丹江口库区移民慢性病患病现状及其影响因素研究
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摘要
目的了解丹江口库区移民慢性病患病现状,并探讨其影响因素,为移民慢性病患病的防治提供理论依据。方法 2016年7—8月,采用多阶段分层整群抽样方法,选取湖北省十堰市丹江口库区搬迁至郧阳区、丹江口市、襄州区、宜城市和黄陂区的1 068名移民。采用一般资料及健康状况调查表、团体用心理社会应激调查表(PSSG)进行调查。丹江口库区移民是否患慢性病与PSSG各维度及其总分的相关性采用Spearman秩相关分析,丹江口库区移民慢性病患病的影响因素采用多因素非条件Logistic回归分析。结果共发放问卷1 068份,全部收回,其中有效问卷983份,有效回收率92.0%,丹江口库区移民慢性病患病率为60.9%(599/983)。不同性别、年龄、婚姻状况、文化程度、职业、外出打工情况、家庭收入满意度、家族病史、经济状况(与移民前比较)丹江口库区移民慢性病患病情况比较,差异有统计学意义(P<0.05)。丹江口库区移民慢性病与生活事件(L)、消极情绪(NE)、消极应对方式(NC)维度、PSSG总分呈正相关(P<0.05),与积极情绪(PE)、积极应对方式(PC)维度呈负相关(P<0.05);多因素非条件Logistic回归分析结果显示,性别、年龄、家庭收入满意度、家族病史、经济状况(与移民前比较)和PSSG总分是移民慢性病患病的影响因素(P<0.05)。结论丹江口库区移民慢性病患病率较高,且其影响因素较多。应定期为移民提供免费健康体检和开展移民社区心理咨询与护理,重点关注留守老人的健康状况及心理问题。
Objective To explore the prevalence and influencing factors of chronic disease among the immigrants from Danjiangkou reservoir area, providing a theoretical basis for the prevention and control of chronic diseases in immigrant population. Methods In this study conducted between July and August 2016, using multistage stratified cluster sampling, we recruited 1 068 residents who immigrated to Yunyang District and Danjiangkou City subordinated to Shiyan City, Xiangzhou District and Yicheng City subordinated to Xiangyang City, as well as Huangpi District subordinated to Wuhan City, from Danjiangkou reservoir area in Shiyan City and investigated them with Demographic Characteristics and Health Questionnaire(developed by LIU Bao-feng), and Psychosocial Stress Survey for Groups(PSSG). Spearman's correlation analysis was performed to investigate the correlations of whether suffering from chronic disease with scores of each dimension of PSSG and its total score. A multivariate analysis was conducted using unconditional Logistic regression models to explore the influencing factorsfor the prevalence of chronic disease in the immigrants. Results A total of 1 068 questionnaires were given out. In addition, 938 questionnaires were collected with a response rate of 92.0%. The overall prevalence of chronic disease was 60.9% among these immigrants. The prevalence of chronic disease significantly varied by sex, age, marital status, educational level, occupation, leaving home for work, level of satisfaction with household income, family history of disease, and economic status(compared with pre-migration)(P<0.05). Spearman's correlation analysis found that the prevalence of chronic disease among these people was positively correlated with life events(L), negative emotion(NE), negative coping style(NC) and PSSG scores(P<0.05), but negatively correlated with positive emotions(PE), positive coping styles(PC)(P<0.05). Multivariate analysis demonstrated that female, older age( ≥ 60 years), low level of satisfaction with household income, family history of disease, poor economic status(compared with pre-migration) and high PSSG scores were risk factors for the prevalence of chronic disease among these people(P<0.05). Conclusion The prevalence of chronic disease was high in the immigrants from Danjiangkou reservoir area, which was associated with many factors. In view of this, regular free physical examination and community-based psychological consultation and care should be delivered to them, and attention should be especially focused on the health and mental status of the left-behind elderly.
