Health-related quality of life and its changes of the Tibetan population in China: based on the 2013 and 2018 National Health Services Surveys.

Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE

Original Publication: [London] : BMJ Publishing Group Ltd, 2011-

Quality of Life* ; State Medicine*; Humans ; Female ; Tibet/epidemiology ; Cross-Sectional Studies ; Surveys and Questionnaires ; China/epidemiology ; Health Status

Objective: Health-related quality of life (HRQoL) was an important health outcome measure for evaluating an individual's overall health status. However, there was limited in the literature on HRQoL and its long-term changes of the Tibetan population. This study aimed to assess HRQoL of Tibetan and its changes over time, and explore the differences in HRQoL for residents at different altitudes.
Design: Data for the cross-sectional study were extracted from the fifth and sixth waves of the National Health Services Surveys which were conducted in 2013 and 2018. A multistage stratified cluster random sampling strategy was used to select representative participants.
Setting: Tibet Autonomous Region in China.
Participants: This study recruited 14 752 participants in 2013 and 13 106 participants in 2018, and after excluding observations with missing values for key variables, 10 247 in 2013 and 6436 in 2018 were included in the study analysis.
Primary and Secondary Outcome Measures: The EQ-5D-3L was used to measure participants' HRQoL.
Results: The mean health state utility scores of the participants were 0.969±0.078 and 0.966±0.077 in 2013 and 2018, respectively. Pain/discomfort was the most frequently prevalent issue reported in 18.1% and 17.9% of the participants in 2013 and 2018, respectively. Tibetans living 3500-4000 m altitude had the best HRQoL. Age, sex, employment status, educational attainment, chronic disease and weekly physical exercise were influencing factors associated with HRQoL.
Conclusions: The HRQoL of the Tibetan population was lower than the general Chinese population, and decreased over time between 5 years. There were differences in HRQoL among Tibetan at different altitudes, with residents living at 3500-4000 m having the best quality of life. More attention should be paid to those Tibetans who are older, female, unemployed and without formal education.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Qual Life Res. 2005 Aug;14(6):1523-32. (PMID: 16110932)
Eur J Clin Nutr. 2021 Feb;75(2):247-252. (PMID: 32620907)
Health Place. 2011 Mar;17(2):671-80. (PMID: 21334961)
Health Policy. 1996 Jul;37(1):53-72. (PMID: 10158943)
Appl Health Econ Health Policy. 2016 Apr;14(2):161-83. (PMID: 26818198)
Space Med Med Eng (Beijing). 2000 Feb;13(1):1-5. (PMID: 12212624)
Integr Comp Biol. 2006 Feb;46(1):18-24. (PMID: 21672719)
High Alt Med Biol. 2011 Winter;12(4):403-4; author reply 405. (PMID: 22206568)
Appl Health Econ Health Policy. 2017 Apr;15(2):127-137. (PMID: 28194657)
BMC Public Health. 2020 Jun 18;20(1):955. (PMID: 32552694)
J Glob Health. 2021 Feb 11;11:08001. (PMID: 33692898)
Annu Rev Psychol. 2011;62:501-30. (PMID: 20636127)
Am J Hum Genet. 2017 Nov 2;101(5):752-767. (PMID: 29100088)
Int J Environ Res Public Health. 2019 Dec 31;17(1):. (PMID: 31906177)
PLoS One. 2013 Jul 02;8(7):e65958. (PMID: 23843948)
Sci Bull (Beijing). 2022 Feb 26;67(4):341-344. (PMID: 36546082)
Pharmacoeconomics. 2016 Jul;34(7):645-9. (PMID: 26892973)
Int J Environ Res Public Health. 2017 Feb 23;14(3):. (PMID: 28241507)
Qual Life Res. 2020 Nov;29(11):3087-3094. (PMID: 32533422)
Front Psychiatry. 2021 Jun 22;12:669234. (PMID: 34239461)
Pol Arch Med Wewn. 2010 Jul;120(7-8):276-81. (PMID: 20693958)
Health Qual Life Outcomes. 2022 May 19;20(1):80. (PMID: 35590333)
High Alt Med Biol. 2001 Winter;2(4):489-99. (PMID: 11809089)
Am J Hypertens. 2014 Nov;27(11):1355-61. (PMID: 24698853)
Vasc Health Risk Manag. 2021 Jun 08;17:317-335. (PMID: 34135590)
Health Qual Life Outcomes. 2006 Mar 03;4:14. (PMID: 16515690)
Heart. 2015 Jul;101(13):1054-60. (PMID: 25953970)
BMC Public Health. 2023 Jan 24;23(1):167. (PMID: 36694154)
Biomed Environ Sci. 2012 Oct;25(5):526-32. (PMID: 23122309)
Med Care. 2003 Feb;41(2):218-31. (PMID: 12555050)
Health Qual Life Outcomes. 2019 Mar 11;17(1):43. (PMID: 30866953)
Value Health. 2018 Nov;21(11):1330-1337. (PMID: 30442281)
Int Rev Psychiatry. 2019 Nov - Dec;31(7-8):637-645. (PMID: 31084447)
JAMA. 2013 Feb 27;309(8):814-22. (PMID: 23443445)
Qual Life Res. 2017 Nov;26(11):3049-3058. (PMID: 28593532)
Endocr Rev. 2015 Apr;36(2):149-73. (PMID: 25675133)
Value Health. 2014 Jul;17(5):597-604. (PMID: 25128053)
BMJ Open. 2017 Sep 3;7(9):e015880. (PMID: 28871016)
BMC Public Health. 2021 Jan 6;21(1):33. (PMID: 33407265)
J Travel Med. 2013 Jul-Aug;20(4):247-55. (PMID: 23809076)
Psychol Bull. 1992 Jul;112(1):155-9. (PMID: 19565683)
Health Qual Life Outcomes. 2022 Jan 29;20(1):14. (PMID: 35093084)

Keywords: China; PUBLIC HEALTH; Quality of Life

Date Created: 20231120 Date Completed: 20231122 Latest Revision: 20231123

20231123

PMC10660197

10.1136/bmjopen-2023-072854

37984958