老年心血管疾病患者膳食行为改善影响因素分析

Analysis of influencing factors on improvement of dietary behavior in elderly patients with cardiovascular disease

目的了解老年心血管疾病患者膳食行为改善的影响因素,为患者健康膳食管理及生命质量改善提供依据。方法于2020年11月至2021年1月采用随机抽样与方便抽样相结合的方法,在甘肃省甘州区抽取60岁及以上心血管疾病患者692人作为调查对象。问卷收集个人社会特征、健康膳食知识及态度、近1年膳食行为主动改善情况、社会环境支持等相关资料,采用SPSS 25.0软件进行探索性因子分析,采用Amos 22.0构建结构方程模型分析老年心血管疾病患者健康膳食行为改善的影响因素。结果692例老年心血管疾病患者中,近一年在日常生活中果蔬摄入增加者565例(81.65%),奶类摄入增加者440例(63.58%),豆类摄入增加者411例(59.39%),食用盐摄入减少者530例(76.59%),油脂摄入减少者504例(72.83%),糖类摄入减少者437例(63.15%)。结构方程模型分析结果显示,影响膳食行为改善的主要因素为健康膳食态度、社会环境支持及个人社会特征,总效应分别为0.653、0.475、0.136,其中健康膳食态度和社会环境支持对膳食行为改善具有显著的直接影响,直接效应分别为0.653、0.375。健康知识知晓对膳食行为改善有负向直接影响,直接效应为-0.123。社会环境支持通过健康膳食态度产生对膳食行为改善产生间接影响,效应为0.102;健康知识知晓通过健康膳食态度对膳食行为改善产生间接影响,效应为0.120。结论甘州区老年心血管疾病患者主动改善膳食行为的比例较高,但存在知行不一致的情况。健康膳食态度的养成、健康社会环境的建成和完善及社会经济地位的提升会有力促进患者膳食行为的改善。

Objective To understand the influencing factors and their interaction mechanisms of dietary behavior improvement in elderly patients with cardiovascular disease,and provide the basis for healthy dietary management and life quality improvement of patients.Methods From November 2020 to January 2021,the random with convenient sampling was used to select 692 residents(≥60 years old)from Ganzhou district of Gansu Province as the subjects.The investigation was performed with questionnaire(collecting the information of personal social characteristics,knowledge and attitudes of healthy diet,active improvement of dietary behavior in the past year,and social environmental support).The software SPSS 25.0 was used to analyze the exploring factors;Amos 22.0 was used for structural equation model to analyze the influencing factors on improvement of dietary behavior in elderly patients with cardiovascular disease.Results Among the 692 elderly patients with cardiovascular disease,in daily life,565(81.65%)had increased fruit and vegetable intake,440(63.58%)had increased milk intake,and 411(59.39%)had increased bean intake.Total 530(76.59%)patients had reduced salt intake,504(72.83%)had reduced fat intake,and 437(63.15%)had reduced sugar intake.The structural equation model analysis showed that the main factors affecting the improvement of dietary behavior were dietary intake attitude,social environment support and personal social characteristics,the total effects were0.653,0.475 and 0.136,respectively;the health dietary attitude and social environment support had significantly direct effects on the improvement of dietary behavior,the direct effects were 0.653 and 0.375,respectively.The direct effect of health knowledge on dietary behavior improvement was-0.123.The indirect effect of social environment support mediated by health dietary attitude was0.102;and the indirect effect of health knowledge mediated by health dietary attitude was 0.120.Conclusion The proportion of active improvement dietary behavior is higher in elderly patients with cardiovascular disease of Ganzhou,but there are inconsistencies between knowledge and action.The cultivation of healthy dietary attitudes and the establishment and improvement of the healthy social environment,and socio-economic status enhancement would effectively promote the improvement of patient dietary behavior.