Objective To explore the prevalence and influencing factors of chronic disease among the immigrants from Danjiangkou reservoir area, providing a theoretical basis for the prevention and control of chronic diseases in immigrant population. Methods In this study conducted between July and August 2016, using multistage stratified cluster sampling, we recruited 1 068 residents who immigrated to Yunyang District and Danjiangkou City subordinated to Shiyan City, Xiangzhou District and Yicheng City subordinated to Xiangyang City, as well as Huangpi District subordinated to Wuhan City, from Danjiangkou reservoir area in Shiyan City and investigated them with Demographic Characteristics and Health Questionnaire(developed by LIU Bao-feng), and Psychosocial Stress Survey for Groups(PSSG). Spearman's correlation analysis was performed to investigate the correlations of whether suffering from chronic disease with scores of each dimension of PSSG and its total score. A multivariate analysis was conducted using unconditional Logistic regression models to explore the influencing factorsfor the prevalence of chronic disease in the immigrants. Results A total of 1 068 questionnaires were given out. In addition, 938 questionnaires were collected with a response rate of 92.0%. The overall prevalence of chronic disease was 60.9% among these immigrants. The prevalence of chronic disease significantly varied by sex, age, marital status, educational level, occupation, leaving home for work, level of satisfaction with household income, family history of disease, and economic status(compared with pre-migration)(P<0.05). Spearman's correlation analysis found that the prevalence of chronic disease among these people was positively correlated with life events(L), negative emotion(NE), negative coping style(NC) and PSSG scores(P<0.05), but negatively correlated with positive emotions(PE), positive coping styles(PC)(P<0.05). Multivariate analysis demonstrated that female, older age( ≥ 60 years), low level of satisfaction with household income, family history of disease, poor economic status(compared with pre-migration) and high PSSG scores were risk factors for the prevalence of chronic disease among these people(P<0.05). Conclusion The prevalence of chronic disease was high in the immigrants from Danjiangkou reservoir area, which was associated with many factors. In view of this, regular free physical examination and community-based psychological consultation and care should be delivered to them, and attention should be especially focused on the health and mental status of the left-behind elderly.
引文
[1]赵玉红,王雪.我国现代社会疾病变化及全民健康问题[J].职业与健康,2014,30(21):3157-3161.ZHAO Y H,WANG X.A discussion on the change of disease pattern and main health problems in China[J].Occupation and Health,2014,30(21):3157-3161.
[2]庄立辉,郭继志,汪洋,等.三峡库区移民心理健康状况及影响因素分析[J].中国公共卫生,2007,23(5):535-536.DOI:10.3321/J.issn:1001-0580.2007.05.012.ZHUANG L H,GUO J Z,WANG Y,et al.Status of mental health and psychosocial factors in Three Gorges immigrants[J].Chinese Journal of Public Health,2007,23(5):535-536.DOI:10.3321/j.issn:1001-0580.2007.05.012.
[3]冯邵珍,冯春琴,郭朝阳,等.南水北调移民搬迁满意度评价与心理社会应激的关系分析[J].重庆医学,2016,45(1):83-87.DOI:10.3969/j.issn.1671-8348.2016.01.028.FENG S Z,FENG C Q,GUO Z Y,et al.Analysis of the relationship between relocation satisfaction and psychosocial stress of transitional period immigrants in the south-to-north water diversion project[J].Chongqing Medical,2016,45(1):83-87.DOI:10.3969/j.issn.1671-8348.2016.01.028.
[4]徐玲,孟群.第五次国家卫生服务调查结果之二——卫生服务需要、需求和利用[J].中国卫生信息管理杂志,2014,11(3):193-194.DOI:10.3969/j.issn.1672-5166.2014.03.01.
[5]刘保锋.三峡移民健康状况和卫生服务利用研究[D].济南:山东大学,2011.
[6]姜乾金,祝一虹,王守谦,等.心理社会应激因素与多项心身健康指标的相关性分析[J].中国行为医学科学,1996,5(4):200-202.JIANG Q J,ZHU Y H,WANG S Q,et al.Psychosocial stress factors and multiple correlation analysis and utilization of psychosomatic health indicators[J].Chinese Journal of Behavioral Medicine and Brain Science,1996,5(4):200-202.
[7]秦敬柱,袁长海,刘保锋,等.山东省三峡移民健康状况及影响因素分析[J].中国公共卫生,2010,26(9):1138-1139.QIN J Z,YUAN C H,LIU B F,et al.Health status and its related factors among Three Gorges migrants in Shandong province[J].Chinese Journal of Public Health,2010,26(9):1138-1139.
