| BackgroundIn the past 20 years,the elderly population in China has been in a rapid growth trend,and the aging of the population has become an important national condition for China's economic and social development in the 21st century.By the end of 2017,China's population aged 60 and over reached 241 million,making it the largest developing country in terms of the number and scale of the elderly population.It is expected that by 2050,the number of the elderly population in China will reach a peak of 487 million,accounting for 34.9%of the total population.The "silver wave"is coming rapidly,and the problem of healthy aging industry development is becoming increasingly prominent.Although health promotion measures for the elderly population in China are constantly being explored and practiced,in the face of the rapidly growing number of elderly groups,various policies still need to be further improved and followed up.Therefore,according to the characteristics of the elderly population,using scientific and reasonable health assessment methods,exploring the health risk factors model of the elderly population,and providing positive,active and comprehensive health promotion countermeasures for the elderly population are the focus of the research field of the elderly population health in China.Objective and significanceTo carry out epidemiological survey on self-rated health status of the elderly population in Guangdong Province,summarize the physical health,mental health,social health characteristics and development trend of the elderly population in Guangdong Province,and formulate the norm of self-rated health assessment scale for the elderly population in Guangdong Province and its different health status(severe poor health,poor health,general health,good health,fairly good health).The paper explores the main factors affecting the health status of the elderly population,establishes the influencing factors model of the self-rated health status of the elderly population in Guangdong Province.Based on this,the corresponding health promotion measures for the elderly in Guangdong Province were proposed,which provided reference for the relevant departments to formulate the health policy for the elderly population,and further promoted the development process of "healthy aging".Through on-site investigation and data processing analysis,we can understand the overall health status of the elderly population in Guangzhou,provide information for the development of relevant health policies,and enrich the theoretical research results on the assessment of the health risks of the elderly population,in order to further develop targeted elderly population.The health risk factor assessment system provides theoretical basis and guidance.At the same time,it can also monitor the health status of the elderly population and help identify healthy high-risk groups.Ultimately,it will provide monitoring of the health level of the elderly population,evaluation of the effectiveness of health services,and development of health policies.The new indicators and methods also provide a more active,proactive and comprehensive health promotion strategy for the elderly population.Research object and method1.Research objectTaking the elderly population in guangdong province(the population aged 60 and over)as the research object,a stratified random sampling method was adopted to select 1,800 elderly population in 5 regions of Guangzhou,Shantou,Maoming,Shaoguan and Shenzhen for on-site self-measured health status evaluation.2.Research toolsIn this study,self-rated health measurement scale Version 1.0(SRHMS V1.0)was used as the core,and the questionnaire on the health status of the elderly population in Guangdong Province was compiled according to the social demographic factors,lifestyle and experience events of the elderly population in Guangdong Province.In recent years,SRHMS V1.0 has been widely used to measure the health status of different populations and regions.The results show that SRHMS V1.0 has good reliability and validity in different social and cultural backgrounds and populations.3.Research methods(1)Data collection methods? Document analysis methodOn the basis of extensive reading of health assessments,health management books and literature on the elderly,the relevant keywords such as "self-test health",“health management" and "Self-rated health" are searched in the corresponding Chinese and English databases,giving priority to The search results are closely related to the topic and the publications with close publication dates are downloaded and carefully read,and the main influencing factors of the health status of the elderly population are summarized.?Field investigation methodIn this study,a self-designed questionnaire was conducted among 1 800 elderly people in Guangzhou,Shantou,Maoming,Shaoguan and Shenzhen to explore the relationship between external factors such as economy,behavior,residence,diet,medical model,community service and environment,and internal factors such as gender,age,race,heredity and the health status of the elderly population.