湖北省荆州市农村居民健康素养的结构方程模型分析

Analysis on health literacy of rural residents with structural equation model in Jingzhou City,Hubei Province

目的通过对农村居民健康素养的结构方程模型构建,了解健康素养3个维度之间的关系和影响因素。方法采用分层多阶段整群抽样的方法,抽取3640名15~69岁的农村居民进行问卷调查,使用Lisrel 8.70软件对3个维度的健康素养进行模型构建、拟合和参数估计。结果模型拟合情况为GFI=0.81,CFI=0.95,SRMR=0.061,RMSEA=0.082,较好地拟合了数据;基本知识和理念对健康生活方式与行为和基本技能的直接效应分别为0.52和0.49,对健康生活方式与行为的总效应为0.69;就医相关理念与知识和地方病、传染病相关知识在健康生活方式与行为和基本知识与理念中载荷最高;信息获取能力和自我保护能力在基本技能中载荷最高。结论农村居民的基本知识和理念对健康生活方式和行为的影响程度高于基本技能。对农村居民的健康教育要更注重就医、地方病、传染病相关知识宣传和信息获取能力和自我保护能力培养。

Objective To explore the relationships among 3 health literacy dimensions of rural residents and to work out impact factors of each dimension by Structural Equation Modeling. Methods 3640 rural residents aged 15 - 69 years were recruited bymuhi-stage stratified cluster sampling method. Lisrel 8. 70 software was used to model, fit, and pa- rameterize 3 health literacy dimensions of rural residents. Results The fitness indexes of the model were goodness-of-fit （ GF1 = 0. 81 ）, comparative fitness index （ CFI = 0. 95 ）, standardized root mean square residual （ SRMR = O. 061 ）, and root mean square of approximation （ RMSEA = 0. 082）. The fitness of the modelwas fine. The direct influence path coeffi- cients of ＂basic knowledge and concept＂ on ＂healthy lifestyle and behavior＂ and ＂basic skill＂ were 0. 52 and 0.49. The total effect coefficient of ＂healthy lifestyle and behavior＂ was 0. 69. Medical-related concepts and knowledge had the highest factor loading on ＂healthy lifestyles and behavior＂ . Endemic diseases related knowledge and infectious diseases related knowledge had the highest factor loading on ＂basic knowledge and concept＂ information acquisition ability and self-protec- tion ability had the highest factor loading on ＂basic skill＂ . Conclusion The impact of ＂basic knowledge and concept＂ on ＂healthy lifestyle and behavior＂ was higher than ＂basic skill＂ . Health education for rural residents should be paid more at- tention to medical care, endemic diseases, infectious diseases related knowledge. The ability of information acquisition and self-protection should be focused onbasic skill promoting.