中国城乡老年人生命质量及影响因素研究

目的 分析中国城乡老年人生命质量现状、城乡差异及影响因素,为改善城乡老年人生命质量提供依据。方法 基于城乡差异视角,采用2018年中国健康养老与追踪调查大样本数据,应用欧洲生命质量五维量表(EQ-5D-3L)对老年人生命质量进行评价。结果 共得到有效样本3 523份,城镇老年人健康效用值均高于乡村老年人,城乡老年人均在疼痛或不舒服、焦虑或抑郁两个维度上存在最多问题。年龄、性别、收入、慢性病患病情况是城乡老人健康效用值的共同影响因素(P<0.05),年龄越高健康效用值越低,女性的健康效用值低于男性,收入较高的老年人健康效用也较高,而患有慢病数量越多的老年人生命质量越差;教育程度只对农村老年人健康效用值有显著影响(P<0.05),受教育水平越高的乡村老年人健康效用值也更高。结论 城乡老年人生命质量存在显著差异。提升城乡老年人的生命质量,需要重点关注高龄、患慢性病、低收入群体以及老年女性群体,尤其需要关注老年人的心理焦虑和疼痛问题。对于乡村老年人应加强健康宣教,提高乡村老人健康素养,提高生命质量,缩小城乡差距。     

贫困、疾病及精准健康扶贫政策:基于贫困居民生命质量评价

目的:将生命质量评价引入精准健康识别与干预政策中,通过比较不同类别贫困居民生命质量特征,揭示扶贫对象各维度现状,为完善精准健康扶贫政策提供参考。方法:评价工具采用WHOQOL-BREF量表,通过入户调查方式收集数据,采用t检验分析与中国常模数据进行比较。结果:贫困居民其人群分布表现为男性(71.7%)多于女性,年龄普遍偏大(平均55岁)。贫困居民与中国常模比较,健康组和疾病组的生命质量评价评分均显著低于中国常模的对照组,说明贫困对于居民生命质量评价的负面影响十分显著。不论处于何种收入水平,健康贫困居民总体评价均高于患病贫困居民。对于患病贫困居民而言,收入越高、其心理和总体评价越好;反之亦然。结论:健康对于贫困居民总体评价具有显著正影响、而患病对于贫困居民总体评价具有显著负影响。收入提高对于患病贫困居民的心理和总体评价改善有效。     

生命历程视角下童年健康对中老年期健康状况影响的中介路径分析

目的 在生命历程理论下探讨童年健康对中老年期健康状况的影响路径,为构建全生命周期的健康理念提供实证依据。方法 本文运用中国健康与养老追踪调查（CHARLS）2014年和2018年截面数据,构建可调节的多重中介效应模型,研究童年期健康状况对中老年期健康影响的中介路径。结果 描述性分析显示,童年自评健康得分在3.35以上,童年期健康水平得分整体上略高于中老年期自评健康水平（3.03）;不同户籍的中老年期自评健康（t=6.614）、童年自评健康（t=2.514）、个体受教育水平（t=35.312）、童年期家庭护理支持（t=9.732）和成年期卫生服务利用（t=26.268）存在显著的统计学差异（P<0.05）。回归分析结果表明,在控制性别、年龄和户籍性质的情况下,童年自评健康对中老年期健康无显著的直接效应（β=0.038,P=0.248,95%CI:-0.027~0.103）;个体受教育水平、童年期家庭护理支持以及成年卫生服务利用均为童年自评健康影响中老年期自评健康的中介变量,β分别为0.041（95%CI:0.030~0.053）、0.085（95%CI:0.046~0.124）、-0.064（95%CI:-0.079~-0.049）,P值均小于0.001;户籍性质具有显著的调节效应,除直接效应外（β=-0.516,P<0.001,95%CI:-0.757~-0.274）,还通过个体教育水平产生显著的间接效应（β=-2.645,P<0.001,95%CI:-3.016~-2.274）,即教育水平是城乡老年人健康差异的重要因素。结论 树立全生命周期的健康理念,从家庭、社会多个层面重视个体儿童期的健康成长经历,提升居民全生命周期的健康素养;提升城乡社会经济和教育事业发展的均衡性,从不同生命历程阶段着手,制定城乡平等的健康促进策略。     

