山东省主动健康示范区域老年人慢病管理知信行现状及影响机制

Current situation and influencing mechanism of knowledge,attitude and practice about chronic disease management among elderly people in Shandong Provinces proactive health demonstration area

目的探索山东省主动健康示范区域老年人慢病管理知信行水平及其影响机制。方法采用多阶段随机抽样方法,共抽取5447名65岁以上的老年人进行问卷调查,采用t检验和单因素方差分析比较慢病管理知信行得分情况,并用多元线性回归模型分析其影响因素,以中介分析探讨其影响机制。结果山东省主动健康示范区域老年人慢病管理知识平均得分为7.47±2.83;态度平均得分为8.47±2.47;行为平均得分为4.94±1.79。回归分析表明,性别、年龄、居住方式、自评健康状况是知识的影响因素;年龄和居住方式影响态度,而性别和年龄是行为的影响因素。中介分析显示,慢病管理知识对态度(β=0.6701,P<0.001)、行为意愿(β=0.0468,P<0.01)和行为(β=0.3056,P<0.001)均具有预测作用,态度对行为意愿(β=0.1698,P<0.001)和行为(β=0.2161,P<0.001)具有预测作用,行为意愿正向预测行为(β=0.0291,P<0.05)。知识对行为的直接效应值为0.1939,占总效应的56.46%,间接效应值为0.1495,占总效应的43.54%。结论山东省主动健康示范区域老年人慢病管理知识和态度水平均较高,但行为转化水平有待进一步提高;慢病管理态度、行为意愿在知识和行为之间起中介作用,且态度还可以通过提升行为意愿来改善行为水平。

Objective To explore the level of knowledge,attitude,and practice and its influential mechanism of chronic disease management among the elderly in the proactive health demonstration area of Shandong Province,China.Methods Using a multi-stage random sampling approach,a total of 5447 elderly people aged≥65 were selected for questionnaire survey.T-test and one-way analysis of variance(ANOVA)were used to compare the scores of knowledge,attitude,and practice in chronic disease management.A multiple linear regression model was performed to analyze the influencing factors,and mediation analysis was used to explore the influencing mechanism.Results In the proactive health demonstration area of Shandong Province,the average knowledge score was 7.47±2.83,the average attitude score was 8.47±2.47,and the average practice score was 4.94±1.79.Regression analysis revealed that gender,age,living style,and self-assessed health status were the influencing factors of knowledge;age and living style were influencing factors of attitude;gender and age were influencing factors of practice.The mediation analysis showed that knowledge had predictive effect on attitude(β=0.6701,P<0.001),behavioral intention(β=0.0468,P<0.01),and practice(β=0.3056,P<0.001).Attitude had predictive effect on behavioral intention(β=0.1698,P<0.001)and practice(β=0.2161,P<0.001),and behavioral intention positively predicts practice(β=0.0291,P<0.05).The direct effect value of knowledge on practice was 0.1939,accounting for 56.46%of the total effect.The value of indirect effect was 0.1495,accounting for 43.54%of the total effect.Conclusion The level of knowledge and attitude about chronic disease management among the elderly in the proactive health demonstration area of Shandong Province is relatively high,but the level of behavioral transformation needs to be further improved.Attitude and behavioral intention towards chronic disease management play a mediatory role between knowledge and practice,and attitude can also improve the level of practice by changing the behavioral intention.