成都市某社区老年人多维健康状况及其影响因素研究

The Elder Multidimensional Health and Relevant Impact Factors in a Community of Chengdu

目的了解成都市某社区老年人的健康现状,探讨各因素间可能的作用方式。方法采用单纯随机抽样的方法在成都市某社区内选取65岁及以上常住老年人口进行面对面调查,对健康状况采用描述性分析,并构建结构方程模型探讨各因素间可能的作用方式。结果该社区老年人的慢性病患病率和2周患病率分别为57.0%和17.1%,部分老年人(21.3%)存在心理健康问题,老年人的社会支持平均得分为34.45分。老年人的健康素养具备率仅为10.6%。结构方程模型拟合结果显示:健康素养影响老年人生理健康和社会支持状况的路径系数分别为0.12和0.34;生理健康影响心理健康和社会支持状况的路径系数分别为0.35和0.19;老有所为情况影响老年人社会支持状况的路径系数为0.11。人口学特征接影响老年人社会支持和老有所为情况的路径系数分别为0.44和0.29。社会经济地位影响老年人健康素养和老有所为情况的路径系数分别为0.89和0.14。结论该社区老年人的慢性病患病率和2周患病率较高,部分老年人存在心理健康问题,老年人的社会支持水平不高。而且,老年人的健康素养具备率不高。影响老年人健康状况的主要因素有人口学特征、健康素养、老有所为情况,社会经济地位可以通过健康素养的中介作用来影响老年人的生理健康和社会支持,进而还可以通过生理健康影响老年人的心理健康。

Objective To investigate the elder health status in a community of Chengdu,and explore the internal relationship of the impact factors. Methods The elders who were 65 years old and above were selected by simple random sampling. The investigation was based on face- to- face questionnaire,and descriptive analysis was used to evaluate health status. Structural equation model was set up to explore the interaction of the impact factors. Results The elder chronic diseases prevalence was 57. 0% and the diseases prevalence within 2 week was 17. 1%. There were some psychological health problems in elders( 21. 3%), the average scores of social support of was 34. 45,and literacy rate of health was only10. 6%. The fitting results of structural equation model showed: the path coefficients of health literacy on physical health and social support were 0. 12 and 0. 34; the path coefficients of physical health on mental health and social support,were 0. 35 and 0. 19; the path coefficient of productive aging on social support was 0. 11; the path coefficients of demographic features on social support and productive aging were 0. 44 and 0. 29; the path coefficients of socio- economic status on health literacy and social support were 0. 89 and 0. 14. Conclusion The prevalence of elder chronic diseases and disease within 2 weeks was in a high level at this community. Some elders had psychological health problems. The level of social support and the health literacy were not high. The demographic features,health literacy,and productive aging could affect the elder health. Socio- economic status could indirectly influence physical health and social support as the intermediary of health literacy. Thus it could influence mental health as the intermediary of physical health.