山东大学学报 (医学版) ›› 2024, Vol. 62 ›› Issue (7): 98-105.doi: 10.6040/j.issn.1671-7554.0.2024.0166
郭艳童1,2,于媛媛1,2,陈莹莹1,2,付雨1,2,张伯韬1,2,袁莹1,2,孙爽爽1,2,赵英淇1,2,朱高培1,2,薛付忠1,2
GUO Yantong1,2, YU Yuanyuan1,2, CHEN Yingying1,2, FU Yu1,2, ZHANG Botao1,2, YUAN Ying1,2, SUN Shuangshuang1,2, ZHAO Yingqi1,2, ZHU Gaopei1,2, XUE Fuzhong1,2
摘要: 目的 探索山东省主动健康示范区域老年人慢病管理知信行水平及其影响机制。 方法 采用多阶段随机抽样方法,共抽取5 447名65岁以上的老年人进行问卷调查,采用t检验和单因素方差分析比较慢病管理知信行得分情况,并用多元线性回归模型分析其影响因素,以中介分析探讨其影响机制。 结果 山东省主动健康示范区域老年人慢病管理知识平均得分为7.47±2.83;态度平均得分为8.47±2.47;行为平均得分为4.94±1.79。回归分析表明,性别、年龄、居住方式、自评健康状况是知识的影响因素;年龄和居住方式影响态度,而性别和年龄是行为的影响因素。中介分析显示,慢病管理知识对态度(β=0.670 1,P<0.001)、行为意愿(β=0.046 8,P<0.01)和行为(β=0.305 6,P<0.001)均具有预测作用,态度对行为意愿(β=0.169 8,P<0.001)和行为(β=0.216 1,P<0.001)具有预测作用,行为意愿正向预测行为(β=0.029 1,P<0.05)。知识对行为的直接效应值为0.193 9,占总效应的56.46%,间接效应值为0.149 5,占总效应的43.54%。 结论 山东省主动健康示范区域老年人慢病管理知识和态度水平均较高,但行为转化水平有待进一步提高;慢病管理态度、行为意愿在知识和行为之间起中介作用,且态度还可以通过提升行为意愿来改善行为水平。
中图分类号:
[1] 国家统计局, 国务院第七次全国人口普查领导小组办公室. 第七次全国人口普查公报(第五号): 人口年龄构成情况[J]. 中国统计, 2021(5): 10-11. [2] 国家卫生健康委, 教育部, 科技部, 等. 关于印发“十四五”健康老龄化规划的通知[J]. 中华人民共和国国家卫生健康委员会公报, 2022(2): 16-25. [3] 郝文婷, 李洁, 景正月, 等. 衰弱在农村慢性病老年人睡眠质量与生活质量间的中介作用[J]. 山东大学学报(医学版), 2021, 59(2): 102-107. HAO Wenting, LI Jie, JING Zhengyue, et al. Physical frailty as a mediator between sleep quality and quality of life in rural elderly with chronic diseases in Shandong Province, China[J]. Journal of Shandong University(Health Sciences), 2021, 59(2): 102-107. [4] 谭忠良. 社区健康管理结合健康教育对老年高血压的控制效果[J]. 中国社区医师, 2021, 37(35): 158-159. TAN Zhongliang. The control effect of community health management combined with health education on senile hypertension[J]. Chinese Community Doctors, 2021, 37(35): 158-159. [5] Zhang XM, Li CY, Liu M, et al. The mediation effect of health literacy on social support and health lifestyle of patients with chronic diseases[J]. Appl Nurs Res, 2024, 75: 151763. [6] 胡秀静, 吴小亚, 王家骥, 等. 慢性病防治视角下的我国医养结合与健康管理发展回顾[J]. 中国慢性病预防与控制, 2019, 27(8): 561-564. [7] Hong E, Mao J, Ke ZC, et al. Knowledge, attitudes and practices towards community-acquired pneumonia and COVID-19 among general population: a cross-sectional study[J]. Antimicrob Resist Infect Control, 2024, 13(1): 6. [8] Jeong JY, Lee H. Determinants of restaurant consumers intention to practice COVID-19 preventive behavior: an application of the theory of planned behavior[J]. Nutr Res Pract, 2021, 15(Suppl 1): S79-S93. [9] Youngcharoen P, Vincent C, Park CG. Theory of planned behavior constructs associated with nurses pain assessment and pro Re Nata(PRN)opioid analgesic administration: a cross-sectional study[J]. Pain Manag Nurs, 2017, 18(3): 153-169. [10] Abdi IH, Firdos R, Ali Laghari Q, et al. Role of laparoscopic cholecystectomy in geriatric patients(>60 years of age)[J]. Prof Med J, 2020, 27(1): 62-67. [11] Entriken C, Pritts TA. Perioperative pulmonary support of the elderly[J]. Curr Geriatr Rep, 2021, 10(4): 167-174. [12] Alkaabi I, Abita M, Mahdi Y, et al. Knowledge, attitude, practices, and sources of information(KAPS)toward COVID-19 during the second wave pandemic among university population in Qatar: a cross-sectional study[J]. Front Public Health, 2022, 10: 906159. doi:10.3389/fpubh.2022.906159. [13] Doan DA, Ho HH, Tran LD, et al. Knowledge, attitudes, and practices of university students regarding COVID-19: a cross-sectional study in Vietnam[J]. BMC Public Health, 2022, 22(1): 2016. [14] Aldhamy H, Maniatopoulos G, McCune VL, et al. Knowledge, attitude and practice of infection prevention and control precautions among laboratory staff: a mixed-methods systematic review[J]. Antimicrob Resist Infect Control, 2023, 12(1): 57. [15] Wang WW, Peng YY, Tang KQ, et al. Knowledge, attitudes, and practices among middle-aged and elderly population towards ultrasound screening for strokes[J]. J Multidiscip Healthc, 2024, 17: 147-157. doi: 10.2147/JMDH.S44.3865. [16] Yazew