(2)Data analysis methodEpidata 3.1 software was used to establish the database to input data and to compare the two inputs to ensure the accuracy of data entry.SPSS 20.0 and AMOS 22.0 were used to analyze the data.The difference was statistically significant with P<0.05.?Reliability and validity analysis methodsIt includes Cronbach's alpha coefficient,Pearson correlation analysis,Exploratory factor analysis,Confirmatory factor analysis,which are mainly used to evaluate the reliability and accuracy of the scale in the health evaluation of elderly population in Guangdong province.? Descriptive analysisIt includes frequency,percentage,average and standard difference,describes the score of self-measured health assessment scale of elderly population from three aspects of physical health,mental health and social health,and summarizes the overall health status of elderly population in Guangdong province.?Norm formulation methodAccording to the conversion score of the total score of the self-measured health assessment scale from high to low,the health status of the subjects was divided into five states,named "severe poor health,poor health,general health,good health,fairly good health.?Single factor analysis and multi-factor analysis methodWilcoxon rank sum test,kruskal-wallis H test,orderly logistic regression test and other tests were used to analyze the influencing factors of the self-measured health of the elderly population,and to construct the health risk factor model of the elderly population in guangdong province.(3)Quality control methodThis research is based on the project of Guangdong Natural Science Foundation(project number:2015A0313267).The whole investigation process is rigorous and carried out in accordance with the project design,so as to ensure the scientific,rational and research purpose of social investigation.In order to complete the survey task on time and according to the quality,and according to the selected factors that may affect the health status of the elderly population,a questionnaire on the health status of the elderly population was designed.Based on the sample size of 1600 elderly people,the sample size of the survey was expanded from 10-20%to 1800 elderly people.A research collaboration group was established to carry out the flow of the health status of the elderly population and its influencing factors.Epidemiological investigation.Before the survey,investigators should be trained in epidemiological investigation;one-to-one survey should be adopted during the survey.Before the test,investigators should explain the method of filling in the scale and the matters needing attention to it to the testers,and then the testers should evaluate themselves independently.If the testers have difficulties in reading and writing,such as illiteracy of the elderly,vision problems,the investigators can explain the questions one by one and record the testers,answers truthfully.The evaluation results should not give prompt guidance to the testers;strict quality control and guidance supervision should be carried out on the investigation site;the team members should discuss and propose solutions to the problems encountered in the investigation in real time;the accuracy and completeness of the data should be verified after the tester completes the questionnaire,and the completed questionnaire should be logically screened at the end of the survey to eliminate the quality of filling out.Those who are not high(such as plagiarizing questionnaires,completing rate less than 80%,checking options are all the same,etc.).Results:1.A total of 1800 questionnaires were sent out in this study,and 1761 valid questionnaires were collected,with an effective recovery rate of 97.78%.2.SRHMS V1.0 is used to evaluate the reliability and validity analysis of the health status of traffic police in Guangdong province(1)Reliability analysis? Half-reliability:Spearman-brown correlation coefficient and Guttman fractional half-reliability coefficient of the two half-scales respectively were 0.804 and 0.802,indicating high fractional half-reliability.? Internal consistency reliabilitySRHMS V1.0 total table TS Cronbach's a coefficient is 0.922.Physiological self-rated health PSH,Psychological self-rated MSH,social self-rated health SSH Cronbach's a coefficient respectively was 0.852,0.808 and 0.902.