慢性萎缩性胃炎患者健康素养状况及相关影响因素分析

苏博超; 冯博俊豪; 李昀珊; 索宝军; 吴一波; 张金太

doi:10.16766/j.cnki.issn.1674-4152.003268

慢性萎缩性胃炎患者健康素养状况及相关影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.003268

1.
陕西(高校)哲学社会科学重点研究基地-健康文化研究中心, 陕西西安 712046
2.
澳门科技大学医学院, 澳门 999078
3.
山东大学公共卫生学院, 山东济南 250012
4.
北京大学第三医院消化科, 北京 100191
5.
北京大学公共卫生学院, 北京 100191
6.
青岛市黄岛区疾病预防控制中心, 山东青岛 266400

基金项目:

陕西省教育厅重大项目 SMZX202104

详细信息

通讯作者:
张金太，E-mail：zjt1974@163.com

中图分类号: R573.32
计量
- 文章访问数: 202
- HTML全文浏览量: 75
- PDF下载量: 10
- 被引次数: 0
出版历程
- 收稿日期: 2022-12-15
- 网络出版日期: 2024-01-13

Analysis of health literacy status and related factors in patients with chronic atrophic gastritis

1.
Shaanxi University Key Research Base of Philosophy and Social Sciences-Health Culture Research Center, Xi'an, Shaanxi 712046, China

摘要

摘要: 目的探究慢性萎缩性胃炎患者的健康素养状况及影响因素，为慢性萎缩性胃炎患者健康教育提供建议。方法于2020年5月6日—2021年1月24日，招募调查员在3所三级医院(山东省2所，北京市1所)、4所二级医院(新疆维吾尔自治区、山西省、湖北省、广东省各1所)和3所一级医院(山西省、广东省、河南省各1所)的病房或者门诊发放并回收问卷，并采用SPSS 26.0统计学软件进行统计描述、χ²检验和logistic回归分析。结果本研究最终获得有效样本数602份，慢性萎缩性胃炎患者具备健康素养的比例为36.9%(222例)；具备功能性、批判性、互动性健康素养的慢性萎缩性胃炎患者比例分别为41.7%(251例)、50.7%(305例)、55.5%(334例)。总健康素养方面，在城乡(χ²=9.823，P < 0.05)、年龄段(χ²=17.815，P < 0.05)、学历(χ²=43.044，P < 0.05)、职业(χ²=21.583，P < 0.05)等方面存在统计学意义。多因素logistic回归分析结果显示，小学以下学历(OR=0.162，95% CI：0.044~0.585)、初中学历(OR=0.270，95% CI：0.106~0.687)、高中/职高/中专学历(OR=0.248，95% CI：0.105~0.583)、大专/本科学历(OR=0.430，95% CI：0.189~0.977)与研究生及以上学历相比，不利于健康素养的培养。结论慢性萎缩性胃炎患者健康素养水平较低，学历对慢性萎缩性胃炎患者健康素养影响差异有统计学意义。
- 萎缩性胃炎 /
- 健康素养 /
- 影响因素 /
- 相关性
Abstract: Objective To explore the status and influencing factors of health literacy in patients with chronic atrophic gastritis and to provide suggestions for health education for patients with chronic atrophic gastritis. Methods Investigators were recruited to distribute and collect questionnaires in the wards or outpatients of 3 tertiary hospitals (2 in Shandong Province, 1 in Beijing), 4 secondary hospitals (1 in Xinjiang Uygur Autonomous region, 1 in Shanxi Province, 1 in Hubei Province and 1 in Guangdong Province) and 3 primary hospitals (1 in Shanxi Province, 1 in Guangdong Province and 1 in Henan Province) from May 6, 2020 to January 24, 2021. SPSS 26.0 was used for descriptive statistics, χ² test and logistic linear regression analysis. Results A total of 602 effective samples were obtained and the proportion of patients with chronic atrophic gastritis with health literacy was 36.9% (222 cases). The proportion of chronic atrophic gastritis patients with functional, critical and interactive health literacy were 41.7% (251 cases), 50.7% (305 cases) and 55.5% (334 cases), respectively. In terms of total health literacy, there were statistical significance in urban and rural areas (χ²=9.823, P < 0.05), age (χ²=17.815, P < 0.05), education (χ²=43.044, P < 0.05), occupation (χ²=21.583, P < 0.05) and so on. The results of multifactorial logistic regression analysis showed that education below elementary school (OR=0.162, 95% CI: 0.044-0.585), junior high school education (OR=0.270, 95% CI: 0.106-0.687), high school/vocational high school/secondary school education (OR=0.248, 95% CI: 0.105-0.583), and college/bachelor ' s degree (OR=0.430, 95% CI: 0.189-0.977) were unfavorable for health literacy development compared to graduate and higher degrees. Conclusion The level of health literacy of patients with chronic atrophic gastritis is low, and the influence of education on the health literacy of patients with chronic atrophic gastritis is statistically significant.
- Atrophic gastritis /
- Health literacy /
- Influencing factors /
- Relativity

