基于合肥市两社区的社会资本在中老年人体型认知中的作用

The role of social capital in body size misperception among community-dwelling middle-aged and elderly people

目的对自身体型的正确认知是采取减重等健康促进行为的前提,本研究旨在调查城市中老年人对自身体型的认知(即自我判断与实际测量的一致性),并基于社会资本理论,探索社会资本在城市中老年人体型认知中的作用。方法通过方便抽样选取合肥城市社区中老年人722名,设计问卷收集调查对象人口学特征、个人认知以及各类型社会资本(纽带型、桥接型以及连接型)指标信息,并在身体测量的基础上分析研究对象自我评估体型和实测体型的一致性,采用二元Logistic回归法分析社会资本在中老年人群自我体型认知中的作用。结果研究对象自我报告“偏瘦”的比例高于实际水平,而“超重”和“肥胖”的比例低于实测水平,男性和女性自我报告体型与实测体型一致性一般。二元Logistic回归分析显示,纽带型社会资本对中老年人体型认知影响较大,其中研究对象的家人“希望自己更胖一点”(OR:2.065,95%CI:1.250~3.411)和“不太关心”(OR:1.775,95%CI:1.099~2.865)会导致中老年人错误认知的可能性上升,而与朋友见面频率较高则中老年人错误认知的可能性下降(OR:0.660,95%CI:0.444~0.979),桥接型社会资本对中老年人体型认知也有显著影响,缺乏社区或家庭医生宣教增加中老年人错误认知的可能性(OR:1.431,95%CI:1.010~2.028)。结论城市社区中老年人易处于“超重或肥胖而不自知”的状态,纽带型和桥接型社会资本影响其对自身体型的正确判断,而连接型社会资本无明显影响。今后应加强对中老年人的体重管理,并可从社会资本的角度入手进行干预,正确引导其家人态度,并鼓励中老年人参加社交活动。

Objective:To investigate the agreement between actual body size and the perceived body size,and the influencing factors of body size mis-perception among middle-aged and elderly residents in urban communities.Methods:722 participants from two communities of Hefei City were surveyed with questionnaire.Height and weight were measured to assess their actual body size.Logistic regression was performed to identify whether social norms related to obesity and family attitude toward their body size were associated with body size mis-perception.Results:Self-reported prevalence of overweight and obesity were lower than the measured rates.The agreement between actual body size and the perceived body size was poor among male and female participants.The likelihood of mis-perception of their body size increased if the participants'family members held the attitude of"hoping me to gain weight"(OR:2.065,95%CI:1.250~3.411)and"don't care too much"(OR:1.775,95%CI:1.099~2.865).On the contrary,higher meeting frequency with friends reduced the possibility of mis-perception(OR:0.85,95%CI:0.752~0.962).Conclusion:Middle-aged and elderly residents in urban community tend to underestimate their body size.Within the components of bonding social capital,family's attitude can affect the correct judgement of the body size among middle-aged and elderly people.However,meeting with friends might be a protective factor.While enhancing health education for the weight management of middle-aged and elderly people,it is also necessary to provide suggestions through social capital perspectives.