糖尿病患病危险因素线性结构模型分析

目的 分析深圳市糖尿病患病危险因素。方法 采用因子分析和线性结构方程模型分析糖尿病患病危险因素，并进行模型拟合与评估。结果 生化指标直接影响患病状况(直接影响权重为0．26)；生理指标不仅直接影响患病状况(直接影响权重0．14)，而且通过生化指标间接影响患病状况(间接影响权重0．06)。性别和生活习惯间接影响患病状况。结论 线性结构模型能较好的分析糖尿病危险因素。     

基于结构方程模型探讨哮喘患者治疗依从性影响因素

目的 探讨结构方程模型在哮喘患者治疗依从性影响因素分析中的应用,为哮喘患者治疗依从性的改善提供依据。方法 应用哮喘患者报告临床结局量表,对太原市366位哮喘患者进行调查。采用结构方程模型分析调查结果。结果 结构方程模型分析:生理领域中,生理机能的改善,使治疗依从性提高。治疗满意度又是生理机能与治疗依从性的中间调节作用。心理领域中,恐怖、抑郁等不良心理状态的缓解,可引起患者治疗依从性提高。社会领域中,参与社会活动越多,获得社会支持越丰富,患者治疗依从性就越高。结论 哮喘患者的生理机能、心理状况、社会活动、社会支持、治疗满意度均与治疗依从性有密切关系。关注哮喘患者,改善其生理机能,给予心理干预,创造活动交流机会,增加人文关怀,有助于治疗依从性的提高。     

Ⅱ型糖尿病危险因素的线性结构关系模型分析

目的：为探讨糖尿病的危险因素，进行了本项研究。方法：采用线性结构关系模型对糖尿病的危险因素进行了分析。分别用协方差矩阵和相关系数矩阵对模型进行配合模型。结果：精神因素对糖尿病的患病状况不仅有直接影响，同时也有间接影响。生活习惯对患病状况无直接影响，但它通过病人的生理状况对患病有间接影响。自我保健因子对患病状况有间接影响。结论：由多项相关系数、多序列相关系数和积矩相关系数组成的矩阵比协方差矩阵具有较好的模型配合效果     

汶川地震灾区居民心理健康状况的影响因素分析

目的了解汶川地震一年半后灾区居民心理健康状况及其影响因素,为其心理重建制定合理措施提供参考。方法通过对汶川、北川、绵竹3个极重灾区882位居民的调查,对居民的心理健康状况进行测评,并采用结构方程模型分析其影响因素。结果灾区居民焦虑症状阳性率为22.6%,抑郁症状阳性率为19.7%;地震灾区居民心理健康状况影响因素依次为:社会特征、生理健康状况、社会支持、地震创伤暴露情况、地震后居住状况;其中生理健康状况、社会支持、地震创伤暴露情况对灾区居民心理健康有直接作用,社会特征与地震后居住状况对心理健康有间接的影响。结论灾区居民的心理健康需持续关注;灾区居民,特别是老年人的社会支持有待加强;灾区居民的心理重建需要卫生保健、家园重建等多方面工作的支持。     

IVF/ICSI前女性患者心理及生理状态对妊娠结局影响的结构方程模型

目的：通过结构方程建模对影响体外受精/胞浆内单精子注射（IVF/ICSI）治疗结局的生理及心理因素进行探索。方法：随机选取442例符合纳入条件的患者,填写状态-特质焦虑量表（STAI）、贝克抑郁量表（BDI）、领悟社会支持量表（PSSS）及医学应对方式问卷（MCMQ）,同时收集所有患者的社会人口学资料、疾病基础状况及治疗情况等,进行相关分析并建立结构方程模型。结果：胚胎质量、负性心理因素对妊娠结局有直接影响,年龄、基础卵泡刺激素（bFSH）、基础窦卵泡数（AFC）、获卵数、促性腺激素（Gn）启动剂量、Gn使用总量、Gn使用时间对妊娠结局有间接影响。结论：患者生理及心理因素之间存在复杂相关关系,除生物学因素的改善,消除负性心理因素后对改善妊娠结局有一定作用。     

