摘要
目的:基于健康生态学模型(HEM),分析我国中老年糖尿病患者的生命质量现状及其影响因素,探讨改善糖尿病患者生命质量的可行路径。方法:采用中国健康与养老追踪调查(CHARLS)2018年份数据,纳入45岁及以上中老年糖尿病患者为研究对象,应用STATA15.0统计分析软件筛选出符合HEM中5个维度以及EQ-5D量表所需的变量。运用中国版EQ-5D-3LTTO积分换算表计算健康效用值,选择非参数检验进行单因素分析,对二分类变量采用Wilcoxon秩和检验,对多分类变量采用Kruskal-Wallis检验,运用Tobit回归等统计学方法从健康生态学模型的5个维度分析其影响因素。结果:最终得到符合条件的中老年糖尿病患者有效样本703份,患者平均健康效用值(0.710±0.225),Tobit回归分析结果表明,个人特质中的“年龄”,行为与生活方式中的“运动习惯”,人际关系网络中的“社会参与”,工作与生活条件中的“稳定收入”“居住环境”以及环境政策中的“养老保险”与中老年糖尿病患者健康效用值呈负相关;个人特质中的“残疾”,行为与生活方式中的“吸烟”以及“睡眠时长”与患者的生命质量呈正相关(P<0.05)。结论:结合健康生态学模型(HEM)发现,目前我国中老年糖尿病患者整体生命质量水平还存在提升空间,且影响因素涉及健康生态学模型(HEM)五个维度,是多层次、多角度的。因此,应通过个人行为、经济、环境、政策等多角度对中老年人糖尿病患者进行综合途径干预,提高该群体生命质量。
Objective To analyze the status of quality of life of the middle-aged and elderly diabetic patients in China and its influencing factors based on the health ecology model(HEM),and explore the feasible ways to improve the quality of life of dia-betic patients.Methods Using the 2018 data of China Health and Retirement Longitudinal Survey(CHARLS),diabetes patients aged 45 and older were included as the study subjects,and STATA15.0 statistical analysis software was used to meet the five di-mensions of HEM and the EQ-5D scale.The Chinese EQ-5D-3LTTO integral conversion table was used to calculate the health utility value,non-parametric test was selected for univariate analysis,Wilcoxon rank sum test was used for two categorized varia-bles,Kruskal-Wallis test was used for multiple categorical variables,and Tobit regression was used to analyze the influencing fac-tors from five dimensions of health ecology model.Results 703 valid samples of eligible middle-aged and elderly diabetic patients were obtained,the mean health utility value of which was(0.710±0.225).The results of Tobit regression analysis showed that"Age"in personal traits,"Exercise habits"in behavior and lifestyle,"Social participation"in a relationship network,"Stable in-come"and"Living environment"in working and living conditions,and the"Endowment insurance"in environmental policies were negatively correlated with the health utility value of middle-aged and elderly diabetic patients,while the"Disability"in personal traits,"Smoking"and"Sleep duration"were positively correlated with the patient's quality of life(P<0.05).Conclusion Com-bined with the health ecology model(HEM),it was found that the overall quality of life level of middle-aged and elderly diabetic patients in China was improved,and its influencing factors involved the five dimensions of health ecology model(HEM),which was multi-level and multi-angle.Therefore,a comprehensive intervention should be conducted for middle-aged and elderly diabetes patients through personal behavior,economy,environ
作者
胡歆瑀
蒲川
邱岚
彭杨
郭黛瑶
Hu Xinyu(School of Public Health,Chongqing Medical University,Chongqing,P.R.China)
出处
《中国卫生事业管理》
北大核心
2023年第6期456-460,480,共6页
Chinese Health Service Management
基金
重庆市科技局2021年技术预见与制度创新项目“基于全生命周期的重点健康管理闭环研究”(cstc2021jsyj-zzysbAX0066)。
关键词
健康生态学模型
糖尿病
生命质量
影响因素
health ecology model
diabetes
quality of life
influencing factors