(2)Validity analysis? Content validityThe correlation coefficients between SRHMS V1.0 and its corresponding dimension scores were 0.608?0.902,while those between SRHMS Vl.O and other dimensions were<0.584,P<0.01.The correlation coefficients between SRHMS V1.0 and total scale scores were 0.704?0.869,and 0.795?0.924 with corresponding sub-scale scores,while those between SRHMS V1.0 and other dimensions were<0.584,P<0.01.The correlation coefficients of sub-scale scores were<0.679,P<0.01,the Cronbache's coefficients of SRHMS V1.0 dimensions were larger than those of other dimensions or SRHMS V1.0 total scores.This study evaluated the internal consistency reliability of the questionnaire(Index system)by calculating Cronbach,s alpha coefficients,and the Cronbach's a coefficients of all items were higher than those of other dimensions or SRHMS V1.0 total scores.The alpha coefficient was 0.713,P<0.01.? Structural validityI.Exploratory Factor AnalysisKMO of SRHMS V1.0 is 0.952,Bartlett's spherical test 2 is 50771.845,and degree of freedom is 946(P<0.001),which indicates that factor analysis is suitable.Eight common factors with characteristic roots>1.000 were extracted by maximum variance rotation analysis.They were social resources,social contact and social support(Contribution rate was 33.637%),physical symptoms and organ functions(Contribution rate was 8.401%),psychological symptoms and negative emotions(Contribution rate was 7.538%),positive emotions(Contribution rate was 5.153%),and positive emotions(Contribution rate was 8.401%).Daily life function(Contribution rate was 3.743%),physical activity function(Contribution rate was 2.875%),role and social adaptation(Contribution rate was 2.605%)and cognitive function(Contribution rate was 2.386%).The cumulative variance contribution rate was 66.340%,and each item had a larger load value on one of the common factors(>0.400).?.Confirmative Factor AnalysisIn order to validate the structural validity of SRHMS VI.0,an initial structural equation model was established based on professional knowledge and scale structure.The maximum likelihood method is used to estimate the parameters,and the path coefficient of the initial model is estimated.Although the fitting results are acceptable,they are still not ideal.According to the fitting and evaluation results of the initial model and the MI index of the model,considering whether there is a potential correlation between the entries,the initial model is constantly revised to get the final model.The fitting indexes of the final model are CMIN/DF=2.854,NFI=0.900,RFI=0.902,IFI=0918,TLI=0.908,CFI=0.917,RMSEA=0.049.The fitting effect of the model is good.(3)Reactivity analysisThe highest scores of SRHMS VI.0 and the three sub-scales of physiological self-rated health,psychological self-rated health and social self-rated health were 99.88,99.53,100 and 99.68,and the lowest scores respectively were 6.88,0.80,1.08 and 15.11.The proportion of the highest score and the lowest score is very small.3.Establishment of SRHMS V1.0 norm for the elderly population in Guangdong Province(1)Mean normBy analyzing the scoring characteristics of SRHMS V1.0 scale,it was found that there were statistical differences between personality and age.Therefore,the average norm of SRHMS V1.0 was established according to gender and age.Among the male elderly population,the total score of TS in the 60-70 age group was(72.92±11.89),and that in the over-70 age group was(66.43±14.53).In the female elderly population,the total score of TS in the 60-70 age group was(70.27±12.80),and that in the over-70 age group was(63.60±14.33).(2)Percentile normThe study was grouped according to the sex and age groups that established the mean norm.The percentile norm of the total score of SRHMS VI.0 scale was established at 5%percentile intervals.Among the male elderly population,the 25,50 and 70 digits of TS in the 60-70 age group were 65.02,74.56 and 81.65,while those over 70 years old were 56.18,67.73 and 78.54.Among the elderly female population,the 25,50 and 70 digit scores of TS in the 60-70 age group were converted into 61.04,71.70 and 79.97,and 53.04,64.27 and 75.20 over the age of 70.(3)Demarcation normBased on the analysis of the total score characteristics of SRHMS V1.0 scale,the self-rated health of urban elderly population in Guangdong Province is divided into five different states:(0,x-s),severe poor health,[x-s,x-0.5s),poor health,[x-0.5s,x+0.5s),general health,[x+0.5s,x+s),good health,[x+s,100],fairly good health.By integrating the data,the universal demarcation norm of SRHMS V1.0 for the elderly population in Guangdong Province was obtained:[0,54.29),severe poor health,[54.29,61.25),poor health,[61.25,72.17),general health,[72.17,82.13),good health,[82.13,100],fairly good health.4.The score of SRHMS VI.0 in the elderly population in Guangdong ProvinceIn this study,the SRHMS V1.0 total score of the elderly population was(68.21±13.92).Among the three sub-scales,the