高原军人对生活事件的主观评价及与自测健康状况的分析

Subjective evaluation of life events associated with the self-rated health in military personnel in high altitude area

目的:了解高原军人对生活事件的主观评价,并分析其与自测健康状况的关系。方法:于2004-07/2004-08采用随机整群抽样法,选择驻西藏某部队男性官兵490人,应用生活事件量表和自测健康评定量表进行调查。自测健康评定量表由许军编制,由10个维度48个条目组成,包括个体健康的生理、心理和社会3个子量表。生活事件量表包括26个条目,每个条目评价从没有影响到严重影响,采用0～4的5级评分法,经因素分析提取适应因子、人际因子、突发事件因子、工作环境因子、前途因子5个因子。对生活事件评价的平均分越高表明相应生活事件对其影响程度越大。在调查过程中由观察对象独立完成测试。主要记录高原军人生活事件量表的适应因子、人际因子、突发事件因子、工作环境因子和前途因子分以及总均分。同时按照生活事件量表项目:生活事件对精神影响程度(轻度、中度和重度影响)的主观评价不同来分组,比较对生活事件主观评价不同的高原军人的自测健康量表总分、生理、心理及社会3个子量表分,并进行生活事件主观评价与自测健康的相关分析。结果:发放问卷490份,调查后共获回答完整、规范合格问卷485份,有效率为99.0%。①对高原军人影响较大的生活事件是来自适应因子、人际因子和工作环境因子,其评分依次为(1.32±0.72),(1.07±0.86),(1.02±0.73)分。②对生活事件主观评价不同的3组高原军人自测健康子量表得分和总分差异均有显著性意义[生理健康:(8.13±0.97),(7.67±0.97),(7.53±1.04)分,F=14.615,P<0.01];[心理健康:(7.00±1.40),(5.85±1.43),(5.52±1.28)分,F=42.610,P=0.000];[社会健康:(7.00±1.39),(6.63±1.40),(6.53±1.88)分,F=9.288,P=0.000];[总分:(7.44±1.00),(6.71±1.00),(6.57±0.93)分,F=32.728,P=0.000]。③高原军人对生活事件的主观评价得分与自测健康3个子量表得分和总分显著负相关(r=-0.235～-0.445,P<0.01)。结论:对高原军人影响较大的生活事件是来自适应、人际关系和工作环境,高原军人对生活事件的主观评价对其自测健康状况有显著影响,可以通过转变认知态度来提高其健康水平。

AIM： To investigate the subjective evaluation on life events and explore its relationship with the self-rated health in military pers.onnel in high altitude area. METHODS： With random cluster sampling, 490 male soldiers in high altitude area were selected from July to August 2004 and assessed with Life Event Scale and Self-rated Health Measurement Scale. The Self-rated Health Measurement Scale was complicated by Xu Jun, which consisted of 10 dimensions, 48 items including physiological, psychological and social subscales. Life Event Scale was composed of 26 items, each item was classified from without effect to severe effect, and 5-grading system （0-4 grade） was adopted. After factor analysis, the adaptive events, interrelationship events, emergent events, and eqents from work and environment were selected. The high mean scores in the life event scale indicated the great effects of the life events. All the subjects completed the test independently. The scores of adaptive events, interrelationship events, emergent events, and events from work and environment and the total mean scores in the life event scale were recorded. The subjects were grouped according to different subjective evaluations： The degree of the effect of life event on mind （mild, moderate and severe）. The total scores of self-rated health scale and the scores of the three subscales of the soldiers with different subjective evaluations were compared and the correlation between subjective evaluation on life events and self-rated health was analyzed. RESULTS： Totally 490 questionnaires were sent out and 485 qualified ones were retrieved with the efficient rate of 99.0%. ①The main factors influencing military personnel were adaptive events, interrelationship events, and events from work and environment （1.32±0.72）, （1.07±0.86）, （1.02±0.73） scores. ②There were significant differences in the scores of the subscales of self-rated health and the total scores among the three groups with different evaluation on events influence [Physiological health： （7.00±1.40）, （5.85±1.43）, （5.52±1.28）, F=42.610, P=0.000; Social health： （7.00±1.39）, （6.63±1.40）, （6.53±1.88）, F=9.288, P=0.000; Total scores： （7.44±1.00）, （6.71±1.00）, （6.57±0.93）, F=32.728, P=0.000]. ③The scores of perceived life events were significantly negatively correlated with the scores of three subscales and total scores of the self-rated health in military personnel in high altitude area （r=-0.235 to -0.445, P 〈 0.01）. CONCLUSION： The adaptive events, interrelationship events, and events from work and environment have great influence upon the military personnel in high altitude area; the subjective evaluation on life events of the soldiers significantly influence the self-rated health, and we can improve their health level through transforming their cognition,