[8]伊雅德,谭红专,黄昕,等.湖南省浏阳市农村居民慢性病患病现状及影响因素分析[J].中华疾病控制杂志,2013,17(1):27-30.YI Y D,TAN H Z,HUANG X,et al.An epidemiological analysis of chronic disease prevalence and its determinants among rural population in Liuyang City,Hunan Province[J].Chinese Journal of Disease Control&Prevention,2013,17(1):27-30.
[9]中华人民共和国国家卫生和计划生育委员会.《中国居民营养与慢性病状况报告(2015)》新闻发布会文字实录[J].中国实用乡村医生杂志,2015,22(15):1-5.DOI:10.3969/j.issn.1672-7185.2015.15.002.
[10]WU F,GUO Y,PAUL K,et al.Prevalence of major chronic conditions among older Chinese adults:the Study on Global AGEing and adult health(SAGE)Wave 1[J].PLo S One,2013,8(9):e74176.DOI:10.1371/journal.pone.0074176.
[11]张倞.60岁以上老人慢性病危险因素的调查分析[J].中国社区医师(医学专业),2012,27(14):304-305.DOI:10.3969/j.issn.1007-614x.2012.27.297.
[12]慕晓,田庆丰,孙锦峰,等.丹江口库区过渡期移民卫生服务需求及利用状况调查[J].中华疾病控制杂志,2014,18(2):155-158.MU X,TIAN Q F,SUN J F,et al.Investigation on the health service demand and utilization of transitional period of immigrants in Danjiangkou reservoir area[J].Chinese Journal of Disease Control&Prevention,2014,18(2):155-158.
[13]孙仙,王平,刘兰,等.宁夏回族自治区农村居民慢性病患病现状及影响因素分析[J].中国公共卫生,2014,30(12):1516-1520.DOI:10.11847/zgggws2014-30-12-07.SUN X,WANG P,LIU L,et al.Prevalence and influence factors of chronic diseases among rural inhabitants in Ningxia Hui Autonomous Region[J].Chinese Journal of Public Health,2014,30(12):1516-1520.DOI:10.11847/zgggws2014-30-12-07.
[14]张连军,袁兆康,郑增旺,等.江西省农村地区老年人慢性病患病状况及其公平性调查[J].中国全科医学,2015,18(7):814-817.DOI:10.3969/j.issn.1007-9572.2015.07.020.ZHANG L J,YUAN Z K,ZHENG Z W,et al.Prevalence of chronic diseases in elderly population in rural areas in Jiangxi province and its equity investigation[J].Chinese General Practice,2015,18(7):814-817.DOI:10.3969/j.issn.1007-9572.2015.07.020.
[15]蔡青,时松和,张书敏,等.丹江口库区待迁移民心理健康与心理应激的相关性研究[J].现代预防医学,2014,41(8):1436-1438,1441.CAI Q,SHI S H,ZHANG S M,et al.Study on the correlationbetween mental health and psychological stress among quasi-migrants in Danjiangkou reservoir area[J].Modern Preventive Medicine,2014,41(8):1436-1438,1441.
[16]中华人民共和国国家卫生和计划生育委员会.解读《中国防治慢性病中长期规划(2017—2025年)》[J].中国实用乡村医生杂志,2017,24(3):1-2.DOI:10.3969/j.issn.1672-7185.2017.03.002.
[2]庄立辉,郭继志,汪洋,等.三峡库区移民心理健康状况及影响因素分析[J].中国公共卫生,2007,23(5):535-536.DOI:10.3321/J.issn:1001-0580.2007.05.012.ZHUANG L H,GUO J Z,WANG Y,et al.Status of mental health and psychosocial factors in Three Gorges immigrants[J].Chinese Journal of Public Health,2007,23(5):535-536.DOI:10.3321/j.issn:1001-0580.2007.05.012.
[3]冯邵珍,冯春琴,郭朝阳,等.南水北调移民搬迁满意度评价与心理社会应激的关系分析[J].重庆医学,2016,45(1):83-87.DOI:10.3969/j.issn.1671-8348.2016.01.028.FENG S Z,FENG C Q,GUO Z Y,et al.Analysis of the relationship between relocation satisfaction and psychosocial stress of transitional period immigrants in the south-to-north water diversion project[J].Chongqing Medical,2016,45(1):83-87.DOI:10.3969/j.issn.1671-8348.2016.01.028.
[4]徐玲,孟群.第五次国家卫生服务调查结果之二——卫生服务需要、需求和利用[J].中国卫生信息管理杂志,2014,11(3):193-194.DOI:10.3969/j.issn.1672-5166.2014.03.01.
