Study on the influence of risk attitude to hepatitis B vaccination behavior of residents in suburban areas
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摘要:
目的 通过天津市郊县居民风险态度对乙型肝炎(乙肝)疫苗接种行为影响因素的调查,探寻健康教育改善路径。 方法 问卷调查宁河县和静海县6个村的1 031名16~60岁成人,采用Pearson χ2检验和非条件二分类Logistic回归分析方法研究风险态度对乙肝疫苗接种行为的影响。 结果 Logistic回归分析显示,对其他变量进行控制后,调查对象的风险态度对其乙肝疫苗接种行为具有一定影响,年龄越小(OR=0.94,95%CI:0.93~0.96,P<0.001)、未婚(OR=8.24,95%CI:2.89~23.60,P<0.001)、自感健康较差(OR=1.78,95%CI:1.53~3.49,P=0.008)、正式工作者(OR=7.18,95%CI:2.29~22.54,P=0.001)、有医保(OR=8.46,95%CI:2.31~30.86,P=0.001)、风险规避(OR=1.65,95%CI:1.06~2.57,P=0.026)和风险中立者(OR=1.50,95%CI:1.03~2.17,P=0.032)更易选择接种乙肝疫苗。 结论 针对风险规避者和风险中立者,加强对乙肝疾病特征和疾病经济负担方面的健康教育,针对风险寻求者,可从乙肝流行趋势和传播途径等方面加强,使其对感染乙肝的概率有更科学的认识。 Abstract:Objective To explore the influence of risk attitude to hepatitis B vaccination behavior of residents in suburban areas, and provide evidence for improvement of health education. Methods A total of 1 031 adults aged 16-60 years old were selected from 6 villages in Ninghe county and Jinghai county. A questionnaire was used to investigate them. Results Logistic regression analysis showed that respondents' hepatitis B vaccination behavior was affected by their risk attitude when controlling other factors. The younger (OR=0.94, 95% CI: 0.93-0.96, P<0.001), unmarried (OR=8.24, 95% CI: 2.89-23.60, P<0.001), low self-rated health (OR=1.78, 95% CI: 1.53-3.49, P=0.008), the formal sector workers (OR=7.18, 95% CI: 2.29-22.54, P=0.001), covered by health insurance (OR=8.46, 95% CI: 2.31-30.86, P=0.001), risk aversion (OR=1.65, 95% CI: 1.06-2.57, P=0.026) and risk neutral (OR=1.50, 95% CI: 1.03-2.17, P=0.032) were more likely to choose hepatitis B vaccination. Conclusions For the risk aversion and risk neutral, health education on disease symptoms and disease economic burden should be enhanced; for the risk seeking, more knowledge on prevalence trend and transmission route need to be improved. -
Key words:
- Risk attitude /
- Hepatitis B vaccine /
- Vaccination behavior /
- Suburban areas
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表 1 调查对象社会人口学特征(%)
Table 1. Demographic characteristics of respondents(%)
分组 人数 构成比(%) 性别 男 539 52.28 女 492 47.72 受教育程度 小学及以下 224 21.73 初中 327 31.72 高中及以上 480 46.56 职业a 农民 306 29.68 打工者 228 22.11 正式工作者 237 22.99 无业者 72 6.98 学生及其他 171 16.59 婚姻状况b 未婚 245 23.76 已婚 742 71.97 离婚及丧偶 29 2.81 自感经济状况 较困难 139 13.48 中等 840 81.47 较好 52 5.04 风险态度 风险寻求 344 33.37 风险中立 253 24.54 风险规避 434 42.10 注:a职业信息缺失17例,b婚姻状况信息缺失15例。 表 2 不同风险态度调查对象的乙肝疫苗接种状况及其比较[n(%)]
Table 2. Coverage of hepatitis b vaccine among respondents by risk attitude[n(%)]
风险态度 接种过 未接种过 χ2值 P值 风险寻求 202(62.73) 120(37.27) 8.622 0.013 风险中立 165(71.12) 67(28.88) 风险规避 292(72.46) 111(27.54) 表 3 不同特征调查对象的风险态度及乙肝疫苗接种情况[n(%)]
Table 3. Coverage of hepatitis b vaccine and risk attitude among respondents by characters[n(%)]
分组 n(%) 风险态度情况(%) χ2值 P值 乙肝疫苗接种率(%) χ2值 P值 风险规避 风险中立 风险寻求 年龄(岁)a 14.56 0.024 152.30 <0.001 16~ 163(15.81) 16.57 17.53 15.74 90.10 25~ 334(32.40) 25.58 33.07 37.73 88.55 45~ 381(36.95) 43.02 35.86 33.10 55.94 ≥65 143(13.87) 14.83 13.55 13.43 43.97 受教育程度 5.28 0.259 115.47 <0.001 小学及以下 224(21.73) 23.26 25.30 18.43 45.24 初中 327(31.72) 30.52 30.04 33.64 57.83 高中及以上 480(46.56) 46.22 44.66 47.93 84.45 自感经济状况 2.60 0.626 11.15 0.004 较困难 139(13.48) 13.95 11.46 14.29 65.93 中等 840(81.47) 80.81 82.21 81.57 70.62 较好 52(5.04) 5.23 6.32 4.15 47.83 注:a年龄信息缺失10例。 表 4 乙肝疫苗接种行为多因素Logistic回归分析
Table 4. Logistic regression analysis of hepatitis b vaccination behavior
