| Background:Since entering the 21st century,our country has stepped into an aging society,and an aging population becomes a prominent social hot issue in our country.Chronic diseases are associated with an ageing population and have become an important public health problem.Represented by cardiovascular and cerebrovascular diseases,tumor and diabetes,chronic diseases increasingly threaten the health of the people of our country and have become the biggest public health problem in China.Overweight and obesity has become the main threat to the health of urban and rural residents in China and showed a trend of rising along with the industrialization progress and the change of life style,the trend of population aging and disease patterns of our country.This phenomenon has leaded to serious harm to the personal health and severe social burden of disease.Containment of the hazard caused by the rising trend of overweight and obesity has been one of the major public health problems of the department of national health.Overweight and obesity is not only an independent chronic disease but also a risk factor to T2DM,cardiovascular disease,cancer and other chronic diseases.Therefore,the strategies transformation for overweight and obesity from treatment to prevention,from high-risk group to susceptible population are important priorities.It is of great significance to conduct effective intervention for overweight and obesity.Objective:Explore the correlation between different factors and overweight or obesity through health survey data analysis to the urban communities,rural communities and upper nursing institution based on the KAPC view.This can provide health management intervention strategy for the community elderly overweight people.Material:(1)Object:The basic questionnaire data of this study was from the "Special Scientific Research for Traditional Chinese Medicine" in 2013 named as "Research health monitoring and key techniques of intervention about of the elderly community based on the characteristics of traditional Chinese medicine".Researchers processes in questionnaire and physical examination among Beijing Huichen elderly community,Hongshan urban community of Hubei province and XiShui rural community in July-September 2014,the respondent were elderly people no less than 45 years old.The project plan was approved by the ethics committee of China Academy of traditional Chinese medicine Guang’an men hospital,and all participants signed informed consent.(2)Basic information and the physical and mental health status:The basic questionnaire data of this study was from the "Special Scientific Research for Traditional Chinese Medicine" in 2013,which mainly included the following basic information:name,gender,age,marital status,birth place,nationality,occupation,educational level,alcohol,tobacco,hobbies,movement,mood,pressure,somatosensory,health and other information.These data were used to understand the basic information of the respondents and physical and mental health status.The healthy cognitive level was used to evaluate the health of respondent’s cognitive level which was detected by HCQ-16 questionnaire scale.(3)Data acquisition:This study adopted questionnaire survey,including respondents filling in the questionnaire and investigator answer completing the questionnaire accompany respondents answering the questions.(4)Quality control:Investigators were medical students of bachelor degree or above receiving special training.Training content mainly includes the purpose of investigation,questionnaire related knowledge training,correct writing way of the questionnaire and communication skills,etc.After completing the questionnaire on the spot investigation,the questionnaire information were verified by the investigators and quality controller to control the quality and ensure the integrity of the questionnaire information.(5)Inclusion and exclusion criteria:The inclusion criteria were no less than 45 old years,and permanent residents with local census register.The exclusion criteria were unconsciousness,serious body diseases and other mental diseases or uncooperative people.(6)The relevant standard:Over-weight and obesity:according to the criterion of<China’s adult overweight and obesity prevention and control guidelines>,BMI=weight/height2(kg/m2),the underweight is BMI<18.5kg/m2,the normal weight is 18.5kg/m2≤BMI<24.0kg/m2,the overweight is 24.0kg/m2≤BMI<28.0kg/m2 and the obesity is BMI≥28.0kg/m2.Method:(1)Study the literatures of overweight and obesity retrospectively for the diagnosis criteria,influencing factors and the Chinese medicine cognition---the etiology and pathogenesis,the characteristic intervention methods(including the dialectical therapy of Chinese medicine,the acupuncture and moxibustion,the sports therapy and synthetic therapy)and intervention models,which can provide theoretical basis for influencing factors and intervention strategies of overweight people.