济南市社区居民癌症健康素养现状及其对相关行为的影响
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摘要
[目的]分析济南市社区居民癌症健康素养现状并探讨其对癌症相关行为的影响。[方法]在济南市3个区随机选择5家社区,采用随机数字表法抽取社区内18～69岁居民进行问卷调查;利用描述性分析、χ~2检验分析居民癌症健康素养状况;采用Logistic回归模型分析癌症健康素养的影响因素及其对癌症相关行为的影响。[结果]共收回有效问卷310份,济南市社区居民癌症健康素养水平为62.9%;文化程度、职业、是否参加过癌症相关健康教育是癌症健康素养水平的影响因素;癌症健康素养越高,越倾向于不吸烟、多吃新鲜水果蔬菜、注意饮用水健康、在患病或有症状时及时就医、参加针对癌症的体检或筛查,OR值分别为1.019(95%CI:1.003～1.036)、1.017(95%CI:1.004～1.030)、1.019 (95%CI:1.005～1.033)、1.017(95%CI:1.002～1.032)、1.019(95%CI:1.001～1.037)。[结论]居民癌症健康素养受多种因素影响,高癌症健康素养人群更倾向于选择健康的行为生活方式,应制定和实施综合性的干预策略,逐步提升社区居民癌症健康素养水平。
[Purpose] To investigate the status quo of cancer health literacy and its effect on cancer-related behaviors among residents in Jinan communities. [Methods] Five communities in 3 districts of Jinan City were randomly selected,and the residents aged 18～69 years old in these communities were randomly extracted for questionnaire survey. Descriptive analysis and χ~2 test were used to analyze the health literacy status. Logistic regression model was used to analyze the influencing factors of cancer health literacy and its impact on cancer-related behaviors. [Results] A total of 310 valid questionnaires were collected. The overall level of cancer health literacy among participants was 62.9%. Educational level,occupation,participation in a cancer prevention program were the influencing factors of cancer health literacy. People with higher cancer health literacy tended to not smoke,eat more fresh fruit and vegetables,pay attention to drinking water,seek medical attention when have symptoms,participate in the screening for cancer,and the OR values were1.019(95%CI:1.003～1.036),1.017(95%CI:1.004～1.030),1.019(95%CI:1.005～1.033),1.017(95%CI:1.002～1.032),1.019(95%CI:1.001～1.037),respectively. [Conclusion] Cancer health literacy is affected by many factors. People having high cancer health literacy are more inclined to choose healthy behavioral lifestyles. Comprehensive intervention strategies should be developed and implemented to improve the health literacy level of community residents.
[Purpose] To investigate the status quo of cancer health literacy and its effect on cancer-related behaviors among residents in Jinan communities. [Methods] Five communities in 3 districts of Jinan City were randomly selected,and the residents aged 18～69 years old in these communities were randomly extracted for questionnaire survey. Descriptive analysis and χ~2 test were used to analyze the health literacy status. Logistic regression model was used to analyze the influencing factors of cancer health literacy and its impact on cancer-related behaviors. [Results] A total of 310 valid questionnaires were collected. The overall level of cancer health literacy among participants was 62.9%. Educational level,occupation,participation in a cancer prevention program were the influencing factors of cancer health literacy. People with higher cancer health literacy tended to not smoke,eat more fresh fruit and vegetables,pay attention to drinking water,seek medical attention when have symptoms,participate in the screening for cancer,and the OR values were1.019(95%CI:1.003～1.036),1.017(95%CI:1.004～1.030),1.019(95%CI:1.005～1.033),1.017(95%CI:1.002～1.032),1.019(95%CI:1.001～1.037),respectively. [Conclusion] Cancer health literacy is affected by many factors. People having high cancer health literacy are more inclined to choose healthy behavioral lifestyles. Comprehensive intervention strategies should be developed and implemented to improve the health literacy level of community residents.
引文
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[19]Zhao JS,Huang MZ,Wu XY,et al.A case-control study on risk factors of colonic cancer[J].Cancer Research on Prevention and Treatment,2008,35(7):524-526.[赵俊仕,黄民主,吴心音,等.结肠癌危险因素的病例对照研究[J].肿瘤防治研究,2008,35(7):524-526.]
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[21]Nicola D,Peter JS.Association between cancer literacy and cancer-related behavior:evidence from Ticino,Switzerland[J].J Public Health Res,2014,3(2):92-97.
[2]Chen W,Zheng R,Baade PD,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.
[3]Shi JF,Shi CL,Yue XP,et al.Economic burden of cancer in China during 1996-2014:a systematic review[J].Chinese Journal of Oncology,2016,38(12):929-941.[石菊芳,石春雷,岳馨培,等.1996-2014年中国恶性肿瘤经济负担的系统评价[J].中华肿瘤杂志,2016,38(12):929-941.]
[4]Guerra CE,Dominguez F,Shea JA.Literacy and knowledge,attitudes,and behavior about colorectal cancer screening[J].J Health Commun,2005,10(7):651-663.