因素 β sx Z值 P值 OR(95% CI)值 性别 女 1.00 男 0.13 0.19 0.76 0.450 1.14(0.82~1.59) 年龄 -0.06 0.01 -7.04 <0.001 0.94(0.93~0.96) 婚姻状况 已婚 1.00 未婚 2.11 4.42 3.93 <0.001 8.24(2.89~23.60) 离婚或丧偶 0.80 1.01 1.77 0.077 2.23(0.92~5.43) 受教育程度 小学及以下 1.00 初中 -0.30 0.18 -1.24 0.214 0.74(0.46~1.19) 高中及以上 0.56 0.52 1.90 0.057 1.75(0.98~3.12) 自感健康 好 1.00 一般 0.84 0.48 4.03 0.000 2.31(1.53~3.49) 差 0.58 0.38 2.67 0.008 1.78(1.17~2.72) 职业 学生及其他 1.00 打工者 0.64 1.77 2.05 0.051 3.15(3.35~9.47) 正式工作者 1.97 4.19 3.38 0.001 7.18(2.29~22.54) 无业 1.26 2.29 1.95 0.052 3.53(0.99~12.56) 农民 -0.93 0.20 -0.34 0.733 0.93(0.60~1.43) 有无医保 无 1.00 有 2.13 5.59 3.23 0.001 8.46(2.31~30.86) 自感收入状况 好 1.00 中等 -0.15 0.22 -0.63 0.530 0.86(0.53~1.38) 差 -0.92 0.47 -1.93 0.053 0.40(0.16~1.01) 风险态度 风险寻求 1.00 风险中立 0.41 0.28 2.14 0.032 1.50(1.03~2.17) 风险规避 0.50 0.37 2.23 0.026 1.65(1.06~2.57) -
[1] Weber EU, Blais A, Betz NE. A domain-specific risk-attitude scale: measuring risk perceptions and risk behaviors[J]. J Behav Decis Mak, 2002, 15(4): 263-290. DOI: 10.1002/bdm.414. [2] Arrow, KJ. Risk perception in psychology and economics[J]. Econ Inq, 1982, 20: 1-9. DOI: 10.1111/j.1465-7295.1982.tbo1138.x. [3] 韩纲, 沈国麟, 储可君. 对甲型HIN流感疫苗有效性及疫苗接种可能性认知的中美比较研究: 基于大众传媒、健康风险感知和自我效能的影响评估(英文)[J]. 国际新闻界, 2013, (1): 152-168. DOI: 10.13495/j.cnki.cjjc.2013.01.002.Han G, Shen GL, Chu KJ, et al. Perceived H1N1 flu vaccine efficacy and likelihood of vaccine uptake in China and the U.S. : assessing the influences of mass media, risk perception and self-efficacy[J]. CJJC, 2013, (1): 152-168. DOI: 10.13495/j.cnki.cjjc.2013.01.002. [4] 郑适, 秦明, 王志刚. 消费者对药品的感知风险与风险态度研究[J]. 中国流通经济, 2016, 30(3): 88-93. DOI: 10.14089/j.cnki.cn11-3664/f.2016.03.012.Zheng S, Qin M, Wang ZG. A Study on Consumers' drug perceived risk and risk attitude[J]. China Business and Market, 2016, 30(3): 88-93. DOI: 10.14089/j.cnki.cn11-3664/f.2016.03.012. [5] 谢晓非, 郑蕊. 认知与决策领域的中国研究现况分析[J]. 心理科学进展, 2003, 11(3): 281-288. DOI: 10.3969/j.issn.1671-3710.2003.03.008.Xie XF, Zheng R. Analysis of current Chinese research on cognition and decision[J]. Adv Psychol Sci, 2003, 11(3): 281-288. DOI: 10.3969/j.issn.1671-3710.2003.03.008. [6] Douglas M, Wildavsky A. Risk and culture[M]. California: University of California Press(Berkeley), 1982: 58-70. DOI: 10.1002/9781444301489.ch6. [7] 田茶, 李军, 韩彩芝, 等. 新生儿乙肝疫苗免疫效果及影响因素分析[J]. 中国公共卫生, 2007, 23(6): 678-679. DOI: 10.3321/j.issn:1001-0580.2007.06.019.Tian C, Li J, Han CZ, et al. Immunoprophylax is efficacy of hepatitis B vaccine and its influential factors after immunological inoculation in newborns[J]. Chin J Public Health, 2007, 23(6): 678-679. DOI: 10.3321/j.issn:1001-0580.2007.06.019. [8] Zheng H, Wang FZ, Zhang GM, et al. An economic analysis of adult hepatitis B vaccination in China[J]. Vaccine, 2015, 33(48): 6831-6839. DOI: 10.1016/j.vaccine.2015.09.011. [9] Lopes LL, Oden GC. The role of aspiration level in risk choice: a comparison of cumulative prospect theory and SP/A theory[J]. J Math Psychol, 1999, 43(2): 286-313. DOI: 10.1006/jmps.1999.1259. [10] 陈军, 李菊芳, 李萍, 等. 外来务工者对突发传染病的风险感知与应对行为调查分析[J]. 护理研究, 2014, 28(17): 2066-2068. DOI: 10.3969/j.issn.1009-6493.2014.17.008.Chen J, Li JF, Li P, et al. Survey of migrant workers' risk perception and coping strategies on emergent infectious diseases[J]. CNR, 2014, 28(17): 2066-2068. DOI: 10.3969/j.issn.1009-6493.2014.17.008. [11] 刘兰, 汪俊华, 黄问湧, 等. 贵州省少数民族地区乙肝防治知识、态度、行为现况调查[J]. 中华疾病控制杂志, 2015, 19(11): 1092-1095, 1100. DOI: 10.16462/j.cnki.zhjbkz.2015.11.004.Liu L, Wang JH, Huang WY, et al. A cross-sectional investigation of hepatitis B prevention knowledge, attitude and practice in minority areas of Guizhou Province[J]. Chin J Dis Control Prev, 2015, 19(11): 1092-1095, 1100. DOI: 10.16462/j.cnki.zhjbkz.2015.11.004.