Study On Sub-health State And Associated Factors Among Civil Servants In Tianjin

ObjectiveTo assess the sub-health state and its influencing factors among civil servants in Tianjin, China. Sub-Health Measurement Scale version1.0(SHMS V1.0) was used to assess the sub-health state of subjects and the reliability and validity of SHMS V1.0were also evaluated. Countermeasures and suggestions to improve the health status of civil servants have also been proposed at last.Subjects and method Study population and SamplingA total of3,610valid samples from22civil service departments based in Tianjin were recruited and stratified cluster sampling strategy was used. Instrument and assessment methodsSelf-designed questionnaire was used, including basic information scale, SHMS V1.0, SF-36and Pittsburgh Sleep Quality Index (PSQI). ProcedureA cross-sectional study was conducted in Tianjin, from August to November2010. Each subject was asked to fill out an anonymous questionnaire by themselves. Data management and statistical analysisQuestionnaires were entered using Epidata Entry3.1and were rechecked to ensure the accuracy of the data. The statistical analysis was conducted using the SPSS15.0statistical package. The reliability and validity of SHMS V1.0and PSQI was evaluated by calculating the split-half reliability, Cronbach’s alpha coefficient, construct validity, discriminate validity and criterion-related validity. The influencing factors of health status were further evaluated using proportional odds logistic regression model. The influencing factors of sub-health were also applied using binary logistic regression model.Result Response rateA total of4,095questionnaires were distributed and3,610effective questionnaires were recovered, yielding a response rate of88.16%. The reliability and validity of SHMS V1.0The test-retest reliability of SHMS V1.0is0.853, the split-half reliability is0.959, Cronbach’s a coefficient is0.928. Factor analysis produced eight components, explained64.43%of total variance. Result of factor analysis match the original theoretical conception about SHMS V1.0. The Spearman correlation coefficient between SHMS V1.0and SF-36is0.786(P<0.001). The reliability and validity of PSQIThe split-half reliability of PSQI is0.881, Cronbach’s a coefficient is0.746. Factor analysis produced eight components which explained52.91%of total variance. Most items have a higher factor loading in one of the three factors, while relatively lower in other factors. Sub-health detection rate of Tianjin civil servantsSub-health detection rate of Tianjin civil servants was65.43%,64.48%for male and66.71%for female.30-40y age group had the highest sub-health detection rate. Associated factors of sub-healthThe proportional odds logistic regression model demonstrate that gender, age, ethnic group, education, irregular breakfast, physical exercise, sleep quality, negative events experience affect the health status of civil servants.The binary logistic regression model showed that sleep disorders significantly increased the detection rate of Tianjin civil servants (OR=11.967), leading the influencing factors. Alcohol consumption, sedentary or prolonged computer operation, negative events experience positively and significantly affected the detection rate. Eating breakfast every day and regular exercise negatively and significantly affected the detection rate, constituting the protective factors of sub-health.ConclusionSHMS V1.0has good reliability and validity, and is suitable for sub-health evaluation among Tianjin civil servants. PSQI has good reliability and validity, and is a simple, effective sleep quality measurement tool.Sub-health detection rate of Tianjin civil servants was65.43%. The rate of women was higher then men,30-40y age group had the highest sub-health detection rate. The associated factors of sub-health include:gender, age, ethnic group, education, job type, unhealthy living habits and lifestyle, negative events experience, and sleep disorders. Excluding the impact of other factors, negative events experience and sleep quality had the strongest correlation with sub-health, and deserves further study.