医学生社会支持、应对方式、乐观性格、心理状况与生活质量的关系研究

目的探讨社会支持、应对方式、乐观性格、心理状况对生活质量的影响,为了解医学生这一特殊群体的心理健康状况提供理论基础。方法选取临床医学专业五年制本科、七年制学生、硕士研究生、博士研究生进行心理健康问卷调查,进而用结构方程模型的方法构建各变量之间的关系模型。结果医学生生活质量不仅受到社会支持、应对方式、乐观性格、心理状况的直接影响,还受到社会支持、应对方式、乐观性格的间接影响。结构方程的外部结构和内部结构拟合效果均较好。结论社会支持、应对方式、乐观性格、心理状况对生活质量的影响得到结构方程模型的有力支持。     

结构方程模型在分析医务人员心理与满意度关系中的应用

目的通过结构方程模型分析医务人员的心理状况与医务人员对医院的满意度之间的关系，为医院管理提供理论参考。方法采用整群抽样法，对某二甲医院275名医务工作者进行问卷调查。通过结构方程模型构建医务人员对医院满意度影响因素的初始模型，并予以验证，再根据模型的参数检验、修正指数对初始模型进行修正，以得到最终模型。结果模型拟合效果良好，拟合优度指数、调整拟合优度指数均大于0．90。医务人员焦虑和抑郁状况都是影响医务人员对医院评价、医院领导的评价及其在本院工作状况的因素。结论医院管理者应重视医务人员心理，使其保持良好的心理状态。     

脑卒中患者治疗满意度和心理中介效应研究

[目的]建立脑卒中患者在心理、社会、治疗领域的结构方程模型,分析脑卒中患者心理和治疗满意度的影响因素,为脑卒中患者治疗提供理论依据。[方法]采用随机抽样的方法对485例确诊的脑卒中患者进行问卷调查,利用《脑卒中患者报告临床结局量表》(Stroke-Pro量表)研制过程中的正式调查数据,采用结构方程模型分析影响脑卒中患者心理和治疗满意度的因素。[结果]心理、社会领域的结构方程模型结果显示:焦虑对抑郁有直接影响,标准化作用大小为0.38;焦虑、社会交往和家庭支持以回避为中介对抑郁产生间接影响,标准化作用大小分别为0.27、0.25和0.09。心理、社会和治疗领域的结构方程模型结果显示:家庭支持对治疗满意度有直接影响,标准化作用大小为0.38;社会交往和家庭支持以回避为中介对治疗满意度产生间接影响,标准化作用大小分别为0.15和0.04。[结论]家庭支持、社会交往以及回避情绪均是脑卒中患者抑郁及治疗满意度的重要影响因素。     

参合农民住院概率影响因素的结构方程模型分析

目的:分析参合农民住院概率的影响因素。方法:采用单因素分析、Logistic回归分析和结构方程模型分析参合农民住院概率的影响因素,并进行模型拟合与评估。结果:结构方程模型显示,健康状况直接影响住院率(直接影响权重为0.26);生理状态不仅直接影响住院率(直接影响权重为0.19),而且通过健康状况和社会因素间接影响住院率(间接影响权重为-0.30);卫生服务可得性对住院率的影响最小(影响权重为0.02),这既能解释单因素分析和Logistic回归分析的结果,也能给出较好的专业解释。结论:线性结构方程模型能较好的分析参合农民住院概率的影响因素。     

参合农民住院概率影响因素的结构方程模型分析

目的:分析参合农民住院概率的影响因素.方法:采用单因素分析、logistic回归分析和结构方程模型分析参舍农民住院概率的影响因素,并进行模型拟合与评估.结果:结构方程模型显示健康状况直接影响住院率(直接影响权重为0.26);生理状态不仅直接影响住院率(直接影响权重为0.19),而且通过健康状况和社会因素问接影响住院率(间接影响权重为-0.30);卫生服务可得性对住院率的影响最小(影响权重仅为0.02),这既能解释单因素分析和logistic回归分析的结果,也能给出较好的专业解释.结论线性结构方程模型能较好的分析参合农民住院概率的影响因素.     

The effect of medical work groups on hospital resource use.

This study tests the ability of medical work groups to overcome coordination problems related to group decision-making in allocating clinical resources to inpatients. The study was conducted over a 32-month period in two medium-sized acute-care hospitals located in Montreal, Quebec, Canada. The data were collected by hand from the medical charts of 10,456 patients in the surgical and medical departments. The Linear Structural Relations (LISREL) approach was employed to address the work-group issue using a task contingent model of work-group organization. In this model, the nature of the task is fundamental because its level of complexity determines both the organization of the work group and the use of resources. Medical work-group mechanisms should be efficient to the extent that resource utilization is explained solely by task characteristics rather than by work-group structure. In this study, the following two major organizational concepts were used as factors to explain resource use: task characteristics and work-group characteristics. Our analysis confirmed the main points of the task contingency theory as applied to the field of medicine. First, the results confirm that resource utilization is explained mainly by task complexity. Second, they confirm that medical work groups modulate their structures on the basis of task characteristics and do not explain resource use. The results also reveal a more complex model in which, for instance, the concepts of medical task and medical professional work are not easy to separate. The results highlight the interest in conceptualizing and analysing medical practice in work groups. It raises important issues that have seldom been taken into account in the study of medical practice variations, which has tended to focus on attending physicians.     

