中国城镇居民心理亚健康的影响因素分析

Analysis of Mental Sub-health Status of Chinese Urban Residents

目的从内因和外因多方面探讨我国城镇居民心理亚健康的影响因素。方法采用多阶段分层抽样方法,用SHMS V1.0亚健康评定量表对我国五省市城镇居民进行心理亚健康的调查。用logistic回归进行影响因素分析,用R软件绘制列线图,并进行影响因素模型的预测效果评价。结果户籍为城镇(OR=0.796)、睡眠时间7~9h(OR=0.722)和超过9小时(OR=0.792)、家庭结构为大家庭(OR=0.611)、成长期与父母的关系好(OR=0.602)、住房不拥挤(OR=0.531)、邻里和睦(OR=0.737)、健身设施多(OR=0.531)、挫商高(OR=0.576)、人生态度为积极乐观(OR=0.546)、兴趣爱好多于3种(OR=0.812),性格为成熟稳重(OR=0.591)、自我健康关注度高(OR=0.778)、休闲促健康效果好(OR=0.523)是心理亚健康的保护因素;婚姻状况为离异或丧偶(OR=1.495)、偶尔吃早餐(OR=1.604)、受二手烟影响(很小、一般和很大的OR分别为1.406,1.527和1.63)、偶尔饮酒(OR=1.342)、不良饮食习惯(OR=1.365)、经常、非天天体育锻炼(经常、有时和偶尔的OR分别为1.356,1.395和1.539)、上网时间为3~5小时(OR=1.236)和5小时以上(OR=1.467)、童年期心理创伤事件(OR=1.503)、二孩政策对健康有影响(OR=1.414)、医疗政策对健康有影响(OR=1.437)是亚健康的危险因素。该影响因素模型对心理亚健康的预测价值较高,偏倚校正的C指数为0.767。结论心理亚健康影响因素涉及人口及保障因素、生活方式因素、家庭及环境因素、个体特征因素、健康意识、经历事件和政策环境等多个方面,提示卫生健康部门在制定相关亚健康或健康政策,或进行健康宣教的时候,需要综合考虑多种因素,以达到预防心理亚健康状态的目的。

Objective To study influencing factors of sub-health of Chinese urban residents from internal and external aspects.Methods A multi-stage stratified random sampling method was used to investigate urban residents in five Chinese provinces and cities.Logistic regression was used to do the influencing analysis;R software was used to draw nomogram.Results Coming from town(OR=0.796),sleeping 7~9 h(OR=0.722)and more than 9 hours(OR=0.792),having extended family(OR=0.611),good relationship with parents(OR=0.602),not crowded housing(OR=0.531),neighborhood harmony(OR=0.737),fitness facilities(OR=0.531),high frustration(OR=0.576),positive and optimistic attitude towards life(OR=0.546),more than 3 interests(OR=0.812),mature and stable personality(OR=0.591),high self-health attention(OR=0.778),good leisure health promotion effect(OR=0.523)are protection factors of mental sub-health;Divorce or widowhood(OR=1.495),occasional breakfast(OR=1.64),exposure to secondhand smoke(OR for very small,general and large exposure were 1.46,1.527 and 1.63,respectively),occasional drinking(OR=1.342),bad eating habits(OR=1.365),not physical exercise everyday(OR for regular,sometimes and occasionally were 1.356,1.395 and 1.539,respectively),3~5 hours(OR=1.236)and more than 5 hours(OR=1.467)of Internet access,childhood trauma events(OR=1.503),health impacted by two-child policies(OR=1.414),and health impacted by medical policies(OR=1.437)are risk factors for mental sub-health.The logistic regression model has higher predictive value,whose bias corrected c-index was 0.767.Conclusion Influencing factors of sub-health including many aspects of internal and external factors,suggesting that prevention should be carried out in consideration of these aspects,especially the direct effects of internal factors and lifestyles,and indirect effects of environmental factors.Association factors of mental sub-health contains demographic and security factors,lifestyle factors,family and environmental factors,personality traits,health awareness,experience events and policy environment.It is suggested that health department needs to consider a variety of factors to prevent mental sub-health state when formulating policies of sub-health or health,or conducting health education.