基于结构方程模型老年人健康状况影响因素分析
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摘要
目的了解老年人健康状况影响因素,为结构方程模型在老年健康问题中的应用提供参考依据。方法于2017年5—8月采用分层随机抽样方法在安徽、湖南、广东、江苏、山东、江西、吉林7个省抽取1 637名≥60岁老年人进行问卷调查,应用结构方程模型分析老年人健康状况的主要影响因素。结果 1 637名≥60岁老年人中,行动方面无任何困难者1 246人(76.12%),自我照顾无任何困难者1 349人(82.41%),身体功能从事日常活动无任何困难者1 238人(75.63%),从事活动能力无任何困难者968人(59.13%),自评健康者887人(54.18%);结构方程模型拟合较好,模型中的老年人健康状况与家庭情况(β′=0.85)、个人情况(β′=0.62)、健康相关行为(β′=0.57)、心理认知因素(β′=0.70)均相关(均P <0.01),与社会支持不相关(P> 0.05)。结论老年人健康状况的主要影响因素为家庭情况、个人情况、健康相关行为和心理认知因素。
Objective To examine health status and its influencing factors among elderly residents in China and to provide references for application of structural equation model(SEM) in researches on health problems in aged populations.Methods We conducted a face-to-face survey among 1 637 community residents aged ≥ 60 years using stratified random sampling in 7 provinces(Anhui, Hunan, Guangdong, Jiangsu, Shandong, Jiangxi, and Jilin) across China during May-August2017. A self-designed questionnaire was used to collected relevant information and EuroQol-5 Dimension(EQ-5 D) was used to assess health condition among the elderly. SEM was adopted to analyze main influencing factors for the health status of the elderly. Results Of all the elderly, 1 246(76.12%) reported no any difficulty in moving about; 1 349(82.41%) reported no difficulty in self-care; 1 238(75.63%) reported no difficulty in physical function during daily activities; and 1349(59.13%)reported no difficulty in daily activities. More than a half(54.18%) of the elderly were self-rated as healthy. The established SEM fits the data well. The SEM analysis revealed that the health status was associated with family status(β′ = 0.85),individual condition(β′ = 0.62), health related behavior(β′ = 0.57), and psychological cognitive factors(β′ = 0.70)(P < 0.01 for all); whereas, no correlation was indicated between health status and relevant social support among the elderly(P > 0.05).Conclusion Main influencing factors for health status are family status, personal status, health related behavior, and psychological cognitive factors among elderly residents in China.
Objective To examine health status and its influencing factors among elderly residents in China and to provide references for application of structural equation model(SEM) in researches on health problems in aged populations.Methods We conducted a face-to-face survey among 1 637 community residents aged ≥ 60 years using stratified random sampling in 7 provinces(Anhui, Hunan, Guangdong, Jiangsu, Shandong, Jiangxi, and Jilin) across China during May-August2017. A self-designed questionnaire was used to collected relevant information and EuroQol-5 Dimension(EQ-5 D) was used to assess health condition among the elderly. SEM was adopted to analyze main influencing factors for the health status of the elderly. Results Of all the elderly, 1 246(76.12%) reported no any difficulty in moving about; 1 349(82.41%) reported no difficulty in self-care; 1 238(75.63%) reported no difficulty in physical function during daily activities; and 1349(59.13%)reported no difficulty in daily activities. More than a half(54.18%) of the elderly were self-rated as healthy. The established SEM fits the data well. The SEM analysis revealed that the health status was associated with family status(β′ = 0.85),individual condition(β′ = 0.62), health related behavior(β′ = 0.57), and psychological cognitive factors(β′ = 0.70)(P < 0.01 for all); whereas, no correlation was indicated between health status and relevant social support among the elderly(P > 0.05).Conclusion Main influencing factors for health status are family status, personal status, health related behavior, and psychological cognitive factors among elderly residents in China.
引文
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[11]孟琴琴,张拓红.机体功能及健康行为对老年人健康自评的影响[J].中华全科医学,2010,8(11):1413-1414,1424.
[12]McGinty HL,Dark-Freudeman A,West RL.Health hopes and fears for the future in relation to health behavior and current health status[J].Journal of Health Psychology,2013,18(12):1509-1518.
[13]张坪兰,游睿芳.各年龄段老年人生活方式对生活质量的影响[J].中国老年学杂志,2014,34(4):1065-1066.
[14]傅宏,陈庆荣.积极老龄化:全球视野下的老年心理健康研究和实践探索[J].心理与行为研究,2015,13(5):713-720.
[15]芦鸿雁,王莉.老年人日常健康行为与健康心理控制源、自我效能感[J].中国老年学杂志,2014,34(17):4997-4998.
[2]世界卫生组织.中国老龄化与健康国家评估报告[R].瑞士:世界卫生组织,2016.
[3]贾欣欣.老年人群健康状况及其影响因素研究[D].南京:南京医科大学,2016.
[4]Govender T,Barnes JM.The health status and unmet health needs of old-age pensioners living in selected urban poor communities in Cape Town,South Africa[J].Journal of Community Health,2014,39(6):1063-1070.
[5]艾斌,王硕,星旦二.老年人社会经济地位影响健康的作用机制--基于沈阳市城市老年人9年追踪调查数据[J].人口与经济,2014(2):48-56.
[6]宋瑛琦,姚永芳.长春市社区老年居民心理健康状况及影响因素[J].中国老年学杂志,2016,36(14):3571-3572.
[7]阎志强.广东老年人口的健康状况特点--基于2015年1%人口抽样调查的分析[J].南方人口,2017,32(6):42-53.
[8]田诗音,陈琪,王睿,等.上海市老年人健康相关生命质量及其影响因素[J].中国公共卫生,2018,34(4):505-509.
[9]郭振友,石武祥,马明霞,等.广西桂林市社区老年人健康相关行为现况调查及其影响因素分析[J].中华疾病控制杂志,2015,19(7):701-703,711.
[10]马娇,卢文学,阿幸,等.农村老年人生命质量及其影响因素分析[J].中国公共卫生,2015,31(6):797-800.
[11]孟琴琴,张拓红.机体功能及健康行为对老年人健康自评的影响[J].中华全科医学,2010,8(11):1413-1414,1424.
[12]McGinty HL,Dark-Freudeman A,West RL.Health hopes and fears for the future in relation to health behavior and current health status[J].Journal of Health Psychology,2013,18(12):1509-1518.
[13]张坪兰,游睿芳.各年龄段老年人生活方式对生活质量的影响[J].中国老年学杂志,2014,34(4):1065-1066.
[14]傅宏,陈庆荣.积极老龄化:全球视野下的老年心理健康研究和实践探索[J].心理与行为研究,2015,13(5):713-720.
[15]芦鸿雁,王莉.老年人日常健康行为与健康心理控制源、自我效能感[J].中国老年学杂志,2014,34(17):4997-4998.