患者对健康危险因素的总体感知及其影响因素:一个全国样本的分析  

National sample analysis on patient's general perception of health risk factors and its influencing factors in China

作　　者：叶贝珠 洪雅君 张萍[1] 程瑶[1] 蒋红卫[1] 孙奕[1] 王乔凤[3] 谢小华[4] Xi Zhu[5] 张乃兴 梁渊 YE Bei-zhu1, HONG Ya-jun1,2, ZHANG Ping1, CHENG Yao1, JIANG Hong-wei1, SUN Yi1, WANG Qiao-feng3, XIEXiao-hua4, XI Zhu5,ZHANGNai-xing6,LIANGYuan1(1. School of Public Health, Tongji Medical College, Huazhong University of Sience and Technology, Wuhan Hubei 430030,China; 2. The 174 th Hospital of Chinese Peoplef Liberation Army, Xiamen Fujian 361003, China;3. The Third Affilidted Hospital, Sun Yat-Sen University, Guangzhoo Guangdong 510630 , China;4. No. 2 People of Hospital of Shenzhen Municipality, Sheuzhen Guangdong 518037, China;5. College of Public Heath,University of Iowa, Iowa USA;6. Health and Family Planning Commission of Shenzhee Municipality, Shenzhee Guangdong 518031 , Chin)

机构地区：[1]华中科技大学同济医学院公共卫生学院,湖北武汉430030 [2]福建省厦门市解放军第174医院,福建厦门361003 [3]中山大学第三附属医院,广东广州510630 [4]广东省深圳市第二人民医院,广东深圳518037 [5]爱荷华大学公共卫生学院 [6]广东省深圳市卫计委,广东深圳518031

出　　处：《中国卫生政策研究》2018年第5期55-60,共6页Chinese Journal of Health Policy

基　　金：国家自然科学基金项目(NSFC71273098/G0308)

摘　　要：目的:了解患者对健康危险因素的总体感知及其影响因素。方法:采用分层整群抽样的方法,并根据WHO健康社会决定因素框架,从结构因素和调节因素的角度来分析对其的影响。结果:调查对象感知的_(源自生活)的健康相关危险因素危害"较大/很大"所占比例(27.1%)高于_(源自工作)的相应比例(21.7%)。Logistic回归分析结果显示,结构因素中有显著性意义的主要是文化程度和经济状况,小学及以下文化程度的调查对象感知到的危险因素的危害更小(OR_(源自生活)=0.64,95%CI:0.54-0.76;OR_(源自工作)=0.75,95%CI:0.63-0.89);经济状况较差/很差的患者其危险因素的危害感知更大(OR_(源自生活)=1.54,95%CI:1.31-1.81;OR_(源自工作)=1.72,95%CI:1.47-2.01);调节因素对两个来源的危险因素的影响没有显著性意义。结论:_(源自生活)的健康危险因素控制可能需要借鉴_(源自工作)的健康危险因素控制的相关措施(即政策法规及相应的组织机构),结构因素和调节因素的影响则揭示健康危险因素的控制可能更需要依靠社会经济发展。Objective： To analyze patient＇s general perception of health risk factors and its influencing factors.Methods： Using stratified cluster sampling method,a national cross-sectional survey was conducted. Influencing factors included structural and intermediary determinants according to the WHO＇s Framework of Social Determinants of Health. Results： The proportion of high risk factors originated from life was higher than that of those originated from work（ being 27. 1% vs 21. 7%）. The results of logistic regression analysis showed that structural determinants had significant influence on patient＇s general perception of health risk factors. The recorded determinants were education（ OR originated from life = 0. 64,95% CI： 0. 54-0. 76; OR originated from work = 0. 75,95% CI： 0. 63-0.89） and economic status（ OR originated from life = 1. 54,95% CI： 1. 31-1. 81; OR originated from work = 1.72,95% CI： 1. 47-2. 01）. Most of moderating determinants showed a non-significant effect on the risk factors from the two sources（ education and economic status）. Conclusions： The characteristics of the patient＇s overall perception of health risk factors suggests that the risk factors originated from life may need to draw on relevant measures（ i. e.,policies and regulations and the corresponding organization） controlled by the health risk factors originated from work. The comparison between structural and moderating determinants revealed that the control of health risk factors is possible and may need to be more reliably dependent on socioeconomic development.

关 键 词：健康危险因素 患者感知 健康的社会决定因素 结构因素 调节因素 

分 类 号：R197[医药卫生—卫生事业管理]