Applicability of the SRHMS V1.0 in the Rural Elderly：an Analysis of 2 048 Cases

doi:10.12114/j.issn.1007-9572.2021.00.218

Abstract

Abstract: Background　To achieve healthy aging along with global aging，integrated geriatric care using person-centered approach has been recognized to be a useful way to satisfy older people's health needs as an international consensus. It is particularly important and urgent to develop a tool to assess the physical，psychological，social，spiritual and environmental health of the elderly in rural China. Objective　To evaluate the applicability of the SRHMS V1.0 in rural elderly people. Methods　From October 2018 to May 2019，2 048 individuals aged 60 or over were selected from Yunnan's rural areas by use of multistage stratified sampling，and received a household survey using a Demographic Questionnaire and the SRHMS V1.0. The reliability and validity of the SRHMS V1.0 were analyzed，and the SRHMS V1.0 normative scores for Chinese rural elderly people in the age group were determined. Results　The survey obtained a response rate of 85.33%. The mean total score and the mean scores of physical，psychological and social health subscales of the SRHMS V1.0 were （63.63±13.69），（64.72±16.94），（62.59±15.34） and （50.71±13.04），respectively. The Cronbach's α of the SRHMS V1.0 was 0.941，and that for the physical，psychological and social health subscales were 0.877，0.885 and 0.875，respectively. With the exception of items 4，5 and 7，and physical symptoms/organ function subscale，item 27 and psychological symptoms/negative emotion subscale with a value of r≤0.600，all the items and corresponding subscales had a value of r≥ 0.600（P<0.001）. The results of confirmatory factor analysis showed that the modified CFA model with χ2/df=5.509，RMSEA=0.047，NFI=0.929，IFI=0.941，TLI=0.933，CFI=0.941，showing an excellent goodness for fit. The The SRHMS V1.0 normative scores for rural elderly people were determined as：very poor［0，49.93），poor［49.93，56.78），fair［56.78，70.48），good ［70.48，77.32），very good ［77.32，100］．Conclusion　The SRHMS V1.0 has good reliability and validity in assessing the health status among rural elderly people，which may be applied and popularized as an assistant tool by general practitioners to perform comprehensive health assessment and deliver community interventions.

Key words: Health services for the aged, Rural health, SRHMS V1.0

摘要： 背景　伴随全球老龄化，以老年人健康需求为中心的综合照护，已成为“健康老龄化”的国际共识。开发适用于中国农村老人“身-心-社-灵-环境”健康评估工具尤显重要和紧迫。目的　评价自测健康评定量表（SRHMS V1.0）在农村地区的适用性及效果。方法　2018年10月—2019年5月，采用多阶段分层抽样法对2 400例≥60岁云南省农村老年人进行入户人口学资料和SRHMS V1.0的问卷调查。分析SRHMS V1.0的信效度，建立农村老年人SRHMS V1.0得分的划界常模。结果　共发放问卷2 400份，获有效样本2 048份，问卷有效回收率为85.33%。2 048例农村老年人SRHMS V1.0总分及生理、心理、社会健康得分分别为（63.63±13.69）、（64.72±16.94）、（62.59±15.34）、（50.71±13.04）分。SRHMS V1.0内部一致性Cronbach's α系数为0.941；生理、心理、社会健康子量表的Cronbach's α系数分别为0.877、0.885、0.875。除条目4、5、7 与身体症状与器官功能维度，以及条目27和心理症状与负向情绪维度相关系数r≤0.600外，其余条目与相应维度的相关系数r≥0.600（P<0.001）。验证因子分析显示，修正后的CFA模型χ2/df=5.509，RMSEA=0.047，NFI=0.929，IFI=0.941，TLI=0.933，CFI=0.941，拟合度优。获得农村老年人健康划界常模，分别为健康很差［0，49.93）、健康较差［49.93，56.78）、健康一般［56.78，70.48）、健康较好［70.48，77.32），健康很好［77.32，100］。结论　SRHMS V1.0在农村老年人运用具有良好信效度，可作为全科医生综合健康评估及社区干预工具推广运用。

关键词: 老年人保健服务, 农村卫生, 自测健康评定量表

GAO Chuqun,ZHANG Hechuan,LUO Songlan, et al. Applicability of the SRHMS V1.0 in the Rural Elderly：an Analysis of 2 048 Cases　[J]. Chinese General Practice, 2021, 24(19): 2418-2422. DOI: 10.12114/j.issn.1007-9572.2021.00.218.
高矗群,张河川,罗松兰等. SRHMS V1.0在2 048例农村老年人中的应用研究[J]. 中国全科医学, 2021, 24(19): 2418-2422. DOI: 10.12114/j.issn.1007-9572.2021.00.218.

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