医学院校教师个体紧张与生命质量关系的研究

目的 调查沈阳市医学院校教师生命质量现况和紧张反应状况,分析生命质量的影响因素.方法 采用整群抽样的方法,抽取沈阳市2所医学院校共293名教师作为调查对象,应用职业紧张量表( occupational stress inventory-revised,OSI-R)和SF-36健康量表(36 short form health survey,SF-36),评价其个体紧张反应程度和生命质量水平.结果 35岁以下教师个体紧张反应得分高于其他年龄组(P＜0.05);女教师个体紧张反应得分较男性高(P＜0.05);教师的学历越高,其个体紧张反应得分越高(P＜0.05);患有慢性病的教师个体紧张反应得分高于未患病教师(P＜0.05);个体紧张反应与教师的生命质量间存在线性关系( P＜0.001),紧张反应得分越高,生命质量越差.结论 医学院校教师的个体紧张程度与生命质量密切相关,降低教师的紧张程度,将有助于改善教师的生命质量.     

社会资本对中国中老年人自我健康评价的影响

目的在个体和区域两个水平上探讨社会资本对中国中老年人自我健康评价的影响。方法数据来源于中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)2011年全国基线数据。运用SPSS 20.0软件,对数据进行一般统计性描述和构建两水平线性多层模型,分析社会资本在个体和区域水平上对我国中老年人自我健康评价的影响。结果区域水平社会资本中"区域组织/协会/设施的数量"变量(b=-0.033,P0.001)和所有个体水平社会资本变量[(出生地(b=0.098,P0.001);接受帮助(b=-0.099,P0.001);提供帮助(b=0.133,P0.001)]与中老年人自我健康评价的关系有统计学意义。结论社会资本的某些变量在区域水平和个体水平上影响我国中老年人自我健康评价。     

河北省城市居民生命质量调查

由于人类健康状况受到环境、个人行为、人类生物学和卫生保健等因素的影响，因此，包括环境维度在内的生命质量测量方法逐渐产生，并发展为评估个体和群体的健康水平，以及评价健康促进工作的综合指标。本针对河北省6个城市人口进行生命质量调查，对制定城市人口的健康促进策略，提高城市人口的健康水平有积极意义。     

无锡市普通健康人群生命质量评价及影响因素分析

目的评价无锡市普通健康人群的生命质量,分析影响人群生命质量的主要因素,为提高人群生命质量提供参考依据。方法对调查对象的基本情况和生命质量进行问卷调查,评价结果与杭州市、四川省、美国常模比较,用t检验、方差分析和多元线性回归统计方法分析影响生命质量的因素。结果无锡市普通健康人群SF-36评价结果与杭州市、四川省、美国常模比较,在不同领域存在差异,尤以GH、VT、MH三个领域显著;多因素分析结果显示影响无锡市普通健康人群生命质量的主要因素有城乡差别、年龄、性别、精神因素(创伤或压抑)、体育锻炼、吸烟和文化程度7个因素。结论制定了无锡市普通健康人群不同性别及年龄的SF-36评价参考值;影响无锡市普通健康人群生命质量的因素是多方面的,但生活行为方式对其各领域的影响日益突出,应提倡健康的生活方式来提高人群的生命质量。     

成都市农转非居民社会资本状况及其与生命质量的相关性探讨

目的分析农转非居民生命质量和社会资本现况,探讨社会资本对其生命质量的影响,为促进农转非居民健康水平提供政策参考。方法从成都市中心城区和郊区各随机抽取一个区,以家庭为单位,采用分层随机抽样方法抽取调查对象;利用SF-12量表对其生命质量进行评价;从个人、家庭、社区、单位和宏观政策5个层面测量其社会资本;通过线性回归模型分析社会资本及各混杂因素对其生命质量的影响。结果相对于城市居民,农转非居民偏老龄化,文化程度低,无业者居多,月收入低;心理健康自评得分低于城市居民(P0.001),家庭、工作单位、宏观层面社会资本得分均低于城市居民(P0.001);个体社会资本得分是其生命质量的保护因素(P0.001)。讨论个体层面社会资本与自评生命质量具有相关性,应重视个体社交网络拓展等方面去改善其生命质量状况。     