HTML全文

表 1 不同社会特征下萎缩性胃炎患者的健康素养状况[例(%)]

Table 1. Health literacy status of patients with atrophic gastritis under different social characteristics [cases (%)]

项目	类别	例数(%)	功能性	互动性	批判性	健康素养
性别	男性	388(64.5)	162(41.8)	220(56.7)	210(54.1)	146(37.6)
	女性	214(35.5)	89(41.6)	114(53.3)	95(44.4)	76(35.5)
χ²值			0.002	0.657	5.225	0.265
P值			0.969	0.418	0.022	0.607
居住地	乡村	471(78.2)	208(44.16)	275(58.39)	252(53.50)	189(40.13)
	城市	131(21.8)	43(32.82)	59(45.04)	53(40.46)	33(25.19)
χ²值			5.419	7.394	6.978	9.823
P值			0.020	0.007	0.008	0.002
年龄	40岁及以下	157(26.1)	84(53.5)	84(53.5)	75(47.8)	71(45.2)
	41~50岁	222(36.9)	102(45.9)	136(61.3)	120(54.1)	89(40.1)
	51~60岁	122(20.3)	39(32.0)	65(53.3)	63(51.6)	37(30.3)
	61~70岁	71(11.8)	20(28.2)	38(53.5)	33(46.5)	18(25.4)
	71岁以上	30(5.0)	6(20.0)	11(36.7)	14(46.7)	7(23.3)
χ²值			32.923	10.044	3.152	17.815
P值			< 0.001	0.074	0.677	0.003
婚姻	未婚	95(15.8)	38(40.0)	43(45.3)	43(45.3)	28(29.5)
	已婚	507(84.2)	213(42.0)	291(57.4)	262(51.7)	194(38.3)
χ²值			0.133	4.769	1.317	2.656
P值			0.715	0.029	0.251	0.103
学历	小学以下	35(5.8)	5(14.30)	13(37.1)	13(37.1)	5(14.3)
	初中	94(15.6)	28(29.8)	48(51.1)	45(47.9)	26(27.7)
	高中/职高/中专	186(30.9)	59(31.7)	107(57.5)	100(53.8)	55(29.6)
	大专/本科	258(42.9)	137(53.1)	146(56.6)	129(50.0)	117(45.3)
	研究生及以上	29(4.8)	22(75.9)	20(69.0)	18(62.1)	19(65.5)
χ²值			67.790	8.863	5.765	43.044
P值			< 0.001	0.115	0.330	< 0.001
职业	公务员及事业单位人员	96(15.9)	49(51.0)	57(59.4)	55(57.3)	46(47.9)
	农、林、牧、渔、水利业生产人员	99(16.4)	29(29.3)	60(60.6)	48(48.5)	27(27.3)
	其他从业及无业人员	93(15.4)	32(34.4)	36(38.7)	36(38.7)	24(25.8)
	商业、服务业人员	82(13.6)	34(41.5)	47(57.3)	41(50.0)	30(36.6)
	生产、运输设备操作人员及有关人员	106(17.6)	40(37.7)	64(60.4)	64(60.4)	38(35.8)
	医疗卫生人员	50(8.3)	27(54.0)	25(50.0)	25(50.0)	25(50.0)
	专业技术人员	76(12.6)	40(52.6)	45(59.2)	36(47.4)	32(42.1)
χ²值			22.510	17.018	13.781	21.583
P值			0.002	0.017	0.055	0.003

下载: 导出CSV

表 2 Logistic回归分析变量赋值情况

Table 2. Logistic regression analysis of variable assignment

自变量	赋值方法
性别	女性=0，男性=1
城乡	乡村=0，城镇=1
年龄	40岁及以下=1，41~50岁=2，51~60岁=3，61~70岁=4，71岁及以上=5
婚姻状况	未婚=0，已婚=1
吸烟	否=0，是=1
饮酒	否=0，是=1
学历	小学=1，初中=2，高中/职高/中专=3，大专/本科=4，研究生及以上=5
职业	公务员及事业单位人员=(1, 0, 0, 0, 0, 0)，农、林、牧、渔、水利业生产人员=(0, 1, 0, 0, 0, 0)，其他从业及无业人员=(0, 0, 1, 0, 0, 0)，商业、服务业人员=(0, 0, 0, 1, 0, 0)，生产、运输设备操作人员及有关人员=(0, 0, 0, 0, 1, 0)，医疗卫生人员=(0, 0, 0, 0, 0, 1)，专业技术人员=(0, 0, 0, 0, 0, 0)，以“专业技术人员”为参照。