(2)We built KAPC perspective with Chinese characteristics through the theoretical study and combining with the characteristics of overweight and obesity intervention model.Count the incidence rate of overweight and obesity people by means of measuring the height,weight and BMI.The respondents were divided into two groups according to BMI of normal weight people and overweight or obesity people after general statistical description.Then the distributions of the attitude,behavioral and state conditional factors of the two groups were described through one-way AVOVA.Those factors that had statistical significance(P<0.05)would be absorbed into logistic regression analysis to analysis the correlation between the factors and overweight or obesity.Then the intervention strategies were put forward combined with the analysis results.Results:(1)A total of 714 people were included into this study according to the inclusion and exclusion criteria,including 160 people of the upper nursing community,288 people of the urban community and 266 people of the rural community.The number of overweight and obesity people was 303 according to the diagnostic criteria,which make up 42.44%of the whole survey people,including 32.35%of the overweight and 10.08%of the obesity.There were 248 men and 466 women,which accounted for 34.7%and 34.7%respectively.There were 288 person aged from 60-75 old years,accounting for 40.30%,and the number of people aged from 45 to 59 was roughly equal to that of 75 old years.About 80.5%of the elderly were in the state of marriage,and other marital status took up 19.5%.In this study,the rate of illiteracy and semiliterate was about 23.89%,junior high school degree or below accounted for 35.45%,senior high school degree or above was 40.66%.The highest occupation proportion was agriculture,forestry,fishing and water conservancy,which was about 33.6%,and there was little difference between men and women.People without title took up 63.7%,people with primary or mid-level title occupied 17.8%and senior titles took up 18.5%.(2)The one-way AVOVA results showed that factors---such as marital status,wills for participating in health education,weight management wills,physical activity,appropriate walking,sleep state,work stress,mood changes,life satisfaction,health assessment,regional,cultural degree,sick---possessed statistical differences between normal group and the overweight or obesity group(P<0.05).(3)The logistic regression analysis showed three results.①Rural community was a protective factor for overweight and obesity.The disease risk of urban community is 0.803 multiple compared with that of upper nursing community,and the risk of rural community is 0.213 multiple compared with that of upper nursing community.Non-marriage state was a protective factor for overweight and obesity.The disease risk of non-marriage state people is 0.330 multiple compared to that of marriage state people.②Higher education was a protection for overweight and obesity people among knowledge factors.With the culture degree going up,the disease risk went down gradually.The disease risk of elementary school and junior high school background people is 0.470 multiple compared to that of illiterate and semiliterate people.The disease risk of high school background or above people is 0.272 multiple compared to that of illiterate and semiliterate people.The overweight and obesity risk of people who had nice cognitive awareness about bad habits leading to disease is 0.352 times compared to those who didn’t.③Wills for participating in health education and weight management wills were favorable factors among attitudinal factors.The disease risk of people who had willing to participate in health education and weight management were 0.618 times and 0.660 times respectively relative to those who didn’t want to.④Among behavioral factors,non-moderate physical activity,non-walking and poor sleep were dangerous factors.The risks of non-moderate physical activity,non-moderate working and poor sleep people were 1.075,1.168,1.547 times respectively than control group.⑤Among state conditional factors,less work pressure,higher life satisfaction and higher self-health evaluation were protective factors for overweight and obesity.Relative to high pressure people,low pressure people have the risk of overweight and obesity for 0.274 times.High life satisfaction people have the risk of overweight and obesity for 0.708 times relative to low life satisfaction people.High self-health evaluation people have the risk of overweight and obesity for 0.175 times relative to low self-health evaluation people.Whereas,sick was risk factors.Relative to the sick,sick people has the risk of overweight and obesity for 2.109 times than those without sickness.Conclusion:(1)KAPC module for the elderly overweight and obese people was tentatively proposed through literature review retrospectively based on the "overall concept" of Chinese medicine.(2)In this study,non-moderate physical activity,non-moderate walking and sickness were dangerous factors for overweight and obese people based on KAPC view,and high degree of education,high healthy cognitive level and preferable physical and mental state condition were favorable factors.(3)Under the guidance of the idea of "Preventive treatment of diseases",combining with literature review and the analysis results of the influence factor about community overweight and obese elderly people based on KAPC perspective,we probe into the intervention strategy for overweight and obesity.Scientific health cognition is the precondition of health attitude and behavior.Only one person truly realize the importance of health and how to keep healthy can he form the idea of health in mind.Sport is one of the basic elements of keep vigorous.We draw conclusions that health education should reflect differentiation,and should be focused on rural community and the appropriate pattern should be family education and peer education.Behavioral interventions should reflect quantification,and should adopt moderate and sustainable way.Therapy of traditional Chinese medicine can help restore a balance of Yin and Yang of the human body,and take count of both life safety and the quality of life,so overweight and obesity people match up traditional Chinese medicine intervention methods according to their own health conditions. |
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