深圳市居民常见慢性病诊断状态与饮食相关知信行情况关联性分析
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摘要
目的研究常见慢性病诊断状态与饮食相关知信行情况的关联性,为制定更加有针对性的慢性病综合防控策略和措施提供科学依据。方法本研究数据来源于2015年深圳市慢性病及危险因素监测,监测对象为深圳市各行政区18～69岁的12 500名常住居民。问卷调查内容包括性别、年龄、文化程度、过去1年7大类食物的摄入频率和摄入量以及有关油盐摄入知信行情况、慢性病患病及诊断情况。测定血压、血糖和血脂,根据调查对象自我报告和血压、血糖和血脂的测定情况,分为一般人群、患病被诊断和患病未被诊断人群3组。采用SPSS 20.0进行单因素方差分析、一般线性模型分析、χ2检验和多因素logistic回归分析。结果共纳入有效样本10 129人,一般人群、患病被诊断人群和患病未被诊断人群的比例分别为42.8%、19.6%和37.6%。采用一般线性模型调整年龄、性别和文化程度后,患病被诊断人群新鲜蔬菜摄入量高于一般人群和患病未被诊断人群,差异有统计学意义(P<0.01),其余种类食物摄入差异均无统计学意义(P>0.05)。多因素logistic回归分析结果显示,以一般人群为对照,除使用限盐工具、控油工具、使用低钠盐外,患病被诊断人群的盐、油知信行情况均较好,均有统计学意义(OR值为1.15～2.16,P<0.05,P<0.01);而患病未被诊断人群除使用限盐工具(OR=0.80)、使用低钠盐(OR=0.84)比例低,知晓食油过多引起肾脏病(OR=1.14)和知道危害后愿意少吃油(OR=1.18)的比例较高外,其余知、信、行方面差异均无统计学意义(P>0.05)。结论在继续加强对一般人群和自我已知患病人群健康促进综合策略的同时,要将未知患病人群作为重点对象之一,采取措施提高患者自我患病知晓度,并积极改善其饮食相关知信行水平。
Objective To study the correlation between the diagnosis status of common chronic diseases and diet related knowledge-attitude-practice,and to provide the scientific basis for developing more targeted comprehensive prevention and control strategies and measures for chronic diseases. Methods Data were from monitoring results of chronic diseases and risk factors in Shenzhen in 2015,the subjects were 12 500 residents(18-69 years old). The questionnaire investigation included gender,age,education level,intake for 7 kinds of foods,the knowledge-attitude-practice of oil and salt intake,and chronic diseases diagnosis. The blood pressure,blood glucose and blood lipid were measured. According to the self-report of blood pressure,blood glucose and blood lipid measurement,the subjects were divided into three groups:the general population group,the diagnosed patients group and the undiagnosed patients group. ANOVA,general linear model and multivariate logistic regression model,χ2 test were used to analyze the data. The used software was SPSS 20.0. Results The effective samples were 10 129 subjects. The proportions of the general population,the diagnosed population and the undiagnosed population were 42.8%,19.6%and 37.6%,respectively. After adjusting age,gender and education level,the general linear model showed that the daily intake of fresh vegetables in diagnosed population was significantly higher than that in general population and undiagnosed population(P<0.01),and there was no significant difference in the intake of other types of food. The multivariate logistic regression model showed that compared to the general population,in addition to using the tools of limit salt or oil,and low sodium salt,the knowledge-attitude-practice of oil and salt intake in diagnosed population was better(OR values were 1.15-2.16,P<0.05 or P<0.01);in the undiagnosed population,the proportions of tools of limit salt(OR=0.80) and low sodium salt(OR=0.84) were lower(P<0.05),the proportions of the knowledge-attitude-practice of kidney disease due to more oil(OR=1.14) and less oil due to knowledge of more oil harm effect(OR=1.18) were higher(P<0.05),there was no significant difference of other knowledge-attitude-practice(P>0.05). Conclusion While continuing to strengthen the comprehensive health promotion strategy for the general population and the diagnosed population,it is necessary to take the undiagnosed population as one of the key objects,and to take the measures for improving the patients self awareness of diseases,and improving the level of diet related knowledge-attitude-practice in patients.