中国式现代化视角下的健康红利：内涵、现状与路径

健康是中国式现代化的应有之义。随着我国人口发展进入新常态,最大化实现健康红利成为长寿时代实现中国式现代化的重要战略选择。现代化的过程也是健康转变的过程,当前我国已步入健康转变的第四阶段即慢性退行性疾病延迟期。我国人口健康水平持续改善,但也面临挑战。长寿时代释放更多健康红利需要从个体、家庭和社会多层面正向发力。要深化对健康的认识,提升个体健康促进的内生动力;树立健康领域优先理念,实现全人群全生命周期健康管理;强化战略协同,增进健康公平;增强社会包容性,创造释放健康红利的良好环境。     

产褥期妇女健康综合测评及影响因素分析

目的应用生命质量评价方法综合测评产褥期妇女健康水平，并进一步探讨产褥期妇女健康水平在社会学、医学、家庭与心理学等方面的影响因素。方法利用WHO统一设计调查表中的45个健康测试条目，应用生命质量评价方法从生理、心理和社会功能3个维度综合测评了产褥期妇女的健康水平，应用多元逐步回归分析方法探讨了产褥期妇女健康水平的影响因素。结果产褥期妇女在生理、心理和社会功能3个维度的健康水平均低于一般育龄妇女．其中心理健康评分最低；同时发现有18个因素能够影响产褥期妇女3个维度的健康评分。结论重视产褥期妇女的生理、心理和社会健康状况；社会、家庭和产妇应共同参与产褥期保健。     

发展生态学理论视角下困境家庭儿童健康水平影响因素研究

目的:探究困境家庭儿童健康水平影响因素,为困境家庭儿童制定健康相应政策提供理论依据。方法:基于发展生态学理论框架,利用2018年8—9月开展的困境家庭儿童全国抽样调查数据,采用卡方检验和两独立样本T检验,分析困境家庭儿童和对照家庭儿童各指标差异,采用有序多分类Logistic回归进行多因素分析,采用倾向值匹配法分析社会救助政策对困境家庭儿童健康的影响。结果:困境家庭儿童与对照组儿童自评健康水平间差异具有统计学意义(P0.01)。基于发展生态学系统观,困境家庭儿童和对照组儿童各指标间差异具有统计学意义(P0.05)。年龄、民族、家庭人均年收入、监护人生活照顾、监护人沟通交流、一周吃新鲜水果次数、家庭是否重视学习、监护人受教育程度、是否接受社会救助补贴、规定接受国家疫苗接种是影响困境家庭儿童健康的因素(P0.05)。接受社会救助补贴对困境家庭儿童自评健康水平有显著正向促进作用(t2.576,P0.01)。结论和建议:家庭因素是困境家庭儿童健康水平重要影响因素,政策干预应当促进落实"家庭责任",重视困境家庭儿童社会保障工作,完善困境家庭儿童社会救助体系。     

Transcending options: Creating a milieu for practicing high‐level wellness

The purpose of this study was to investigate the relationship between living in a female‐headed one‐parent family and the family's practice of prevention behaviors. The participants included 59 female‐headed, one‐parent families as well as other data sources that provided a societal perspective on the phenomenon. Interviews, observations, a health diary, and a card sort were used for data collection.

This study was carried out according to the tenets of grounded theory. The major finding was the emergence of the theory of transcending options. This theory describes the family's practice of prevention behaviors as a subset of the family's life circumstances. The family's behaviors (health and nonhealth) were a response to the societal options that the woman perceived were available to the female‐headed, one‐parent family.

