3;90) | 76 (64;88) | 90 (73,3;100) | 80 (60;93,3) | 80,7 (66,4;91,4) |
No | 87,5 (67,5;95) | 76,7 (53,3;93,3) | 80 (64;88) | 90 (73,3;100) | 80 (60; 93,3) | 82,1 (65;92,8) |
Other chronic disease |
p
:0,003
|
p:0,385 |
p
:<0,001
|
p:0,988 |
p
:0,010
|
p
:<0,001
|
Present | 85 (65;95) | 76,7 (53,3;93,3) | 72 (56;88) | 90 (73,3;100) | 80 (53,3;93,3) | 79,3 (63,6;91,4) |
Not | 87,5 (70;95) | 76,7 (53,3;93,3) | 80 (64;92) | 90 (73,3;100) | 80 (60;93,3) | 82 (66,4;92,1) |
Hospital type |
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
p
:<0,001
|
Training hospital | 90 (72,5;95) | 80 (60;93,3) | 84 (68;88) | 93,3 (76,7;100) | 80 (66,7;93,3) | 85,7 (70,7;93,6) |
University hospital | 85 (65;97,5) | 73,3 (50;86,7) | 76 (60;88) | 90 (70;100) | 73,3 (53,3;93,3) | 80 (63,6;90) |
Other | 80 (62,5;95) | 70 (46,7;86,7) | 72 (56;88) | 86,7 (63,3;100) | 73,3 (53,3;86,7) | 76,4 (59,3;88,6) |
HBeAg status |
p
:<0,001
|
p:0,098 |
p
:0,015
|
p
:0,022
|
p
:<0,001
|
p
:<0,001
|
Positive | 82,5 (65;95) | 73,3 (50;90) | 76 (60;88) | 86,7 (66,7;100) | 73,3 (53,3;93,3) | 79,3 (62,9;91,4) |
Negative | 87,5 (67,5;95) | 76,7 (53,3;93,3) | 80 (64;88) | 90 (73,3;100) | 80 (60;93,3) | 82,1 (66,4;92,1) |
HBQOL results according to patient groups
Variables included in the Model | Mean square | F | Sig. |
---|---|---|---|
Gender | 8186,916 | 26,001 | <0,001 |
Marriage status | 6385,542 | 20,280 | <0,001 |
Other chronic disease | 4789,179 | 15,210 | <0,001 |
HBeAg status | 480,405 | 1526 | 0,217 |
ALT level | 2547,493 | 8091 | 0,004 |
Hospital type | 716,785 | 2276 | 0,131 |
Received treatment for hepatitis B | 1020,020 | 3240 | 0,072 |
Inactive disease | 3017,300 | 9583 | 0,002 |