Analysis of chronic disease health literacy and influencing factors among urban and rural residents in Hefei in 2019
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摘要:
目的 了解合肥市城乡居民慢性病防治健康素养水平及影响因素, 为健康教育策略和措施的制定提供数据参考。 方法 采用多阶段抽样方法在合肥市9个县区的36个行政村/居委会随机抽取2 681名常住居民进行问卷调查, 多因素Logistic回归分析模型分析筛选慢性病防治健康素养水平的影响因素。 结果 2019年合肥市居民慢性病防治健康素养具备率为16.1%(95% CI:14.7%~17.5%), 受教育程度和家庭人均年收入越高者具备慢性病健康素养的比例越高(P < 0.001), 而相对于无慢性病者, 患有2种及以上慢性病者慢性病健康素养的具备率较低(OR=0.406, 95% CI:0.175~0.943, P=0.036)。慢性病防治素养的相关问题中, “大豆制品的好处认知”、“水果和蔬菜功能上可相互替代”和“癌症早期危险信号认知”正确率较低, 分别为23.4%、17.5%和7.0%。 结论 应进一步加强重点人群健康素养教育, 调整慢性病防治健康素养教育的内容和方式。 Abstract:Objective To understand the status and influencing factors of Chronic disease health literacy of residents in Hefei City, so as to provide basic data for health education strategies and measures. Methods 2 681 permanent residents were randomly selected from 36 administrative villages or neighborhood committees in 9 counties and districts of Hefei by multistage sampling methods. Multiple Logistic regression was used to screen the influencing factors of Chronic disease health literacy status. Results In 2019, the level of chronic disease health literacy among residents in Hefei was 16.1%(95% CI: 14.7%-17.5%). The residents had higher rate of chronic diseases health literacy(P < 0.001) with higher level of education and higher per capita annual income. Compared with the participants who never had chronic diseases, the participants who had great than or equal to 2 kinds of chronic disease had lower chronic di-sease health literacy. The least accuracy questions about chronic disease health literacy was "Benefits of soy products", "Fruits and vegetables are functionally replaceable" and "Early warning signs of cancer". Conclusions The contents and methods of health literacy education for chronic diseases prevention and treatment should be adjusted to further strengthen health literacy education for key groups. -
Key words:
- Residents /
- Chronic noncommunicable disease /
- Health literacy /
- Influencing factors
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表 1 合肥市城乡居民不同人口学特征的慢性病防治素养水平分析
Table 1. Analysis on chronic disease health literacy of demographic characteristics among urban and rural residents in Hefei City
特征 例数 构成比(%) 慢性病素养具备人数 慢性病素养具备率(%) χ2值 P值 本地户籍 2.242 0.134 否 344 12.9 65 18.9 是 2 329 87.1 366 15.7 性别 0.886 0.346 男 1 019 38.1 173 17.0 女 1 654 61.9 258 15.6 地区 14.801 < 0.001 农村 1 539 57.6 212 13.8 城市 1 134 42.4 219 19.3 年龄(岁) 30.177 < 0.001a 15~ 1 065 39.8 219 20.6 35~ 1 133 42.4 164 14.5 ≥55 475 17.8 48 10.1 文化程度 98.524 < 0.001a 初中及以下 1 424 53.3 144 10.1 高中/中专 600 22.4 111 18.5 大专及以上 649 24.3 176 27.1 职业 37.455 < 0.001 事业单位职工 461 17.2 107 23.2 企业职工 653 24.4 112 17.2 学生 321 12.0 59 18.4 其他 470 27.6 73 15.5 农民 768 28.7 80 10.4 家庭总人口数 3.323 0.190 ≤3 923 34.5 156 16.9 4~ 1318 49.3 218 16.5 ≥6 432 16.2 57 13.2 家庭人均年收入(元) 38.003 < 0.001a < 7 500 1 000 37.4 119 11.9 7 500~ 809 30.3 123 15.2 12 500~ 521 19.5 104 20.0 ≥25 000 343 12.8 85 24.8 慢性病 10.651 < 0.001 无 2 148 80.4 371 17.3 有 525 19.6 60 11.4 患慢性病数量 13.168 < 0.001a 0 2 148 80.4 371 17.3 1 425 15.9 54 12.7 ≥2 100 3.7 6 6.0 合计 2 673 100.0 431 16.1 注:a:趋势χ2检验。 
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表 2 合肥市城乡居民慢性病防治健康素养相关问题回答正确率
Table 2. Rate of correct answer to relative question about chronic disease health literacy among urban and rural residents in Hefei City
问题 回答人数 正确回答人数 回答正确率(%) 1.水果和蔬菜功能上可相互替代 2 673 467 17.5 2.儿童青少年可能发生抑郁症 2 673 2 453 91.8 3.自测血压的认识 2 673 1 590 59.5 4.吸烟危害的认识 2 673 1 678 62.8 5.癌症早期危险信号 2 673 187 7.0 6.大豆制品的好处 2 673 626 23.4 7.运动对健康的作用 2 673 1 802 67.4 8.超重与肥胖人群控制体重的正确方法 2 673 2 091 78.2 9.超重与肥胖的患病认知 2 673 2 035 76.1
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表 3 合肥市城乡居民慢性病防治健康素养具备率的多因素Logistic回归分析模型分析
Table 3. Multiple Logistic regression on status of chronic disease health literacy among urban and rural residents in Hefei City
变量 β值 Sx值 Wald值 OR(95% CI)值 P值 受教育程度 初中及以下 1.000 高中/中专 0.612 0.139 19.291 1.845(1.404~2.424) < 0.001 大专及以上 1.036 0.132 61.548 2.819(2.176~3.652) < 0.001 家庭人均年收入(元) < 7 500 1.000 7 500~ 0.223 0.141 2.513 1.250(0.949~1.646) 0.113 12 500~ 0.398 0.151 6.895 1.488(1.106~2.002) 0.009 ≥25 000 0.522 0.167 9.797 1.686(1.216~2.338) 0.002 患慢性病数量 0 1.000 1 -0.084 0.162 0.271 0.919(0.669~1.262) 0.603 ≥2 -0.901 0.430 4.391 0.406(0.175~0.943) 0.036 连续变量 -2.311 0.121 365.743 < 0.001
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