应用格林模式对马鞍山市居民阿尔茨海默病相关行为的研究

秦美婷; 赵一入; 汤其强

doi:10.16462/j.cnki.zhjbkz.2019.10.015

应用格林模式对马鞍山市居民阿尔茨海默病相关行为的研究

doi: 10.16462/j.cnki.zhjbkz.2019.10.015

1.
230026 合肥, 中国科学技术大学人文与社会科学学院科技传播与科技政策系
2.
230001 合肥, 中国科学技术大学附属第一医院神经内科

基金项目:

国家社会科学基金 13BXW038

详细信息

通讯作者:
赵一入, E-mail: yiruz@mail.ustc.edu.cn

中图分类号: R749.16;R193
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- 被引次数: 0
出版历程
- 收稿日期: 2019-03-12
- 修回日期: 2019-07-18
- 刊出日期: 2019-10-10

Study on alzheimer's disease-related behavior of residents in Ma'anshan City by PRECEDE-PROCEED model

1.
Department of Science and Technology of Communication and Policy, School of Humanities and Social Sciences, University of Science and Technology of China, Hefei 230026, China
2.
Department of Neurology, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230001, China

Funds:

National Social Science Fund of China 13BXW038

More Information

Corresponding author: ZHAO Yi-ru, E-mail: yiruz@mail.ustc.edu.cn

摘要

摘要: 目的应用格林模式中三大因素与行为进行相关性分析，以便了解马鞍山市常住居民阿尔茨海默病（alzheimer's disease，AD）的相关行为，探索三大因素对AD有关行为的影响。方法采用问卷调查法，以滚雪球抽样法进行问卷发放，合计回收有效问卷761份。数据分析采用SPSS 21.0软件，其中倾向因素与行为分析采用AMOS 21.0建模，利用结构方程模型（structural equation model，SEM）分析相关性；促成因素、强化因素与行为之间采用Spearman和Pearson相关性分析。结果倾向因素中态度对行为的总体影响为0.562，知识对行为的间接影响为0.243；促成因素中医疗质量（r=-0.073，P=0.045）、开展分级诊疗（r=0.146，P < 0.001）、制定老年疾病相关政策（r=0.099，P=0.006），三者均与行为有相关性。强化因素中自我健康评估（r=0.110，P=0.002）、通过组织健康传播（r=0.191，P=0.035）或大众健康传播（r=0.115，P=0.011）渠道获得AD相关信息的频率，以及人际健康传播（r=0.274，P < 0.001）或组织健康传播（r=0.177，P < 0.001）中对老年健康议题的传播频率，五者与行为的关系均呈正相关。结论通过健康传播途径提高阿尔茨海默病与老年健康相关知识的传播、促进当地医疗条件的改善，以及开展分级诊疗并制定与老年疾病相关的政策，有助于促进受众对阿尔茨海默病持以正向的行为。
- 阿尔茨海默病 /
- 格林模式 /
- 健康传播 /
- 马鞍山市
Abstract: Objective In order to study the behaviors of Ma'anshan residents on alzheimer's disease (AD), by using the three factors of PRECEDE-PROCEED model, this paper analyzed their correlation with behaviors, explored the influence of three factors on AD related behavior. Methods The study used snowball sampling method to conduct questionnaire survey, 761 valid questionnaires were collected in total. SPSS 21.0 software was applied to analyze the data, and AMOS 21.0 modeling was used to analyse the predisposing factors and behaviors, structural equation model (SEM) was used to analyze the correlation. Spearman and Pearson were used to analyze the relativity among enabling factors, reinforcing factors and the behaviors. Results It was found that about predisposing factors, attitude affected behavior with a general influence coefficient of 0.562, and knowledge had an indirect effect on behavior with an influence coefficient of 0.243. Among the enabling factors, medical quality (r=-0.073, P=0.045), hierarchical medical treatment (r=0.146, P < 0.001) and policy support on elderly diseases (r=0.099, P=0.006) were all correlated with behaviors. The self-health assessment (r=0.110, P=0.002) of reinforcing factors, the frequency of obtaining AD related information through organization health communication (r=0.191, P=0.035) or mass health communication (r=0.115, P=0.011) channels and the frequency of elderly health issue transmission in interpersonal health communication (r=0.274, P < 0.001) or organization health communication (r=0.177, P < 0.001), which were positively correlated with behaviors. Conclusions It is conducive to promote people's positive behaviors toward AD through health communication sharing on AD and other elderly diseases, the improvement of local medical conditions, the implementation of hierarchical medical treatment and the formulation of relevant policies of elderly diseases.
- Alzheimer's disease /
- PRECEDE-PROCEED model /
- Health communication /
- Ma'anshan City

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图 1 格林模式

注：本图引自Green LW, Kreuter MW. Health promotion planning: An educational and ecological approach [M]. McGraw-Hill, 1999:35. 图文由本文作者绘制与翻译。

Figure 1. PRECEDE-PROCEED model

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图 2 格林模式中三大因素的行为模型

Figure 2. Behavioral model of 3 factors of PRECEDE-PROCEED model

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图 3 倾向因素与行为关系修正后之SEM的检验结果

Figure 3. Test results of the modified SEM for the relationship between predisposing factors and behaviors

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表 1 AMOS 21.0中有关倾向因素与行为的潜在变量和显在变量编码

Table 1. Latent variable and manifest variable coding related to predisposing factors and behaviors in AMOS 21.0

潜在变量	维度	代码	显在变量(观测变量)
知识		Z1	疾病概念
		Z2	危险因素
		Z3	保护因素
		Z4	主要症状
		Z5	严重性
		Z6	预防方式
		Z7	发病部位
		Z8	技术支持与公益活动
态度	对自己	T1	我愿意主动获取AD相关知识
	对家人	T2	我很关注家中老年人的记忆状况
		T3	我认为AD会给家庭带来很大的精神压力
	对患者	T4	AD家属最好对外界隐瞒，以免带来负面眼光
		T5	哪怕是AD初期尚有行为能力的患者也不应该参加社会活动
行为	对自己	X1	了解AD危险因素和预防措施后，自己会采取何种行为方式
		X2	担心自己会患AD，是否会提前做好养老规划
	对家人	X3	若发现家中老年人出现记忆障碍、认知障碍、迷路或不认家门时，会采取何种措施
		X4	若家中老年人“确诊”患有AD，是否接受治疗
	对患者	X5	若在街上遇到佩戴“黄手环”的AD老年人，会如何对待
		X6	对AD患者是否会出钱出力

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表 2 修正后SEM适配度之评价指标及甄别

Table 2. The evaluation index and discrimination of the adaptability of modified SEM

统计检验量	NC	RMR	GFI	AGFI	PGFI	IFI	TLI	CFI	RMSEA	PNFI
修正模型指标	2.863	0.013	0.968	0.958	0.749	0.944	0.934	0.943	0.028	0.742
参考标准	1 < NC < 3	< 0.05	>0.90	>0.90	>0.50	>0.90	>0.90	>0.90	< 0.05	>0.50

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表 3 修正后SEM的标准化回归系数及显著性检验

Table 3. Standardized regression coefficient and significance test of modified SEM

路径	Estimate	S.E.	C.R.	P值
态度←知识	0.433	0.295	5.049	< 0.001
行为←态度	0.562	0.042	8.045	< 0.001

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