| Objective: Xinjiang has been entered the ageing society in2010, The elderly peoplewere2.33million,10.8%by the end of2011. The increasing nuclear families decreasethe capacity to care the elders, many elderly people will select nursing home to live intheir old age. At the same time, elderly people were social vulnerable groups,60～70%of them combined with various diseases, they were expected to assume a greater role inmaintaining their health and wellness. At present, health education and health promotionare viewed as the principal methods to improve health level in internationally, healthliteracy become an important indicator for judgment. Health literacy has been definedas“the degree to which individual have the capacity to obtain, process and understandbasic health information and services needed to make appropriate health decision”. Thepurpose of this study were to find out the status quo and influence factors of healthliteracy of elderly people in nursing home, the relations among health literacy andself-care agency, physical-mental health, social condition, to apply the structural equationmodel (SEM) to establish the influence modes of health literacy. To provide theevidences for intervention program and to improve self-care agency, physical and mentalhealth, social condition. Methods: A stratified cluster random sampling method wasselected. There are44nursing home,4500elderly people in Urumuqi, Changji, Karamay,Shihezi city. The investigator obtained the information from elderly people who met theinclusive and exclusive criteria through interview method. A total of1396questionnaireswere qualified and were studied. All data were analyzed by statistical analysis softwarepackage of SPSS (version15.0) and AMOS (Analysis of Moment Structures, version17.0), including descriptive analysis, single factor analysis, multiple linear regression,pearson correlation analysis, canonical correlation analysis and SEM analysis. Results:1. The status quo and influence factors of health literacy of elderly people in nursing home.(1) Analysis on the status quo and influence factors of health literacy of elderly people innursing home: The results showed that the health literacy of elderly people in nursinghome of Xinjiang were very low. The score of health literacy were highest in age from65to74, the higher the age were, the lower the health literacy were. Male were higher thanfemale. Han were higher than minority. The higher the education lever were, the higherthe health literacy were, the college and above were the highest. The higher thehousehold income were, the higher the health literacy were. In marital status, thedivorced elderly people were the highest, the unmarried were the lowest. The higher theformer profession were, the higher the health literacy were, the managers were thehighest, the professionals were secondly, the peasants were the lowest. The influencefactors of health literacy include education level, race, former profession, householdincome, age, marital status.(2) Comparation between local city and the XinjiangProduction and Construction Corps. The health literacy scores of elderly people innursing home of local city were75.46±30.41, the four dimensions such as healthknowledge were34.30±18.34, health attitudes were23.60±7.75, health behavior were11.00±4.32, health skills were7.41±5.32, to compared with the Xinjiang Productionand Construction Corps (the health literacy scores were70.17±22.83, the fourdimensioms such as health knowledge were31.81±13.48, health attitudes were22.52±6.65, health behavior were9.35±3.61, health skills were4.49±3.40), there werenot statistical significants in health knowledge, health attitudes (P＞0.05), and werestatistical significants in health literacy, health behavior and health skills (P＜0.05).(3)Comparation between cooperation with hospital and noncooperation with hospital: Thehealth literacy scores of elderly people in nursing home of the cooperation with hospitalwere73.09±25.18, the four dimensions such as health knowledge were32.58±14.35,health attitudes were22.98±6.81, health behavior were12.10±4.13, health skills were6.67±3.52, to compared with the noncooperation with hospital (the health literacy scoreswere71.61±28.74, the four dimensioms such as health knowledge were32.47±17.16,health attitudes were22.78±7.49, health behavior were9.59±3.81, health skills were5.03±5.07), there were statistical significants in health behavior, health skills (P＜0.05)and were not statistical significants in health literacy, health knowledge, health attitudes(P＞0.05).2. The relation among health literacy and self-care agency, physical-mentalhealth, social condition.(1) The relation between health literacy and self-care agency:The self-care agency scores were108.72±17.37, the high level were about43.48%, intermediate level were about56.38%, low level were about0.14%, The self-care agencygave priority to the intermediate level. Canonical correlation analysis showed thatcorrelation coefficient between health literacy and self-care agency were0.457. Thecorrelation were larger between health attitudes, health behavior and self-care skills,self-esteem.(2) The relation between health literacy and social support: The socialsupport scores were31.33±7.34, they were very low to compare with national norm(t=8.42, P＜0.001). Canonical correlation analysis showed that correlation coefficientbetween health literacy and social support were0.372. The correlation were largerbetween health attitudes, health behavior and subjective support, objective support.(3)The relation between health literacy and health status: The health status scores (physicalhealth were52.57±10.70, mental health were52.20±8.19, ADL were23.67±9.27): thetotal points of physical health and mental health were104.77±16.92, the high level wereabout25.64%, intermediate level were about71.20%, low level were about3.15%, thephysical health and mental health gave priority to the intermediate level. The functionallesion of activities of daily living in elderly people were about52.29%, they weredependent in different degrees. Canonical correlation analysis showed that correlationcoefficient between health literacy and health status were0.308. The correlation werelarger between health attitudes, health behavior and physical health, ADL. They werepositive correlation between health attitudes, health behavior and physical health, werenegative correlation between health attitudes, health behavior and ADL.3. To establishinfluence mode of health literacy to self-care agency, physical-mental health, socialcondition through SEM. The path analysis showed: there was a direct influence path fromhealth literacy to self-care agency, the path coefficient were0.263. there was a directinfluence path from health literacy to social support, the path coefficient were0.471.There were direct and indirect influence path from health literacy to health status: thepath coefficient were0.074of a direct influence path, the path coefficient were0.194ofthree indirect influence paths, the total effects were0.268. In a word, the influence werevery significant from health literacy to self-care agency, social support and health status.Among them, There were more influence paths from health literacy to health status, theindirect effects were larger than direct effect. Conclusion:1. The health literacy levelwere very low in elderly people of nursing home. The key intervention objects of healthliteracy are those elderly people who are female, minority, lower education level and theXinjiang Production and Construction Corps. If more nursing homes are cooperated withhospitals, and more work teams are formed to provide health education and health promotion, to improve health literacy and meet health requirement, more elderly peoplecan manage health by himself, the healthy aging will come true.2. There are closerelations among health literacy, self-care agency, physical and mental health, socialcondition, the emphases and contents of health literacy intervention should be focus onhealth attitudes, health behavior.3. The model fitting are fine of the SEM of healthliteracy influence mode, they are correspond with the threshold theory. The regressionpath analysis show that all the influence path are tenable. The health literacy influencemode can be used in the intervention works of health education and health promotion inelderly people of nursing home. |
PDF Full Text Request