BG, Abate HK, MekonnenE CK. Knowledge, attitude and practice towards COVID-19 in Ethiopia: asystematic review; 2020 [J]. Patient Prefer Adherence, 2021, 15: 337-348. doi: 10.2147/PPA.S288186. [17] Conner M, Norman P. Understanding the intention-behavior gap: the role of intention strength[J]. Front Psychol, 2022, 13: 923464. doi:10.3389/fpsyg.2022.923464. [18] Mukosha M, Muyunda D, Mudenda S, et al. Knowledge, attitude and practice towards cervical cancer screening among women living with human immunodeficiency virus: implication for prevention strategy uptake[J]. Nurs Open, 2023, 10(4): 2132-2141. [19] 王琢, 韩严敏, 张健, 等. 老年传染病防治知信行现状及影响因素[J]. 中国老年学杂志, 2023, 43(23): 5869-5873. [20] Liu LF, Qian XJ, Chen Z, et al. Health literacy and its effect on chronic disease prevention: evidence from Chinas data[J]. BMC Public Health, 2020, 20(1): 690. [21] Yang KH, Liu H, Ma LH, et al. Knowledge, attitude and practice of residents in the prevention and control of COVID-19: an online questionnaire survey[J]. J Adv Nurs, 2021, 77(4): 1839-1855. [22] 阚超杰, 张晓. 应用Fairlie分解法的老年人自评健康状况性别差异研究[J]. 中华疾病控制杂志, 2019, 23(1): 75-79. KAN Chaojie, ZHANG Xiao. Disparity in self-rated health between male and female elderly: a Fairlie decomposition analysis[J]. Chinese Journal of Disease Control & Prevention, 2019, 23(1): 75-79. [23] 陆一鸣, 朱泽善, 文建强, 等. 2015年甘肃省15~69岁居民健康素养水平及影响因素研究[J]. 中华疾病控制杂志, 2018, 22(3): 235-239. LU Yiming, ZHU Zeshan, WEN Jianqiang, et al. Health literacy and associated factors among residents aged 15-69 years in Gansu, 2015[J]. Chinese Journal of Disease Control & Prevention, 2018, 22(3): 235-239. [24] 宋江宇, 周素红, 柳林, 等. 日常活动视角下居民健康影响的性别差异: 以广州为例[J]. 地理科学进展, 2018, 37(7): 999-1010. [25] 刘清, 王志, 徐春华, 等. 奉贤区老年护理院护工传染病防治素养及影响因素分析[J]. 预防医学, 2019, 31(4): 420-422. [26] 王兴华, 李倩, 周虎. 2013年芜湖市镜湖区居民健康素养调查报告[J]. 中华疾病控制杂志, 2014, 18(8): 768-771. WANG Xinghua, LI Qian, ZHOU Hu. Investigation on health literacy levels of residents in Jinghu District of Wuhu City, 2013[J]. Chinese Journal of Disease Control & Prevention, 2014, 18(8): 768-771. [27] Chowdhury SR, Chandra Das D, Sunna TC, et al. Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis[J]. eClinicalMedicine, 2023, 57: 101860. doi:10.1016/j.eclinm.2023.101860. [28] Rakhshani T, Dada M, Kashfi SM, et al. The effect of educational intervention on knowledge, attitude, and practice of women towards breast cancer screening[J]. Int J Breast Cancer, 2022, 2022: 5697739. doi:10.1155/2022/5697739. [29] 尹淑英, 梁亚楠, 纪晓倩, 等. 山东省农村不同性别老年人健康状况及影响因素[J]. 中国老年学杂志, 2021, 41(9): 1965-1967. [30] Clark CR, Ommerborn MJ, Moran K, et al. Predicting self-rated health across the life course: health equity insights from machine learning models[J]. J Gen Intern Med, 2021, 36(5): 1181-1188. [31] Kananen L, Enroth L, Raitanen J, et al. Self-rated health in individuals with and without disease is associated with multiple biomarkers representing multiple biological domains[J]. Sci Rep, 2021, 11(1): 6139. [32] Reinwarth AC, Wicke FS, Hettich N, et al. Self-rated physical health predicts mortality in aging persons beyond objective health risks[J]. Sci Rep, 2023, 13(1): 19531. [33] Yang HL, Deng Q, Geng QS, et al. Association of self-rated health with chronic disease, mental health symptom and social relationship in older people[J]. Sci Rep, 2021, 11(1): 14653. [34] Stodolska A, Zawisza K, Wizner B, et al. Neglect and self-rated health among older adults-a cross-sectional study in Poland[J]. Folia Med Cracov, 2023, 63(2): 5-28. [35] Li H, Zhang JY, Wang L, et al. A health promoting-lifestyle prediction model for dementia prevention among Chinese adults: based on the health belief model[J]. BMC Public Health, 2022, 22(1): 2450. [36] 于瑞莹, 李庆信, 张浩然, 等. “健康中国”背景下不同群体老年人健康管理认知现状调查与对策[J]. 卫生职业教育, 2022, 40(22): 126-129. |
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