The theory of transcending options describes this process on a continuum. There are three major points on the continuum: choosing options, seeking options, and transcending options. The interface between the family's life circumstances and their practice of prevention behaviors is evident at each of these points.     

Families,Transitions, and Health

This paper critically reviews the Caroff-Mailick classification of families seen around health care crises, and of reciprocal roles suggested for health social workers depending on severity and trajectory of illness and on family's functioning levels. As balance, transitional crisis theory, holistic health concepts, and team approaches to the mobilized family as the nit of caregiver attention are discussed. Newer alternative family styles are reviewed which challenge middle class caregiver mores and practices. Family forces which may prejudice worker assessment are reviewed, and the need to mitigate unhealthy and constricting environmental conditions is stressed.     

The PedsQL™ Family Impact Module: Preliminary reliability and validity

Background

The PedsQL? Measurement Model was designed to measure health-related quality of life (HRQOL) in children and adolescents. The PedsQL? 4.0 Generic Core Scales were developed to be integrated with the PedsQL? Disease-Specific Modules. The newly developed PedsQL? Family Impact Module was designed to measure the impact of pediatric chronic health conditions on parents and the family. The PedsQL? Family Impact Module measures parent self-reported physical, emotional, social, and cognitive functioning, communication, and worry. The Module also measures parent-reported family daily activities and family relationships.

Methods

The 36-item PedsQL? Family Impact Module was administered to 23 families of medically fragile children with complex chronic health conditions who either resided in a long-term care convalescent hospital or resided at home with their families.

Results

Internal consistency reliability was demonstrated for the PedsQL? Family Impact Module Total Scale Score (α = 0.97), Parent HRQOL Summary Score (α = 0.96), Family Functioning Summary Score (α = 0.90), and Module Scales (average α = 0.90, range = 0.82 – 0.97). The PedsQL? Family Impact Module distinguished between families with children in a long-term care facility and families whose children resided at home.

Conclusions

The results demonstrate the preliminary reliability and validity of the PedsQL? Family Impact Module in families with children with complex chronic health conditions. The PedsQL? Family Impact Module will be further field tested to determine the measurement properties of this new instrument with other pediatric chronic health conditions.

     

Quality of life, health satisfaction and family impact on caregivers of children with developmental delays

Objective   To study the quality of life, health satisfaction and family impact on caregivers of children with developmental delays in Taiwan.
Design   Cross-sectional study.
Subjects   The caregivers of children with diagnoses of developmental delays recruited from a teaching hospital in northern Taiwan.
Methods   The main caregivers of 48 male and 22 female children with developmental delays were recruited. WHOQOL-BREF for health-related quality of life (HRQOL), PedsQL-Health Satisfaction for health satisfaction, PedsQL-Family Impact Module and Impact on Family Scale for family impact were evaluated. The correlation of caregivers' HRQOL, health satisfaction and family impact were also studied.
Results   Caregivers in nuclear families had higher health satisfaction scores (78.2 for nuclear families vs. 66.9 for extended families, P  < 0.05) when assessed by the PedQL-Health Satisfaction questionnaire. Children's age was negatively correlated with family impact, including parent (−0.272, P  = 0.023), family (−0.262, P  = 0.029) and total scores (−0.281, P  = 0.018) as assessed using the PedsQL-Family Impact Module.
Conclusion   A negative relation between impact of burden and child's age suggests that family members gradually adapt to the delayed developmental status in their children as they grow. Caregivers in nuclear families having higher health satisfaction than those in extended families may be due to Chinese cultural effects.     

The responsiveness of the uterine fibroid symptom and health-related quality of life questionnaire (UFS-QOL)

Background

Pediatric health-related quality of life (HRQOL) has emerged as an important health outcome in clinical trials and healthcare research, for which HRQOL assessment instruments have played an important role. However, these instruments are not available in all countries or all languages. The Pediatric Quality of Life Inventory? (PedsQL?) Family Impact Module is a multidimensional instrument developed to assess the impact of chronic medical conditions on the HRQOL of parents and family functioning. The objective of the present study was to evaluate the psychometric properties of the PedsQL? Family Impact Module cross-culturally adapted for use in Brazil.

