重庆社区人群健康行为流行病学研究

发布时间：2018-05-14 15:11

本文选题：健康行为 + 重庆　；参考：《第三军医大学》2009年硕士论文

【摘要】：行为是机体生物效应和心理效应的综合表现形式,对健康影响具有非特异性、长时间作用、簇聚(clustering)协同效应等特点。健康行为(health behaviors,HB)与人群健康水平和生活质量紧密相关,是21世纪人类健康促进策略的关注重点,被研究者誉为健康基石。随着对疾病谱和健康问题变化特点的深入认识,美国、英国、澳大利亚等西方发达国家早在20世纪80年代即开展了广泛的行为流行病学的研究,在健康行为理论、研究方法,以及干预手段等领域取得了长足的发展。今天,健康行为(生活方式)的人群干预项目及评价工作已经成为政府、军队和研究机构的日常工作内容,为所属人群在传染病、非传染病、以及伤害事件预防和控制中发挥了有效作用。我国是人口最多的发展中国家,面临经济发展不平衡,卫生资源相对不足,医疗负担沉重等问题。近年来,虽然疾病预防和全民健康促进理念逐渐得到政府、机构和社区人群的认同,但健康行为推广和维护措施却缺乏力度,人群中不健康行为和生活方式普遍存在。社会人群健康问题如何进入良性循环,维持长久性的健康发展,这是我们面临的巨大挑战。本课题以重庆社区人群为研究对象,首先采用现况调查的方法对该人群的饮食行为、卫生行为、运动行为、驱避危险行为和心理应对行为等进行调查,以了解普通社区人群健康行为的现状和分布特征;然后,采用实验研究的方法,对洗手行为进行干预,以探索健康行为建立的有效干预方法。相关结果如下: 1.调查对象具有良好的人群代表性:调查样本1 309人,涉及重庆市所辖的渝中区、南岸区、沙坪坝区、云阳县、巫山县、万州区等40个区县。其中有效问卷1 263份,有效率96.5%。10%随机重测样本126人,重测问卷符合率为89.6%。调查对象的一般特征具有一定的地域代表性。其中男性668名,女性595名,平均年龄32.39±8.68岁;主城区居民620名,区县居民643名;脑力劳动者614名,体力劳动者460名;高中以下文化程度366名,占28.9%。 2.被调查人群中不健康行为现状不容乐观:调查结果显示,不健康卫生行为、不健康饮食行为、缺乏运动行为和无驱避危险行为的现象在人群中普遍存在。5种主要不健康行为的发生频率分别是:缺乏有效体育运动为78.1%,乘车不系安全带51.4%,饮酒42.8%(其中男性64.7% ,女性18.3% ),吸烟29.5%(其中男性54.3%,女性1.5%),超重或肥胖19.2%。此外,不健康饮食行为中,吃甜食的比例最高,为76%(其中男性71.1%,女性81.5%);不健康卫生行为中,未达到每年一次体检的比例最高,为71.0%;趋避危险行为中,不知晓人工复苏技术的比例最高,为88.6%。 3.不健康行为存在簇聚:人群中,多种不健康行为同时并存的现象普遍,其中只有3.7%的调查人员无不健康行为;21.5%有一种,37.5%有两种,22.3%有三种,13.2%有四种,1.7%同时有五种。几乎所有的吸烟者(78.8%)同时具有其余的二至四种不健康行为。其次是75.7%的超重或肥胖者同时具有其余的二至四种的不健康行为;男性、体力劳动者、低文化程度人群更易发生不健康行为的簇聚现象。提示在行为干预研究中可利用行为簇聚特点,设定重点人群和关键行为进行干预,以增加干预效益。 4.不健康行为受多种因素的影响:单因素和多因素Logistic回归分析结果显示,46-60岁、男性、低文化程度是不健康饮食行为的高发人群;从事脑力劳动,高学历,年龄较大的人群更易发生缺乏体育活动行为;低年龄组、男性的卫生行为较差;区县居民的趋避危险行为相对更差。提示不同健康行为的影响因素不同,在干预研究中应当根据对象和目标分别予以对待。 5.联合形式的措施可明显提高行为干预效果:干预试验结果显示,在建立适宜环境条件的基础上,单纯的现场行为警示干预和单纯的激励措施干预对促进洗手行为的建立效果相近。但二者联合干预的效果明显增加。提示健康教育、环境警示和激励措施相结合的联合干预方法更有利于健康行为的迅速建立。
[Abstract]:Behavior is a comprehensive expression of organism ' s biological effect and psychological effect . It has non - specific , long - term effect and synergistic effect on health . Health behaviors ( HB ) are closely related to the health level and quality of life . It is the focus of human health promotion strategy in the 21st century .

