我国中老年慢性病患者自评健康状况及影响因素研究——基于个人-家庭-社会视角

目的 了解我国中老年慢性病人群健康自评状况及其影响因素，为提高该人群健康水平提供参考。方法 以2018年全国性调查数据（CFPS）为基础，从个人-家庭-社会视角构建4个分析模型，采用二元logistic回归法，分析45岁及以上慢性病患者健康自评的影响因素。结果 自评为健康者占35.96%，自评为非健康者占64.04%。二元logistic 回归显示，有伴侣（P=0.034，OR=1.075），受教育程度在大专/本科及以上（P=0.003，OR=1.802）选择在基层卫生服务机构就医（P=0.030，OR=1.198），对医生更信任（P=0.037，OR=1.228），心理健康水平较好（P＜0.001，OR=3.013），生活独立水平较高（P＜0.001，OR=1.203），睡眠时间在＞6～10小时（P=0.030，OR=1.942），一周锻炼时长在＞7～14小时（P=0.037，OR=2.146），家庭年收入在＞10～20万元（P=0.032，OR=0.753），与子女关系更密切（P=0.028，OR=2.738），拥有额外房产（P=0.003，OR=1.686），使用移动设备社交（P=0.025，OR=1.269），对邻里更信任（P=0.035，OR=1.032），人缘关系较好（P=0.001，OR=1.599），社会地位较高（P=0.025 OR=1.226），幸福感较高（P=0.014，OR=1.451）均为中老年慢性病患者健康自评的保护因素。结论 我国中老年慢性病人群的健康自评水平不高，应发挥基层卫生服务机构、互联网的正向作用并对空巢、失能等慢性病人群予以关注。

A study on the the health status and influencing factors of middle-aged and elderly patients with chronic diseases based on the individual-family-social perspective

To understand the health self-evaluation status and influencing factors of the middle-aged and elderly people with chronic diseases in China, so as to provide references for improving the health of the people. Methods Based on the 2018 National Survey Data(CFPS), with chronic diseases Patients over 45, four analysis models were established from the perspective of individual-family-society, and binary logistic regression was used to analyze the Influencing factors of self-rated health. Results The self-rated healthy accounted for 35.96%, and the self-rated unhealthy accounted for 64.04%. The binary logistic regression showed that partner(P=0.034,OR=1.075),the college/undergraduate education level(P=0.003, OR=1.802),medical treatment in primary health service institutions(P=0.030, OR=1.198), more trust in doctors(P=0.037, OR=1.228), better mental health(P<0.001, OR=3.013), higher level of independence of life(P<0.001, OR=1.203), sleep time >6-10 hours(P=0.030, OR=1.942), exercise time >7-14 hours per week(P=0.037, OR=2.146), family income 100 000 to 200 000 yuan(P=0.032, OR=0.753), closer relationship with children(P=0.028, OR=2.738), own additional real estate(P=0.003, OR=1.686), socialize with mobile devices(P=0.025, OR=1.269),trust with neighborhood(P=0.035, OR=1.032), good relationship(P=0.001, OR=1.599), higher social status(P=0.025 OR=1.226), higher happiness(P=0.014,OR=1.451)all protective factors for self-evaluation of health in middle-aged and elderly patients with chronic diseases.Conclusion The health self-evaluation status of the empty nests and disabled chronic disease groups is low.To improve personal health literacy, the active role of Primary health service agencies and the Internet should be brought. More attention should be paid to the status of empty nests and disabled chronic disease groups.