中国全科医学

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山东省社区老年人慢性病自我管理系统脆弱性影响因素研究

邢家润1,陈彤1,秘玉清1,寇儒欣1,陈倩1,王梦雪2,罗盛2,李伟1*   

  1. 1.261053 山东省潍坊市,山东第二医科大学公共卫生学院 2.261053 山东省潍坊市,山东第二医科大学管理学院
  • 通讯作者: 李伟,教授/博士生导师;E-mail:imliwei@163.com
  • 基金资助:
    国家自然科学基金资助项目(71774119);山东省自然科学基金面上项目(ZR2023MG019,ZR2023MG004);中国学位与研究生教育学会面上项目(2020MSA247,2020MSA145);山东省软科学课题(2022RKY07011,2022RKY07010);山东省人文社会科学课题(2022-ZXJK-18);山东省研究生教育质量提升计划项目(SDYJG21167);中华医学会医学教育分会和中国高等教育学会医学教育专业委员会 2020 年医学教育研究立项课题(2020A-N04035)

Analysis of Factors Influencing the Vulnerability of Chronic Disease Self-management System for the Elderly in Shandong Province

XING Jiarun1,CHEN Tong1,MI Yuqing1,KOU Ruxin1,CHEN Qian1,WANG Mengxue2,LUO Sheng2,LI Wei1*   

  1. 1.School of Public Health,Shandong Second Medical University,Weifang 261053,China 2.School of Management,Shandong Second Medical University,Weifang 261053,China
  • Contact: LI Wei,Professor/Doctoral supervisor;E-mail:imliwei@163.com

摘要: 背景  慢性病具有病程长、迁延不愈的特点,其发病率的升高严重威胁着人们的身心健康。目前,虽有研究者对慢性病发病影响因素进行了探讨,但针对老年人自身管理慢性病影响因素的研究较少。目的  探讨社区老年人慢性病自我管理系统脆弱性的影响因素,为提高社区老年人慢性病自我管理水平提供理论依据。方法  2020年10—11月、2021年3月,采用多阶段分层随机抽样法对山东省社区老年人慢性病自我管理情况进行调查。本研究基于本课题组前期研究成果,采用自行设计的社区老年人慢病自我管理脆弱性影响因素调查表进行调查,包括:社区老年人基本情况、社区老年人慢性病自我管理系统敏感性调查表、社区老年人慢性病自我管理系统应对能力调查表。采用多元线性逐步回归分析探究社区老年人慢病自我管理脆弱性影响因素。结果  共发放问卷共2800份,收回有效问卷2650份,有效回收率94.64%。2650名社区老年人来自山东省3个地市9个区(县)的27个社区。多元线性逐步回归分析结果显示,文化程度、职业类型、居住环境、营养与饮食、活动能力、心理健康和慢性病共患病情况是社区老年人慢性病自我管理系统敏感性的影响因素(P<0.05)。自我监测、自我认知力、自我约束力、情感支持、医疗保险、养老保险、就诊时间、就诊程序满意情况、服务效果满意情况是社区老年人慢性病自我管理系统应对能力水平的影响因素(P<0.05)。结论  社区老年人慢性病自我管理系统脆弱性受到多种因素的影响,可开展包括加强社区健康宣教活动,转变老年人自身健康观念;开展敬老爱老活动,营造良好护老氛围;提升社区自身服务能力,提供更准确的卫生服务等针对性措施来降低社区老年人慢性病自我管理系统脆弱性。

关键词: 慢性病, 自我管理, 老年人, 脆弱性, 影响因素分析

Abstract: Background Chronic diseases have the characteristics of long course and prolongation,and the increase in incidence seriously threatens people's physical and mental health. At present,although some researchers have discussed the influencing factors of the incidence of chronic diseases,there are few studies on the influencing factors of chronic diseases managed by the elderly themselves. Objective To understand the factors affecting the vulnerability of the self-management system of chronic disease in community-based elderly in Shandong Province,and to provide a theoretical basis for improving the self-management level of chronic disease in community-based elderly. Methods A multi-stage stratified random sampling method was used to sample 2650 elderly people over the age of 65 in Shandong Province for a questionnaire survey,and the main influencing factors were identified by comprehensive univariate analysis and multiple stepwise regression analysis. Results In the sensitivity dimension,the influencing factors such as personal characteristics and occupational types in the community were statistically significant. In the dimension of coping ability,the influencing factors such as self-monitoring,self-cognition,and self-discipline were statistically significant. Conclusion The vulnerability of chronic disease self-management systems for the elderly in the community is influenced by a variety of factors. Activities that include strengthening community health education can be carried out to change the health perceptions of the elderly themselves;Carry out activities to respect and love the elderly and create a good atmosphere for the elderly;Targeted measures such as improving the community's own service capacity and providing more accurate health services to reduce the vulnerability of the chronic disease self-management system for the elderly in the community.

Key words: Chronic disease, Self-management, Aged, Vulnerability, Root cause analysis

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