下载: 导出CSV

表 3 萎缩性胃炎患者健康素养影响因素logistic回归分析

Table 3. Logistic regression analysis of factors influencing health literacy of patients with atrophic gastritis

学历	B	SE	Wald χ²	P值	OR值	95% CI
小学	-1.829	0.659	7.698	0.006	0.161	0.044~0.585
初中	-1.310	0.477	7.550	0.006	0.270	0.106~0.687
高中/职高/中专	-1.395	0.437	10.212	0.001	0.248	0.105~0.583
大专/本科	-0.844	0.418	4.065	0.044	0.430	0.189~0.977
注：本表仅展示差异有统计学意义的变量。

下载: 导出CSV

参考文献(20)

[1]	MUHSEN K, SINNREICH R, MEROM D, et al. Prevalence and determinants of serological evidence of atrophic gastritis among Arab and Jewish residents of Jerusalem: a cross-sectional study[J]. BMJ Open, 2019, 9(1): ec24689. DOI: 10.1136/bmjopen-2018-024689.
[2]	DE VRIES A C, VAN GRIEKEN N C, LOOMAN C W, et al. Gastric cancer risk in patients with premalignant gastric lesions: a nationwide cohort study in the Netherlands[J]. Gastroenterology, 2008, 134(4): 945-952. doi: 10.1053/j.gastro.2008.01.071
[3]	ENDO K, NAKADA H, KADOTA Y, et al. Risk factors for atrophic gastritis in the Japanese young and middle-aged: a study using double-contrast upper gastrointestinal barium X-ray radiography[J]. Jpn J Radiol, 2018;36(12): 706-711. doi: 10.1007/s11604-018-0782-8
[4]	沈红利, 高雅萍, 王跃萍, 等. 同伴支持教育对慢性萎缩性胃炎患者健康行为及生活质量的影响[J]. 世界华人消化杂志, 2020, 28(19): 972-978. SHEN H L, GAO Y P, WANG Y P, et al. Effects of peer support education on health behaviors and quality of life in patients with chronic atrophic gastritis[J]. World Journal of Chinese Digestion, 2020, 28(19): 972-978.
[5]	中国人民共和国卫生部. 健康66条: 中国公民健康素养读本[M]. 北京: 人民卫生出版社, 2008: 16-17. Ministry of Health of the People's Republic of China. Health 66: a reader on health literacy for Chinese citizens[M]. Beijing: People's Health Publishing House, 2008: 16-17.
[6]	曾强, 胡馨, 胡强. 单纯性肥胖青少年健康素养状况及影响因素分析[J]. 中国健康教育, 2019, 35(12): 1070-1074. ZENG Q, HU X, HU Q. Analysis of health literacy status and influencing factors among adolescents with simple obesity[J]. China Health Education, 2019, 35(12): 1070-1074.
[7]	中华医学会, 中华医学会杂志社, 中华医学会消化病学分会, 等. 慢性胃炎基层诊疗指南(2019年)[J]. 中华全科医师杂志, 2020, 19(9): 768-775. doi: 10.3760/cma.j.cn114798-20200706-00785 Chinese Medical Association, Chinese Medical Association Journal Society, Chinese Medical Association Society of Gastroenterology, et al. Guidelines for the primary care of chronic gastritis (2019)[J]. Chinese Journal of General Practitioners, 2020, 19(9): 768-775. doi: 10.3760/cma.j.cn114798-20200706-00785
[8]	于建勋, 杨岚岚, 田毓霞, 等. 老年人慢性胃炎与幽门螺杆菌感染的临床意义[J]. 中国老年学杂志, 2004, 24(10): 911-912. doi: 10.3969/j.issn.1005-9202.2004.10.017 YU J X, YANG L L, TIAN Y X, et al. Clinical significance of chronic gastritis and Helicobacter pylori infection in the elderly[J]. Chinese Journal of Gerontology, 2004, 24(10): 911-912. doi: 10.3969/j.issn.1005-9202.2004.10.017
[9]	ISHIKAWA H, TAKEUCHI T, YANO E. Measuring functional, communicative, and critical health literacy among diabetic patients[J]. Diabetes Care, 2008, 31(5): 874-879. doi: 10.2337/dc07-1932