Objective To study the correlation between the diagnosis status of common chronic diseases and diet related knowledge-attitude-practice,and to provide the scientific basis for developing more targeted comprehensive prevention and control strategies and measures for chronic diseases. Methods Data were from monitoring results of chronic diseases and risk factors in Shenzhen in 2015,the subjects were 12 500 residents(18-69 years old). The questionnaire investigation included gender,age,education level,intake for 7 kinds of foods,the knowledge-attitude-practice of oil and salt intake,and chronic diseases diagnosis. The blood pressure,blood glucose and blood lipid were measured. According to the self-report of blood pressure,blood glucose and blood lipid measurement,the subjects were divided into three groups:the general population group,the diagnosed patients group and the undiagnosed patients group. ANOVA,general linear model and multivariate logistic regression model,χ2 test were used to analyze the data. The used software was SPSS 20.0. Results The effective samples were 10 129 subjects. The proportions of the general population,the diagnosed population and the undiagnosed population were 42.8%,19.6%and 37.6%,respectively. After adjusting age,gender and education level,the general linear model showed that the daily intake of fresh vegetables in diagnosed population was significantly higher than that in general population and undiagnosed population(P<0.01),and there was no significant difference in the intake of other types of food. The multivariate logistic regression model showed that compared to the general population,in addition to using the tools of limit salt or oil,and low sodium salt,the knowledge-attitude-practice of oil and salt intake in diagnosed population was better(OR values were 1.15-2.16,P<0.05 or P<0.01);in the undiagnosed population,the proportions of tools of limit salt(OR=0.80) and low sodium salt(OR=0.84) were lower(P<0.05),the proportions of the knowledge-attitude-practice of kidney disease due to more oil(OR=1.14) and less oil due to knowledge of more oil harm effect(OR=1.18) were higher(P<0.05),there was no significant difference of other knowledge-attitude-practice(P>0.05). Conclusion While continuing to strengthen the comprehensive health promotion strategy for the general population and the diagnosed population,it is necessary to take the undiagnosed population as one of the key objects,and to take the measures for improving the patients self awareness of diseases,and improving the level of diet related knowledge-attitude-practice in patients.
引文
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[11]张高辉,胡军,陈希,等. 2013年山东省成年居民糖尿病患病率、知晓率、治疗和控制状况分析[J].中国慢性病预防与控制,2017,25(12):881-884.
[12]向新志,丁贤彬.重庆市慢性病监测居民糖尿病患病率、知晓率、管理率与治疗率分析[J].公共卫生与预防医学,2016,27(3):56-60.
[13] Wang L,Gao P,Zhang M,et al. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013[J]. JAMA,2017,317(24):2515-2523.
[14]卓志鹏,宋金萍,袁雪丽,等.控油限盐工具对深圳社区慢性病患者膳食干预的影响[J].现代预防医学,2017,44(9):1618-1621.
[15]董文兰,姜莹莹,毛凡,等.国家慢性病综合防控示范区高危人群和患者管理评价[J].中国慢性病预防与控制,2013,21(6):649-652.
[16]罗伟炎,温菊芬,沈敏,等.家庭医生签约服务模式对社区慢性病高危人群的干预效果分析[J].中国初级卫生保健,2017,31(9):41-42.
[2]凌文华.膳食模式与慢性病防治[J].中华预防医学杂志,2018,21(3):217-220.
[3] Roberts CK,Barnard RJ. Effects of exercise and diet on chronic disease[J]. J Appl Physiol(1985),2005,98(1):3-30.
[4] Mastorci F,Vassalle C,Chatzianagnostou K,et al. Undernutrition and overnutrition burden for diseases in developing countries:the role of oxidative stress biomarkers to assess disease risk and interventional strategies[J]. Antioxidants(Basel),2017,6(2):41. DOI:10.3390/antiox6020041.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中国实用内科杂志,2018,38(4):292-344.
[6]国家基本公共卫生服务项目基层高血压管理办公室、基层高血压管理专家委员会.国家基层高血压防治管理指南[J].中国循环杂志,2017,32(11):1041-1048.
[7]诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-953.
[8]赵峰,罗小草,许希,等.我国居民营养知识现状分析[J].护理实践与研究,2012,9(5):117-118.
[9]邓琳,巢健茜,徐辉,等.南京市老年2型糖尿病患者社区医院综合健康管理效果评价[J].中华疾病控制杂志,2018,22(4):349-353.
[10]刘小立,卓志鹏,池洪珊,等.深圳市慢性病防控工作现状与展望[J].中华医院管理杂志,2012,28(10):783-784.
[11]张高辉,胡军,陈希,等. 2013年山东省成年居民糖尿病患病率、知晓率、治疗和控制状况分析[J].中国慢性病预防与控制,2017,25(12):881-884.
[12]向新志,丁贤彬.重庆市慢性病监测居民糖尿病患病率、知晓率、管理率与治疗率分析[J].公共卫生与预防医学,2016,27(3):56-60.
[13] Wang L,Gao P,Zhang M,et al. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013[J]. JAMA,2017,317(24):2515-2523.
[14]卓志鹏,宋金萍,袁雪丽,等.控油限盐工具对深圳社区慢性病患者膳食干预的影响[J].现代预防医学,2017,44(9):1618-1621.
[15]董文兰,姜莹莹,毛凡,等.国家慢性病综合防控示范区高危人群和患者管理评价[J].中国慢性病预防与控制,2013,21(6):649-652.
[16]罗伟炎,温菊芬,沈敏,等.家庭医生签约服务模式对社区慢性病高危人群的干预效果分析[J].中国初级卫生保健,2017,31(9):41-42.