Investigation on the health literacy level of chronic diseases among newly diagnosed diabetic patients and prediabetic population in Jiangsu Province
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摘要:
目的 了解江苏省成年居民糖尿病新发患者及其前期人群的慢性病健康素养现状及影响因素,分析其与糖尿病防制知识的关系,为提升社区慢性病预防管理效果提供依据。 方法 采用多阶段分层随机抽样,对经糖尿病筛查发现的糖尿病新发患者及其前期人群进行一般资料、糖尿病防制知识、健康素养水平调查。 结果 经筛查试验发现糖尿病新发患者及前期人群1 502人,平均年龄为(55.09±7.70)岁,其中男性612(40.7%)人,慢性病健康素养条目平均为(3.95±0.62)分。其中,交流互动能力维度条目均分最低为(3.65±0.90)分。768(51.1%)人慢性病健康素养水平充足。多因素分析结果显示,文化程度、收入水平、离退休情况等社会经济因素是其主要影响因素。调查人群的糖尿病防制知识得分与健康素养水平呈正相关。 结论 江苏省成年居民糖尿病新发患者及其前期人群慢性病健康素养水平较高,但通过交流、互动、主动获取健康信息、解决健康问题的能力较差。健康素养水平与糖尿病防制知识得分呈正相关。低文化程度、低收入、离退休人群是促进健康素养工作的重要对象。 Abstract:Objective To estimate the current status and influencing factors of chronic disease health literacy among newly diagnosed diabetic patients and pre-diabetic population among adult residents of Jiangsu Province, and to analyze the relationship between health literacy level and diabetes prevention knowledge, so as to provide a basis for improving the effectiveness of disease prevention and management. Methods A multistage stratified random sample was used to investigate the general information, diabetes prevention knowledge, and health literacy level of 1 502 prediabetic and newly diagnosed patients. Results The screening test identified 1 502 people with new-onset diabetes and prediabetes, with a mean age of (55.09±7.70) years, including 612 (40.7%) men, whose mean chronic disease health literacy entries scored (3.95±0.62); the lowest mean score (3.65±0.90) was for the communication and interaction ability dimension entries, and 768 (51.1%) of the population had an adequate level of chronic disease health literacy. The results of the multifactor analysis showed that socioeconomic factors such as education level, income level, and retirement status were the main influencing factors. The knowledge score of diabetes prevention and control of the surveyed population was positively correlated with the level of health literacy. Conclusions Adult residents with newly diagnosed diabetes and prediabetes in Jiangsu Province have a high level of health literacy, but their level of proactively acquiring health information and solving health problems through communication and interaction is low. The level of health literacy is positively correlated with the score of diabetes prevention knowledge. Low-educated, low-income, and retirees are the targets of health literacy promotion actions. -
Key words:
- Health literacy /
- Chronic disease /
- Prediabetic state
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表 1 调查对象各特征情况[n(%)]
Table 1. The characteristics of the survey object [n(%)]