With the deep understanding of the characteristics of disease spectrum and health problems , Western developed countries such as the United States , the United Kingdom , Australia and other western developed countries have made great progress in the fields of health behavior theory , research methods , and interventions . Today , the population intervention project and evaluation work of healthy behavior ( lifestyle ) have become the daily work contents of government , army and research institutions , and play an effective role in the prevention and control of infectious diseases , non - communicable diseases and injury events .

In recent years , although the concept of disease prevention and universal health promotion has been accepted by government , institution and community , health behavior promotion and maintenance measures are lack of strength , unhealthy behavior and lifestyle are prevalent among the population . How to enter the virtuous circle and maintain long - term healthy development is the great challenge facing us .

In order to understand the current situation and distribution characteristics of the healthy behaviors of the general community population , the author makes an investigation on the behaviors of eating behavior , hygiene behavior , sports behavior , repellent risk behavior and psychological response behavior of the population in Chongqing community population . Then , the method of experiment research is adopted to intervene the hand - washing behavior to explore the effective intervention method of health behavior . The relevant results are as follows :

1 . The survey object has a good population representation : 1,309 survey samples , and 40 districts , such as Yuzhong District , Nankai District , Shapingba District , Yunyang County , Wushan County and Wanzhou District , which are under the jurisdiction of Chongqing . Among them , the effective questionnaires are 1,263 , the effective rate is 96.5 % . The average age is 32.39 卤 8.68 years .

2 . The prevalence of unhealthy behaviors in the investigated population was not optimistic . The results showed that the prevalence of unhealthy behaviors , unhealthy diet behavior , lack of exercise behavior and non - refoulement risk behaviors were prevalent among the population . The frequency of the five major unhealthy behaviors was 78.1 % , 51.4 % for non - healthy diet , and 19.2 % for overweight or obese . In addition , the proportion of non - healthy eating was the highest , which was 71.0 % . In the avoidance of dangerous behavior , the proportion of the technique of artificial resuscitation was not known to be the highest , which was 88.6 % .

3 . There are clusters of unhealthy behaviors : among the population , there are only 3.7 % of the investigators have no unhealthy behavior ; 21.5 % have one , 37.5 % have two , 22.3 % have three , 13.2 % have four , 1.7 % have five . Almost all smokers ( 78.8 % ) have the remaining two to four unhealthy behaviors .

4 . Unhealthy behavior is influenced by many factors : single factor and multi - factor logistic regression analysis shows that 46 - 60 years old , male , low - culture degree is unhealthy dietary behavior high - incidence crowd ; engaged in mental labor , high education , older age group is more vulnerable to lack of physical activity behavior ; low age group , male ' s health behavior is poor ; the district / county residents ' approach to avoid dangerous behavior is relatively worse . It is suggested that different health behaviors affect different factors , and should be treated according to the object and target in the intervention study .

5 . Joint form measures can obviously improve the effect of behavioral intervention : the results of intervention experiment show that the intervention of field behavior warning and the intervention of simple incentive measures are close to the effect of promoting the hand - washing behavior .

【学位授予单位】：第三军医大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R193;R181.3

【参考文献】