[10]	张晓飞, 底会娟, 励秀武, 等. 功能沟通评判性健康素养量表的汉化与信效度分析[J]. 中华现代护理杂志, 2018, 24(18): 2136-2140. doi: 10.3760/cma.j.issn.1674-2907.2018.18.007 ZHANG X F, DI H J, LI X W, et al. Sinicization and reliability analysis of the functional communication judgmental health literacy scale[J]. Chinese Journal of Modern Nursing, 2018, 24(18): 2136-2140. doi: 10.3760/cma.j.issn.1674-2907.2018.18.007
[11]	姚宏文, 石琦, 李英华. 我国城乡居民健康素养现状及对策[J]. 人口研究, 2016, 40(2): 88-97. YAO H W, SHI Q, LI Y H. Current situation and countermeasures of health literacy among urban and rural residents in China[J]. Population Research, 2016, 40(2): 88-97.
[12]	曾强, 胡馨, 胡强. 单纯性肥胖青少年健康素养状况及影响因素分析[J]. 中国健康教育, 2019, 35(12): 1070-1074. ZENG Q, HU X, HU Q. Analysis of health literacy status and influencing factors among adolescents with simple obesity[J]. China Health Education, 2019, 35(12): 1070-1074.
[13]	刘虹妍, 刘亚欣, 顾典, 等. 重庆市贫困地区慢性病人群健康素养现状及影响因素分析[J]. 现代预防医学, 2020, 47(7): 1262-1266. LIU H Y, LIU Y X, GU D, et al. Analysis of the current situation and influencing factors of health literacy among chronic disease population in poor areas of Chongqing[J]. Modern preventive medicine, 2020, 47(7): 1262-1266.
[14]	鲜洪, 刘官文, 廖薇, 等. 2018年四川省绵竹市居民健康素养现状及影响因素分析[J]. 预防医学情报杂志, 2020, 36(4): 382-388. XIAN H, LIU G W, LIAO W, et al. Analysis of the current situation and influencing factors of health literacy among residents of Mianzhu City, Sichuan Province in 2018[J]. Journal of preventive medicine intelligence, 2020, 36(4): 382-388.
[15]	王茜, 张俊青, 徐义超, 等. 合肥市城乡居民2019年慢性病防治健康素养水平及其影响因素[J]. 中华疾病控制杂志, 2020, 24(6): 682-685, 732. WANG X, ZHANG J Q, XU Y C, et al. Health literacy level of urban and rural residents in Hefei city in 2019 for chronic disease prevention and treatment and its influencing factors[J]. Chinese Journal of Disease Control, 2020, 24(6): 682-685, 732.
[16]	王瑞, 贾晓蓉, 李善鹏, 等. 青岛市居民健康素养与健康状况的关系研究[J]. 中华疾病控制杂志, 2019, 23(1): 70-74. WANG R, JIA X R, LI S P, et al. Study on the relationship between health literacy and health status of Qingdao residents[J]. Chinese Journal of Disease Control, 2019, 23(1): 70-74.
[17]	陆雯歆, 马亚娜, 刘俊宾, 等. 2018年苏州市居民健康素养水平及影响因素分析[J]. 现代预防医学, 2019, 46(20): 3768-3771, 3786. LU W X, MA Y N, LIU J B, et al. Analysis of health literacy level and influencing factors of residents in Suzhou in 2018[J]. Modern preventive medicine, 2019, 46(20): 3768-3771, 3786.
[18]	沈红利, 高雅萍, 王跃萍, 等. 同伴支持教育对慢性萎缩性胃炎患者健康行为及生活质量的影响[J]. 世界华人消化杂志, 2020, 28(19): 972-978. SHEN H L, GAO Y P, WANG Y P, et al. Effects of peer support education on health behaviors and quality of life in patients with chronic atrophic gastritis[J]. World Journal of Chinese Digestion, 2020, 28(19): 972-978.
[19]	蒋维连, 李芳, 杨平, 等. 老年慢性心力衰竭患者的多学科健康素养管理实践[J]. 中华全科医学, 2021, 19(3): 416-420. doi: 10.16766/j.cnki.issn.1674-4152.001825 JIANG W L, LI F, YANG P, et al. Multidisciplinary health literacy management practices in elderly patients with chronic heart failure[J]. Chinese Journal of General Practice, 2021, 19(3): 416-420. doi: 10.16766/j.cnki.issn.1674-4152.001825
[20]	顾英, 顾青, 郁晞, 等. 上海市某郊区社区与公共场所不同人群健康素养监测评价[J]. 中华全科医学, 2013, 11(6): 920-922. GU Y, GU Q, YU X, et al. Evaluation of health literacy monitoring among different populations in community and public places in a suburban area of Shanghai[J]. Chinese Journal of General Practice, 2013, 11(6): 920-922.