Methods

The PedsQL? Family Impact Module was administered to 95 parents/guardians of children with cancer in active therapy from 2 to 18 years of age of both genders. Subjects were recruited by means of convenience samples from the Pediatric Hematology/Oncology Centers at two public hospitals. The 'in-patient' sample was defined as individuals who were hospitalized for the administration of chemotherapy. The 'out-patient' sample was defined as individuals who were receiving chemotherapy and were not hospitalized.

Results

Test-retest reliability exhibited correlation values ranging from 0.81 to 0.96 for all subscales. Internal consistency reliability was demonstrated for the PedsQL? Family Impact Module: Total Scale Score (α = 0.89), Parent Health-Related Quality of Life Summary Score (α = 0.83) and Family Summary Score (α = 0.73). The Total Impact Score for the in-patient and out-patient samples was 67.60 and 56.43, respectively (p < 0.01). The construct validity demonstrated that the PedsQL? Family Impact Module proved capable of distinguishing between families whose children/adolescents were hospitalized and families of children/adolescents who are being taken care of at home.

Conclusion

The Brazilian version of the PedsQL? Family Impact Module was considered reliable and valid for assessing the impact of a chronic pediatric health condition on the HRQOL of parents and family functioning. The instrument should be field tested on other chronic pediatric illnesses.     

Comparing health-related quality of life of employed women and housewives: a cross sectional study from southeast Iran

Background

Quality of life differs for different people in different situations and is related to one's self-satisfaction with life. Considering the role of women in family and social health and the specific cultural characteristics of our province, we aimed to compare the quality of life of employed women with housewives in Zahedan, Iran.

Methods

This cross-sectional study was carried out during 2009–2010 in Zahedan, Iran. The sample consisted of 110 housewives and 110 employed women selected randomly from ten health care centers. Health-related quality of life was assessed using the SF-36. Analysis of covariance (ANCOVA) was used to compare quality of life in housewives and employed women while controlling for age, education and income.

Results

The mean (±SD) age of participants was 33.87± 8.95 years. Eighty-eight women (40%) had a university degree with a mean (±SD) official education of 10.8 (±4.9) years. The results indicated that employed women scored higher than housewives in all measures except for physical functioning. The differences were found to be remarkable for vitality, mental health and role emotional. However, after controlling for age, education and family income, none of differences reached significant level.

Conclusion

After controlling for potential confounders, the findings from this study indicated that there were no significant differences in quality of life between employed women and housewives. However, employed women scored higher on the SF-36, especially on the role emotional, vitality, and mental health. The findings suggest that associations exist between some aspects of health-related quality of life and employment. Indeed improving health-related quality of life among housewives seems essential.

     

The Chinese version of the Pediatric Quality of Life Inventory™ (PedsQL™) Family Impact Module: cross-cultural adaptation and psychometric evaluation

Background  

A pediatric chronic health condition not only influences a child's life, but also has impacts on parent health-related quality of life (HRQOL) and family functioning. To provide care and social support to these families, a psychometrically well-developed instrument for measuring these impacts is of great importance. The present study is aimed to evaluate the psychometric properties of the Chinese version of the PedsQL™ Family Impact Module.     

教育对健康的影响及其作用机制研究——基于中国家庭追踪调查的实证分析

目的：研究个体教育水平对健康的影响,分析教育对健康的作用机制。方法：利用CFPS2020数据,通过Logit模型与线性回归分析教育水平对健康是否存在影响,运用中介效应分析对其作用机制进行探讨。结果：以身体不适、自评健康和心理健康为因变量,受教育年限的提升对个体健康存在显著正效应,但高等教育个体中该效应不显著;中介效应分析显示,以代表健康行为的吸烟、锻炼和代表预算约束的收入水平为中介变量,教育对健康的中介作用存在,支持健康行为说和预算约束说。结论：教育对健康存在正向影响,但其主要体现在初中等教育阶段;更高的受教育年限促使个体通过改善健康行为和收入,进而提高健康水平。