农村中老年慢性病患者家庭功能对健康素养的影响研究——自我效能的中介作用  

Researches on the Impact of Family Function on the Health Literacy among Middle-Aged and Elderly Patients with Chronic Diseases in Rural Areas Based on the Mediating Role of Self-efficacy

作　　者：吴超凡 俞郑 魏中原 任盼盼 张翔[1] Wu Chaofan(School of Medicine and Health Management,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,P.R.China)

机构地区：[1]华中科技大学医药卫生管理学院,湖北武汉430030

出　　处：《中国卫生事业管理》2024年第8期905-909,共5页Chinese Health Service Management

基　　金：国家自然科学基金项目“新时期农村地区健康服务供需协同耦合及其治理策略研究”(72074084)。

摘　　要：目的:探索农村中老年人慢性病患者健康素养的影响机制并提出可行性的建议,从而提高农村中老年慢性病患者健康素养和自我管理能力。方法:利用2023年1月至2月间于湖北省恩施市建始县和江西省赣州市石城县进行实地问卷调查的526份农村中老年慢性病患者的样本,使用t检验(方差检验)进行单因素分析;使用最小二乘法建立回归模型、固定效应模型检验家庭功能对健康素养的影响;使用逐步回归法、Bootstrap法探究自我效能在其中的中介效应。结果:样本中仅有18.25%的农村中老年慢性病患者具备健康素养;不同性别、年龄、婚姻状况、居住情况、受教育程度、家庭月收入、医保类型、患慢性病种类以及自评健康的农村中老年慢性病患者的健康素养得分差异均有显著性(P<0.05);农村中老年患者家庭功能情况越好健康素养水平越好(β=0.33,P<0.001),同时家庭功能也会通过提升患者的自我效能(β=0.14,P<0.001)来促进健康素养水平提升(β=0.13,P<0.001)。Bootstrap结果显示农村中老年患者家庭功能影响健康素养的直接效应为0.10(P<0.001),通过自我效能的间接效应为0.02(P<0.001),占比16.67%。结论:农村中老年慢性病患者健康素养水平现状较差;农村中老年慢性病患者家庭功能对健康素养有直接影响,并通过自我效能的中介效应产生影响。Objective To explore the influence mechanism of health literacy among middle-aged and elderly patients with chronic diseases in rural areas and propose feasible suggestions,and improve their health literacy and self-management abilities.Methods A total of 526 cases of middle-aged and elderly patients with chronic diseases in rural areas were collected through a field survey conducted in Jianshi County,Enshi City of Hubei Province,and Shicheng County,Ganzhou City of Jiangxi Province,from January to February 2023.T-test was used for univariate analysis.Least squares method was used to establish a regression model,and a fixed effects model was applied to examine the impact of family function on health literacy.The mediating effect of self-efficacy was explored by using stepwise regression and Bootstrap method.Results Only 18.25%of the sampled middle-aged and elderly patients with chronic diseases in rural areas had health literacy.Significant differences in health literacy scores were observed among patients with different genders,ages,marital statuses,living situations,education levels,monthly household incomes,medical insurance types,types of chronic diseases,and self-rated health statuses(P<0.05).Better family function was associated with higher levels of health literacy among middle-aged and elderly patients in rural areas(β=0.33,P<0.001).And family function also promoted health literacy by enhancing patients'self-efficacy(β=0.14,P<0.001;β=0.13,P<0.001).The Bootstrap results showed that the direct effect of family function on health literacy among middle-aged and elderly patients in rural areas was 0.10(P<0.001),and the indirect effect mediated by self-efficacy was 0.02(P<0.001),account-ing for 16.67%of the total effect.Conclusion The status of health literacy among middle-aged and elderly patients with chronic diseases in rural areas is poor.Family function has a direct impact on their health literacy and exerts an influence through the me-diating effect of self-efficacy.

关 键 词：健康素养 家庭功能 自我效能 慢性病患者 

分 类 号：R195[医药卫生—卫生统计学]