Describing patients with a duration of sick leave over and under one year in Norway

Objective: This study aimed to describe the somatic, social, psychological, and work-related factors that characterize participants with a duration of sick leave over and under one year. Methods: During 2012, 181 patients on long-term sick leave were consecutively recruited and asked to answer an extensive survey. Several outcomes were reported, addressing work-related factors and somatic, psychological, and social symptoms. In cross-sectional analyses, sick leave duration was dichotomized as > or < one year, based on Norwegian legislation. Linear and logistic regressions were used to estimate population probabilities and means. Results: The estimated prevalence of pain, fatigue, anxiety, and depression was overall high. There was a tendency towards a higher prevalence of fatigue, anxiety, and depression in those with sick leave duration less than one year, with the exception of sleep problems, which was more frequent in the population with longer duration. Relationship with friends, family, co-workers, and the last workplace were worse in the population with longer duration. Conclusions: Cross-sectional analyses indicated that social and work-related problems are more adverse in patients with longer duration of sick leave, while psychological and somatic symptoms appear less adverse. This is one of the first studies quantitatively demonstrating these differences through comprehensive, simultaneously measured self-report questionnaires.     

河南省农村地区HIV/AIDS生存质量及影响因素调查

目的 调查HIV感染者生存质量及影响因素.方法 使用中文版WHOQOL-BREF量表,对驻马店市农村地区2608例HIV感染者进行问卷调查,计算生存质量总分及各领域得分,通过多元线性回归模型分析生存质量总分及生存质量各领域得分的影响因素.结果 HIV感染者生存质量得分为生理领域(12.96±1.94)、心理领域(11.79±1.19)、社会领域(13.79±2.44)、环境领域(12.40±1.93)、生存质量总得分(51.02±6.03).女性生存质量总分及生存质量各领域得分均高于男性.经多元线性回归模型分析得出生存质量影响因素有性别、年龄、职业、家庭纠纷及食欲等.结论 该地区HIV感染者生存质量社会领域得分较高,但心理领域得分较低,建议加强对该人群的心理干预.     

慢性阻塞性肺疾病患者心理状况及影响因素分析

[目的 ]　了解慢性阻塞性肺疾病 (COPD)患者心理状况和影响因素 ,探讨其诊断及处理方法。　 [方法 ]　选择 166例COPD患者 ,用Zung氏抑郁自量表 (SDS)和汉密顿抑郁量表 (HRSD)对COPD患者进行分析。　[结果 ]　COPD组患者分数显著高于健康组 ,COPD发作期组又显著高于稳定期组 ,其发病与年龄、社会支持、病程和病情的轻重等因素有关。　 [结论 ]　COPD患者伴有心理障碍 ,其发生与多种因素有关 ,治疗时要重视和兼顾心理症状的诊治。     

Age differences in the effects of network composition on psychological distress.

The main goal of this research is to better understand age differences in the effects of social networks on mental health. Using a social network approach to revise the convoy of social support model (Kahn and Antonucci, 1980), we examine specifically how two aspects of social support networks (kin composition and convoy dimensions) influence psychological distress for older and younger samples (18-59 and 60+). We hypothesize that kin composition will influence distress in general but especially for the younger sample, while two competing hypotheses for the convoy of social support model are tested. Using data from a three-wave panel health study, structural equation models (LISREL 8.20) indicate that a greater proportion of kin in the perceived support network and the presence of family members in the inner circle of the convoy significantly reduce distress, primarily for the younger sample. Implications for the convoy model are discussed.     

