基于社会生态学模型的农村老年人健康促进行为影响因素研究

Analysis of the Influencing Factors of Health Promotion behaviors of the Rural Elderly People Based on Social Ecological Model

目的:以社会生态学模型为基础,从不同层面厘清影响农村老年人健康促进行为的影响因素,为老年人健康管理提供参考依据。方法:2023年8月,采用便利抽样的方法,对宁夏农村地区老年人进行问卷调查。将老年人健康促进行为作为因变量,将社会生态学模型五个层次的指标作为自变量,运用SPSS 26.0软件进行独立样本t检验、单因素方差分析、分层线性回归,运用Stata 17.0软件,采用Shapley值分解法量化影响因素。结果:共发放问卷245份,回收有效问卷243份,有效回收率为99.18%。农村老年人健康促进行为总分为(48.35±7.87),健康习惯维度得分最高(17.09±2.51);分层线性回归分析结果表明,自理能力(β=4.067,P=0.011)、生病的处理方式(β=1.546,P=0.023)、社会支持度(β=2.969,P=0.001)、家至公共场所的距离(β=-3.314,P<0.001)的农村老年人健康促进行为水平差异具有统计学意义。Shapley值分解结果显示,社会生态学各维度对农村老年人健康促进行为的解释贡献率依次为人际与组织层面(39.29%)、社区与公共政策层面(31.79%)、个体层面(28.92%)。结论:本次调查的农村老年人健康促进行为总体处于良好水平,建议应从个体、组织、社区、政策多方面入手进行干预,以此加强老年人对健康生活方式的重视。

Objective To understand the influencing factors of health promoting behavior of rural elderly from different levels based on the social ecological model,so as to provide a reference for health management of the elderly.Methods Convenient sampling method was used to conduct a questionnaire survey among the elderly in rural areas of Ningxia in August 2023.The health promotion behavior of the elderly was taken as the dependent variable,and the indicators of social ecological model at five levels were taken as the independent variables.SPSS 26.0 software was used to conduct independent sample t test,one-way ANOVA,hierarchical linear regression.Stata 17.0 software was used to quantify the influencing factors by Shapley value decomposition method.Results A total of 245 questionnaires were issued,and 243 valid were collected,with an effective recovery rate of 99.18%.The total score of health promoting behavior was(48.35±7.87),and the score(17.09±2.51)of healthy habits dimension was the highest.There were statistically significant differences in health promoting behavior level of self-care ability(β=4.067,P=0.011),coping style when ill(β=1.546,P=0.023),social support(β=2.969,P=0.001),distance from home to public activities(β=-3.314,P<0.001).The results of Shapley value decomposition showed that the contribution rates of social ecological model to health promotion behavior of the rural elderly were ranked as interpersonal and organizational level(39.29%),community and public policy level(31.79%),and individual level(28.92%).Conclusion The health promoting behavior of the elderly in rural areas is at a good level.It is suggested that individual,organization,community and policy interventions should be carried out in order to strengthen the elderly's attention to healthy life style.