[5]刘保锋.三峡移民健康状况和卫生服务利用研究[D].济南:山东大学,2011.
[6]姜乾金,祝一虹,王守谦,等.心理社会应激因素与多项心身健康指标的相关性分析[J].中国行为医学科学,1996,5(4):200-202.JIANG Q J,ZHU Y H,WANG S Q,et al.Psychosocial stress factors and multiple correlation analysis and utilization of psychosomatic health indicators[J].Chinese Journal of Behavioral Medicine and Brain Science,1996,5(4):200-202.
[7]秦敬柱,袁长海,刘保锋,等.山东省三峡移民健康状况及影响因素分析[J].中国公共卫生,2010,26(9):1138-1139.QIN J Z,YUAN C H,LIU B F,et al.Health status and its related factors among Three Gorges migrants in Shandong province[J].Chinese Journal of Public Health,2010,26(9):1138-1139.
[8]伊雅德,谭红专,黄昕,等.湖南省浏阳市农村居民慢性病患病现状及影响因素分析[J].中华疾病控制杂志,2013,17(1):27-30.YI Y D,TAN H Z,HUANG X,et al.An epidemiological analysis of chronic disease prevalence and its determinants among rural population in Liuyang City,Hunan Province[J].Chinese Journal of Disease Control&Prevention,2013,17(1):27-30.
[9]中华人民共和国国家卫生和计划生育委员会.《中国居民营养与慢性病状况报告(2015)》新闻发布会文字实录[J].中国实用乡村医生杂志,2015,22(15):1-5.DOI:10.3969/j.issn.1672-7185.2015.15.002.
[10]WU F,GUO Y,PAUL K,et al.Prevalence of major chronic conditions among older Chinese adults:the Study on Global AGEing and adult health(SAGE)Wave 1[J].PLo S One,2013,8(9):e74176.DOI:10.1371/journal.pone.0074176.
[11]张倞.60岁以上老人慢性病危险因素的调查分析[J].中国社区医师(医学专业),2012,27(14):304-305.DOI:10.3969/j.issn.1007-614x.2012.27.297.
[12]慕晓,田庆丰,孙锦峰,等.丹江口库区过渡期移民卫生服务需求及利用状况调查[J].中华疾病控制杂志,2014,18(2):155-158.MU X,TIAN Q F,SUN J F,et al.Investigation on the health service demand and utilization of transitional period of immigrants in Danjiangkou reservoir area[J].Chinese Journal of Disease Control&Prevention,2014,18(2):155-158.
[13]孙仙,王平,刘兰,等.宁夏回族自治区农村居民慢性病患病现状及影响因素分析[J].中国公共卫生,2014,30(12):1516-1520.DOI:10.11847/zgggws2014-30-12-07.SUN X,WANG P,LIU L,et al.Prevalence and influence factors of chronic diseases among rural inhabitants in Ningxia Hui Autonomous Region[J].Chinese Journal of Public Health,2014,30(12):1516-1520.DOI:10.11847/zgggws2014-30-12-07.
[14]张连军,袁兆康,郑增旺,等.江西省农村地区老年人慢性病患病状况及其公平性调查[J].中国全科医学,2015,18(7):814-817.DOI:10.3969/j.issn.1007-9572.2015.07.020.ZHANG L J,YUAN Z K,ZHENG Z W,et al.Prevalence of chronic diseases in elderly population in rural areas in Jiangxi province and its equity investigation[J].Chinese General Practice,2015,18(7):814-817.DOI:10.3969/j.issn.1007-9572.2015.07.020.
[15]蔡青,时松和,张书敏,等.丹江口库区待迁移民心理健康与心理应激的相关性研究[J].现代预防医学,2014,41(8):1436-1438,1441.CAI Q,SHI S H,ZHANG S M,et al.Study on the correlationbetween mental health and psychological stress among quasi-migrants in Danjiangkou reservoir area[J].Modern Preventive Medicine,2014,41(8):1436-1438,1441.
[16]中华人民共和国国家卫生和计划生育委员会.解读《中国防治慢性病中长期规划(2017—2025年)》[J].中国实用乡村医生杂志,2017,24(3):1-2.DOI:10.3969/j.issn.1672-7185.2017.03.002.