变量 总体 糖尿病前期 糖尿病 χ2/t值 P值 性别 3.912 0.048 男 612(40.7) 437(39.3) 175(45.0) 女 890(59.3) 676(60.7) 214(55.0) 年龄组(岁) 9.181 0.027 <45 130(8.7) 99(8.9) 31(8.0) 45~<55 552(36.8) 414(37.2) 138(35.5) 55~<65 687(45.7) 516(46.4) 171(44.0) ≥65 133(8.9) 84(7.5) 49(12.6) 文化程度 1.840 0.606 文盲/半文盲 422(28.1) 308(27.7) 114(29.3) 小学 350(23.3) 253(22.7) 97(24.9) 初中 510(34.0) 384(34.5) 126(32.4) 高中/职高/中专及以上 220(14.6) 168(15.1) 52(13.4) 离退休 0.484 0.486 退休 473(31.5) 345(31.0) 128(32.9) 在职 1 029(68.5) 768(69.0) 261(67.1) 职业 0.571 0.903 农民/渔民 1 125(74.9) 838(75.3) 287(73.8) 工人 254(16.9) 184(16.5) 70(18.0) 公务员/事业单位人员 57(3.8) 43(3.9) 14(3.6) 其他 66(4.4) 48(4.3) 18(4.6) 月收入(元) 2.087 0.555 <1 000 537(35.8) 397(35.7) 140(36.0) 1 000~<3 000 565(37.6) 414(37.2) 151(38.8) 3 000~<5 000 278(18.5) 205(18.4) 73(18.8) ≥5 000 122(8.1) 97(8.7) 25(6.4) 地区 2.518 0.113 苏北 678(45.1) 489(43.9) 189(48.6) 苏南 824(54.9) 624(56.1) 200(51.4) 家族史 24.527 <0.001 无 1 174(78.2) 904(81.2) 270(69.4) 有 283(18.8) 183(16.4) 100(25.7) 不知道 45(3.0) 26(2.3) 19(4.9) 吸烟 0.359 0.549 否 1 129(75.2) 841(75.6) 288(74.0) 是 373(24.8) 272(24.4) 101(26.0) 饮酒 0.008 0.931 否 1 049(69.8) 778(69.9) 271(69.7) 是 453(30.2) 335(30.1) 118(30.3) 体育锻炼 2.874 0.090 否 347(23.1) 245(22.0) 102(26.2) 是 1 155(76.9) 868(78.0) 287(73.8) BMI 4.772 0.189 正常 382(25.4) 293(26.3) 89(22.9) 体重过轻 12(0.8) 9(0.8) 3(0.8) 超重 687(45.7) 515(46.3) 172(44.2) 肥胖 421(28.0) 296(26.6) 125(932.1) 年龄(x±s, 岁) 55.09±7.70 54.87±7.73 55.71±7.58 1.844 0.065 BMI(x±s, kg/m2) 26.34±3.76 26.22±3.73 26.70±3.81 2.186 0.029 FPG(x±s, mmol/L) 6.53±1.96 5.85±0.64 8.46±2.94 17.271 <0.001 HbA1c(x±s, %) 5.95±1.20 5.55±0.56 7.11±1.69 17.769 <0.001 糖尿病防制知识得分(x±s, 分) 8.28±6.19 8.16±6.16 8.62±6.27 1.267 0.205 表 2 慢性病健康素养各维度得分情况
Table 2. Scores of health literacy of chronic diseases in each dimension
项目 条目数 总分(分) 维度得分(x±s,分) 条目均分(x±s,分) 健康素养水平[n(%)] 不充足 充足 获取信息能力 9 45.00 36.78±8.00 4.09±0.89 569(37.9) 933(62.1) 交流互动能力 9 45.00 32.83±8.08 3.65±0.90 876(58.3) 626(41.7) 改善健康意愿 4 20.00 16.49±3.21 4.12±0.80 330(22.0) 1 172(78.0) 经济支持意愿 2 10.00 8.70±1.97 4.35±0.98 312(20.8) 1 190(79.2) 健康素养总分 24 120.00 94.80±14.83 3.95±0.62 734(48.9) 768(51.1) 表 3 慢性病健康素养水平充足多因素logistic回归分析
Table 3. Multivariate logistic regression analysis of health literacy level of chronic diseases
特征 人数 健康素养充足 信息获取能力充足 交流互动能力充足 改善健康意愿充足 经济支持意愿充足 n(%) OR(95% CI)值 n(%) OR(95% CI)值 n(%) OR(95% CI)值 n(%) OR(95% CI)值 n(%) OR(95% CI)值 性别 女 890 428(48.1) 1.00 475(53.4) 1.00 372(41.8) 1.00 682(76.6) 1.00 678(76.2) 1.00 男 612 340(55.6) 1.28 (0.96~1.71) 458(74.8) 0.77 (0.53~1.14) 254(41.5) 1.05 (0.85~1.30) 490(80.1) 1.04 (0.79~1.39) 512(83.7) 0.76 (0.57~1.03) 年龄组(岁) <45 130 85(65.4) 1.00 107(82.3) 1.00 57(43.8) 1.00 113(86.9) 1.00 113(86.9) 1.00 45~<55 552 326(59.1) 0.96 (0.63~1.47) 408(73.9) 1.14 (0.66~2.00) 218(39.5) 0.84 (0.57~1.25) 436(79.0) 0.62 (0.35~1.10) 456(82.6) 0.87 (0.49~1.54) 55~<65 687 301(43.8) 0.84 (0.54~1.32) 349(50.8) 0.60 (0.34~1.06) 298(43.4) 1.03 (0.70~1.53) 521(75.8) 0.61 (0.33~1.11) 519(75.5) 0.66 (0.37~1.18) ≥65 133 56(42.1) 1.28 (0.68~2.41) 69(51.9) 0.91 (0.43~1.93) 53(39.8) 1.01 (0.61~1.68) 102(76.7) 0.74 (0.34~1.61) 102(76.7) 0.78 (0.36~1.66) 文化程度 文盲/半文盲 422 118(28.0) 1.00 107(25.4) 1.00 168(39.8) 1.00 300(71.1) 1.00 304(72.0) 1.00 小学 350 181(51.7) 2.48 (1.80~3.40) 212(60.6) 3.22 (2.30~4.52) 142(40.6) 1.30 (1.02~1.66) 266(76.0) 1.27 (0.90~1.81) 267(76.3) 1.00 (0.71~1.43) 初中 510 317(62.2) 3.57 (2.59~4.94) 423(82.9) 10.07 (6.98~14.53) 208(40.8) 1.46 (1.07~1.98) 420(82.4) 1.78 (1.23~2.56) 435(85.3) 1.58 (1.08~2.31) 高中/职高/中专及以上 220 152(69.1) 4.69 (3.10~7.10) 191(86.8) 15.21 (9.05~25.54) 108(49.1) 1.66 (1.10~2.51) 186(84.5) 1.87 (1.15~3.04) 184(83.6) 1.32 (0.82~2.12) 离退休 退休 473 177(37.4) 1.00 222(46.9) 1.00 182(38.5) 354(74.8) 1.00 356(75.3) 1.00 在职 1 029 591(57.4) 1.49 (1.08~2.07) 711(69.1) 1.03 (0.71~1.49) 444(43.1) 818(79.5) 1.01 (0.70~1.45) 834(81.0) 0.99 (0.69~1.42) 职业 农民/渔民 1 125 538(47.8) 1.00 645(57.3) 1.00 448(39.8) 862(76.6) 1.00 875(77.8) 工人 254 144(56.7) 1.02 (0.75~1.38) 182(71.7) 1.28 (0.89~1.85) 121(47.6) 202(79.5) 0.99 (0.69~1.42) 210(82.7) 公务员/事业单位人员 57 45(78.9) 1.87 (0.93~3.77) 51(89.5) 1.17 (0.46~2.96) 29(50.9) 53(93.0) 2.81 (0.96~8.24) 50(87.7) 其他 66 41(62.1) 1.09 (0.63~1.86) 55(83.3) 2.02 (0.94~4.33) 28(42.4) 55(83.3) 1.14 (0.58~2.26) 55(83.3) 月收入(元) <1 000 537 228(42.5) 1.00 285(53.1) 1.00 199(37.1) 398(74.1) 1.00 392(73.0) 1.00 1 000~<3 000 565 290(51.3) 1.21 (0.93~1.56) 336(59.5) 0.98 (0.74~1.32) 243(43.0) 449(79.5) 1.23 (0.92~1.65) 452(80.0) 1.38 (1.04~1.84) 3 000~<5 000 278 167(60.1) 1.21 (0.87~1.68) 203(73.0) 1.05 (0.71~1.54) 126(45.3) 223(80.2) 1.05 (0.71~1.53) 233(83.8) 1.54 (1.04~2.28) ≥5 000 122 83(68.0) 1.50 (0.95~2.38) 109(89.3) 2.72 (1.38~5.37) 58(47.5) 102(83.6) 1.11 (0.64~1.93) 113(92.6) 3.43 (1.66~7.07) 地区 苏北 678 352(51.9) 486(71.7) 1.00 253(37.3) 1.00 515(76.0) 546(80.5) 苏南 824 416(50.5) 447(54.2) 0.44 (0.34~0.57) 373(45.3) 1.38 (1.12~1.71) 657(79.7) 644(78.2) 家族史 无 1 174 599(50.3) 722(61.5) 499(42.5) 912(77.7) 1.00 934(79.6) 有 283 151(51.0) 187(66.1) 116(41.0) 235(83.0) 1.30 (0.92~1.84) 224(79.2) 不知道 45 18(53.4) 24(53.3) 11(24.4) 25(55.6) 0.34 (0.19~0.64) 32(71.1) 吸烟 否 1 129 565(50.0) 660(58.5) 1.00 477(42.2) 872(77.2) 888(78.7) 是 373 203(54.4) 273(73.2) 1.11 (0.75~1.65) 149(39.9) 300(80.4) 302(81.0) 饮酒 否 1 049 515(49.1) 1.00 615(58.6) 1.00 426(40.6) 808(77.0) 822(78.4) 是 453 253(55.8) 1.14 (0.85~1.53) 318(70.2) 0.82 (0.57~1.17) 200(44.2) 364(80.4) 368(81.2) -
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