Parental factors and adolescents' smoking behavior: an extension of The theory of planned behavior

BACKGROUND: The aim of the present study is to investigate whether general parenting factors (i.e., quality parent-child relationship, psychological control, strict control, parental knowledge) and parental smoking add to The theory of planned behaviour [Organ Behav. Hum. Dec. 50 (1991) 179] in predicting the onset of smoking. A mediation model is applied in which parental factors affect smoking behavior indirectly by affecting smoking cognitions (i.e., attitude, self-efficacy, and social norm). METHODS: The model was tested in a longitudinal study on 1,070 adolescents, aged 10-14 years old. Structural equation models (SEM) on current and on future smoking behavior were tested. RESULTS: The findings showed that the quality of the parent-child relationship and parental knowledge affected adolescents' smoking behavior indirectly, while parental smoking behavior had a direct effect. Strict control and psychological control were found to be unrelated to adolescents' smoking onset. CONCLUSIONS: In prevention campaigns, parents should be informed of the extent to which they exert influence on their child's smoking behavior and should be given advice and information on how they can prevent their children from starting to smoke.     

2型糖尿病危险因素及作用方式研究

目的 探讨2型糖尿病危险因素及作用方式．为制定针对高危人群及全人群的干预措施提供依据。方法 将200例确诊的2型糖尿病患者作为研究对象．采用线性结构关系模型(LISREL)方法分析．筛选主要危险因素，并探讨其作用方式及作用强度。结果 糖尿病家族史，肥胖、血压，精神心理因素及不良生活方式等是2型糖尿病的主要危险因素。糖尿病家族史对2型糖尿病的作用方式主要为直接作用，且作用较大(其总和效应系数为0．2184)；而精神心理因素、生活方式(不常体育锻炼、喜食脂肪)除了有较小的卣接作用外．更主要是通过血压和肥胖间接影响糖尿病的发生(其总和效应系数分别为0．2035和0．0858)；而高血压、肥胖与2型糖尿病之间具有相关关系。结论 2型糖尿病与遗传因素和环境因素有关．且环境因素间相互作用，互为因果．故针对高危人群及全人群，采取适度运动．合理膳食．保持良好的精神心理状态，控制体重和血压等综合干预措施是预防2型糖尿病发生的重要手段。     

Change of water consumption and its potential influential factors in Shanghai: a cross-sectional study

ABSTRACT: BACKGROUND: Different water choices affect access to drinking water with different quality. Previous studies suggested social-economic status may affect the choice of domestic drinking water. The aim of this study is to investigate whether recent social economic changes in China affect residents' drinking water choices. METHODS: We conducted a cross-sectional survey to investigate residents' water consumption behaviour in 2011. Gender, age, education, personal income, housing condition, risk perception and personal preference of a certain type of water were selected as potential influential factors. Univariate and backward stepwise logistic regression analyses were performed to analyse the relation between these factors and different drinking water choices. Basic information was compared with that of a historical survey in the same place in 2001. Relations between self-reported drinking-water-related diarrhoea and different water choices, diarrhoea and water hygiene treatment were investigated using chi-square test. RESULTS: The percentage of tap water consumption remained relatively stable and a preferred choice, with 58.99% in 2001 and 58.25% in 2011. The percentage of bottled/barrelled water consumption was 36.86% in 2001 and decreased to 25.75 % in 2011. That of household filtrated water was 4.15% in 2001 and increased to 16.00% in 2011. Logistic regression model showed strong correlation between one's health belief and drinking water choices (p<0.001). Age, personal income, education, housing condition, risk perception also played important roles (p<0.05) in the models. Drinking-water-related diarrhoea was found in all types of water and improper water hygiene behaviours still existed among residents. CONCLUSIONS: Personal health belief, housing condition, age, personal income, education, taste and if worm ever founded in tap water affected domestic drinking water choices in urban China.     

Confirmatory factor analysis of the Child Feeding Questionnaire (CFQ) in Japanese elementary school children

The validity of the Child Feeding Questionnaire (CFQ), one of the measures used to assess parental child feeding practices and attitudes, has been confirmed in American populations. We used confirmatory factor analysis to test the validity and factor structure of the translated version of the CFQ among parents of Japanese elementary school children. The structural equation modelling software Linear Structural Relationships (LISREL) was applied to explore the validity of the translated CFQ to examine child feeding behaviours and attitudes in a sample of 920 parents of Japanese elementary schoolchildren from schools in Koshu City in Yamanashi prefecture (grades 4-6), Japan. The confirmatory factor analysis suggested that after dropping the items with a low factor loading and adding three error covariances between items, the 7-factor model displayed acceptable fit and most items loaded as expected. Of the 24 direct factor-item correlations, 22 were greater than 0.50. Our study confirmed the validity of the translated CFQ to assess child feeding practices and attitudes among parents of elementary schoolchildren brought up in a Japanese eating culture.