摘要
目的:探讨健康素养、自我效能感和服药依从性对中老年慢性病患者自评健康状况的相对贡献度,解析其内部作用路径。方法:基于2021年中国居民心理与行为调查(PBICR)数据,采用随机森林模型评估健康素养、自我效能感和服药依从性对中老年慢性病患者自评健康状况的相对贡献度;通过构建多重中介模型评估它们的内部作用机制。结果:中老年慢性病患者的自评健康水平的中位数为77分。健康素养、自我效能感与服药依从性在中老年慢性病患者自评健康中的相对贡献度位居前三。健康素养不仅可以直接影响慢性病患者的自评健康状况(β=0.248,P<0.001),而且可以通过自我效能感与服药依从性的单独或链式中介作用对其产生影响。结论:中老年慢性病患者的自评健康状况有待改善;健康素养、自我效能感和服药依从性对其健康改善至关重要,建议通过对三者的联合干预,提高患者健康水平。
Objective To explore the relative contribution of health literacy,self-efficacy and medication adherence to the impact of self-assessed health status of middle-aged and elderly patients with chronic diseases,and analyze their internal pathways of action.Methods Based on data from the 2021 Psychological and Behavioral Survey of Chinese Residents(PBICR),a random forest model was used to evaluate the contribution of health literacy,self-efficacy and medication adherence to the impact of self-assessed health status of middle-aged and elderly patients with chronic diseases,and a multiple mediation model was constructed to assess the internal mechanism of these factors.Results The median self-assessed health level of middle-aged and elderly patients with chronic diseases was 77 points.Health literacy,self-efficacy,and medication adherence ranked top three relative contributions to self-assessed health among middle-aged and elderly patients with chronic diseases.Health literacy can not only directly influence the self-assessed health status of patients with chronic diseases(β=0.248,P<0.001),but can also have an impact on them through the mediating effects of self-efficacy and medication adherence,either individually or in chains.Conclusion The self-assessed health status of middle-aged and elderly patients with chronic diseases needs to be improved.Health literacy,self-efficacy,and medication adherence are critical to their health improvement.It is recommended to implement combined intervention of all three to improve the patients health.
作者
张秀敏
赵旭阳
郭瑞瑞
刘怡璇
陈怡冰
李冉然
Zhang Xiumin(School of Public Health,Jilin University,Changchun,P.R.China)
出处
《中国卫生事业管理》
北大核心
2025年第8期955-960,共6页
Chinese Health Service Management
基金
吉林省科技厅科技战略与规划研究项目“全民健康覆盖视角下吉林省城乡居民的健康公平性研究”(20200101133FG)。
关键词
中老年
慢性病
自评健康状况
随机森林模型
链式中介
middle-aged and elderly
chronic diseases
self-assessed health status
random forest model
chained mediation