social self-rated health sub-scale(PSH)had the lowest conversion score(66.77±17.13).The physiological and psychological self-test health sub-scale scores were(69.68±16.17),(67.68±15.69)points,are slightly higher than the social self-rated health sub-scale conversion score.5.The incidence of different health status of the elderly population in Guangdong ProvinceThe results of this study showed that the health status of the elderly in Guangdong Province was "severe poor health","poor health","general health","good health" and“fairly good health”,respectively accounting for 17.3%,14.2%,25.0%,27.1%,16.4%?6.Analysis of influencing factors of self-rated health status of the elderly in Guangdong Province(1)Single factor analysis of self-rated health status of the elderly in Guangdong ProvinceThere were significant differences in the total scores of the self-rated health scales of the elderly population with different socio-demographic factors such as gender,age,BMI,education level,marital status,and housing status(P<0.01),smoking,drinking,physical exercise,and sleep.There was a statistically significant difference in the total scores of the elderly self-test health scales with time factors such as lifestyle factors(P<0.01).(2)Multi-factor analysis of self-rated health status of the elderly in Guangdong ProvinceThe results of ordered logistic regression showed that the main factors affecting the self-rated health level of the elderly in Guangdong were gender,age,BMI,education level,marital status,living conditions,smoking,drinking,physical exercise,and sleep time.7.Countermeasures and recommendationsAs a special group,the elderly population adopts effective health promotion measures for the elderly,which can improve the health of the elderly,reduce social costs,and reduce the burden on the country and the family.This paper proposes corresponding health promotion strategies from the perspectives of policies,environment,health awareness and actions from countries,governments,communities,hospitals,families and individuals.At the national and government levels,government departments should review existing policies and regulations on healthy ageing,and develop stronger and targeted policies and regulations that should be strictly enforced at the hospital level.As a hospital providing services,it should focus on strengthening the institutional construction of long-term care.At the same time,it should formulate differentiated care programs,train nursing teams,and adapt to the needs of aging society development.At the community level,community health service institutions should be used as carriers to improve health care.Equipment and old-age facilities,while vigorously carrying out elderly health education,enhance the self-care awareness and ability of the elderly.At the family and self level,the children and relatives of the elderly should be actively mobilized to participate in various forms of health education for the elderly in order to establish good family relationships,provide better family support,and encourage the elderly to develop good living habits.Lifestyle and attitude towards life.Conclusion:1.The self-test health assessment scale(SRHMS V1.0)scale has good reliability and validity,and can accurately,reliably and sensitively reflect the self-test health status of the elderly population in Guangdong Province.2.The total conversion score of the scores of the self-rated health assessment scale of the elderly in Guangdong Province was(68.21±13.92).Among the three sub-scales,the PSH conversion score of the social self-measured health sub-scale was the lowest(66.77±17.13).The converted scores of physiological and psychological health sub-scales were respectively(69.68±16.17)and(67.68±15.69),which were slightly higher than the converted scores of social health sub-scales.3.In this study,the demarcation norm of SRHMS V1.0 scale of elderly population in guangdong province was established according to gender and age,and the health status of elderly population was successively divided into 5 states:severe poor health,poor health,general health,good health and fairly good health.The incidence of different health status respectively were 17.3%,14.2%,25.0%,27.1%and 16.4%.4.Factors affecting the self-rated health status of the elderly in Guangdong Province include:socio-demographic factors such as gender,age,BMI,education level,marital status,and housing status,lifestyle factors such as smoking,drinking,physical exercise,and sleep time.5.The factors influencing the self-measured health status of the elderly population in guangdong province include:gender,age,BMI,education level,marital status,living conditions and other socio-demographic factors;smoking,drinking,physical exercise,sleep time and other lifestyle factors. |
PDF Full Text Request