[5]Diviani N,Schulz PJ.What should laypersons know about cancer?Towards an operational definition of cancer literacy[J].Patient Education Counseling,2011,85(3):487-492.
[6]Davis TC,Williams MV,Marin E,et al.Health literacy and cancer communication[J].CA Cancer J Clin,2010,52(3):134-149.
[7]Nicola D,Peter JS.First insights on the validity of the concept of cancer literacy:a test in a sample of Ticino(Switzerland)residents[J].Patient Education Counseling,2012,87(2):152-159.
[8]Nie XQ,Li YH,Li L.Statistical analysis of 2012 Chinese resident’s health literacy monitoring[J].China Journal of Health education,2014,30(2):178-181.[聂雪琼,李英华,李莉.2012年中国居民健康素养监测数据统计分析方法[J].中国健康教育,2014,30(2):178-181.]
[9]Wen XQ,Han ZZ,Zhao Jie,et al.Relationship between health literacy and utilization of basic public health services among diabetics[J].China Journal of Health Education,2015,5:456-459.[温秀芹,韩琤琤,赵洁,等.糖尿病患者健康素养与基本公共卫生服务利用的关系研究[J].中国健康教育,2015,5:456-459.]
[10]Xu ZR,Zhang HP,Wang XJ,et al.Investigation on health literacy of residents in Guandu district of Kunming city[J].China Health Industry,2017,24:170-172.[徐志荣,张慧萍,王晓君,等.昆明市官渡区居民肿瘤防治健康素养现状调查[J].中国卫生产业,2017,24:170-172.]
[11]Liu YL,Gong SP,Zhang J,et,al.Survey on health literacy and its influence factors about cancer prevention and control among residents in Jinan[J].Chinese Journal of Public Health Management,2018,1:127-130.[刘月玲,宫舒萍,张军,等.济南市居民肿瘤防治健康素养及影响因素分析[J].中国公共卫生管理,2018,1:127-130.]
[12]Wang L,Cai ZY,Bao LQ,et al.Analysis of health literacy factors on residents’health,Shanghai Baoshan District[J].Chinese Journal of Health Education,2017,12:1129-1132.[王路,蔡忠元,包路奇,等.上海市宝山区居民健康素养影响因素分析[J].中国健康教育,2017,12:1129-1132.]
[13]Ao Q,Jiang YZ,Liu JA,et al.Health knowledge and behavior literacy and their influencing factors among residents in Hubei province[J].Chinese Journal of Public Health,2018,34(4):580-583.[敖琴,江宜梓,刘军安,等.湖北省居民健康知识与健康行为素养状况及其影响因素[J].中国公共卫生,2018,34(4):580-583.]
[14]Bennett CL,Ferreira MR,Davis TC,et al.Relation between literacy,race,and stage of presentation among lowincome patients with prostate cancer[J].J Clin Oncol,1998,16(9):3101-3104.
[15]Liu ZQ,He F,Cai L.A case-control study on smoking,passive smoking and the risk of lung cancer[J].Chinese Journal of Disease Control&Prevention,2015,19(2):145-149.[刘志强,何斐,蔡琳.吸烟、被动吸烟与肺癌发病风险的病例对照研究[J].中华疾病控制杂志,2015,19(2):145-149.]
[16]Liu YX,Wang JZ.Meta-analysis of the Relationship between smoking and stomach cancer[J].Journal of the Chinese Academy of Medical Sciences,2002,24(6):559-563.[刘云霞,王洁贞.吸烟与胃癌关系的Meta分析[J].中国医学科学院学报,2002,24(6):559-563.]
[17]Ji XM,Sun L,He ZS,et al.Nonviral risk factors of nasopharyngeal carcinoma(NPC)in populations at low risk of NPC[J].Chinese Journal of Disease Control&Prevention,2010,14(5):393-396.[纪雪梅,孙凌,何忠时,等.吸烟饮酒作为低发区鼻咽癌致病因素的分析[J].中华疾病控制杂志,2010,14(5):393-396.]
[18]Fan XZ,Ming X,Wang WW,et al.Meta-analysis of drinking water-related risk factors on digestive tract cancer in China[J].Modern Preventive Medicine,2013,40(11):2000-2004.[范允舟,明星,王玮玮,等.中国消化道癌症与饮水相关危险因素Meta分析[J].现代预防医学,2013,40(11):2000-2004.]
[19]Zhao JS,Huang MZ,Wu XY,et al.A case-control study on risk factors of colonic cancer[J].Cancer Research on Prevention and Treatment,2008,35(7):524-526.[赵俊仕,黄民主,吴心音,等.结肠癌危险因素的病例对照研究[J].肿瘤防治研究,2008,35(7):524-526.]
[20]Miller KD,Siegel RL,Lin C C,et al.Cancer treatment and survivorship statistics,2016.[J].CA Cancer J Clin,2016,66(4):271-289.
[21]Nicola D,Peter JS.Association between cancer literacy and cancer-related behavior:evidence from Ticino,Switzerland[J].J Public Health Res,2014,3(2):92-97.