Analysis On Influencing Factors Of Functioning And Disability For Community Residents

Objective: A survey was conducted on the functional and disability status of community residents in several provinces across the country.We aimed to analyze the impact of health status and medical services on functional and disability status and to discuss disability prevention strategies and options for interventions,which can effectively reduce the risk and social,economic and psychological burden of various disabilities.Methods: All the research subjects in this study came from the sub-project 1(Establishment of the Community Cohort on Mental Disorders)of the national research and development plan(Cohort Studies on Mental Disorders in China).The survey subjects came from 16 cities in 8 provinces or autonomous regions(Beijing,Tianjin,Jilin Province,Hunan Province,Shaanxi Province,Ningxia City,Shandong Province,Zhejiang Province).These subjects participated in "Chinese Mental Health Survey" in 2013,and finished our questionnaire face to face in 2018.In total,1033 questionnaires were collected,of which 914 were valid samples.Epidata software was used to entry data,CIDI program was used for diagnosis,SPSS24.0 software was used to analyze the date.Krusk-Wallis H non-parametric test was used for univariate analysis,and significant factors from above analysis were included in multivariate logistic regression model for analysis.Results:(1)A total of 914 valid samples were colleted in this survey.Among the patients,392(42.9%)was males and 522(57.1%)were females.125(13.6%)participants were under 45 years old,346(37.9%)participants were 45-59 years old,348(38.1%)participants aged 60-74 years old,and 95(10.4%)participants greater than or equal to 75 years old.900(98.5%)subjects were Han Chinese.671(73.4%)participants had at least one kind of chronic diseases.406 participants(44.7%)had chronic neck/low back pain,271(29.6%)had arthritis/rheumatic disease,159(17.4%)had frequent or severe headaches,and 134(14.7%)had other chronic pain.279(30.5%)people were with blood pressure,147(16.1%)people were with heart disease,95(10.4%)people were with diabetes/hyperglycemia,104 people were with accidents,injuries or poisoning(11.4%),and 245(26.8%)people had sleep disorders.79(8.6%)people suffered from at least one mental disease.67(7.3%)people suffered from depression,13(1.4%)people had a bad mood,5(0.5%)people had bipolar disorder,and 58(6.3%)people had suicidal thoughts.556(60.8%)people had gone to hospital to see a doctor,333(36.4%)people were hospitalized,9(1.0%)people had received counseling or treatment,22(2.4%)people had received prescriptions or medications,195(21.3%)people had regular doctors,and 381(41.7%)people had a regular hospital/clinic.65(7.1%)people had no basic medical insurance,154 people had basic medical insurance for urban employees,32 people had basic medical insurance for urban non-employees,and 663 people had new rural cooperative medical care.90(9.8%)people had public medical services,and 120(13.1%)people participated in commercial health insurance.(2)Amon the 914 community residents who participated in the survey,631(69.0%)had no impairments,191(20.9%)had mild injuries,and 92(10.1%)had moderate or above injuries.The results show that there were have significant differences in the distribution of functional and disability status among age,ethnicity,and some chronic diseases(with chronic neck/back pain,arthritis/rheumatic disease,frequent or severe headache,other chronic pain,high blood pressure,heart disease,diabetes/hyperglycemia,stomach/intestinal ulcers,stroke,other chronic diseases and asthma),accidental/injury/poisoning,sleep disorders,mental illness(depression,poor mood,bipolar disorder),suicidal ideation,go to hospital see a doctor,hospitalization,psychological counseling/treatment,prescription drugs,regular doctor,basic medical insurance,and commercial health insurance(P <0.05).(3)The analysis of logistic regression revealed that age is a risk factor for functional and disability injury.With chronic neck/back pain(OR=1.533,95% CI:1.075-2.243),arthritis/rheumatic disease(OR=1.853,95%CI:1.285-2.670),frequent or severe headache(OR=1.958,95%CI:1.267-3.025),other chronic pain(OR=2.083,95%CI:1.353-3.209),diabetes(OR=1.881,95%CI:1.155-3.062),stroke(OR=3.016,95%CI:1.540-5.912),asthma(OR=2.912,95%CI:1.257-6.753),the accident,injury or poisoning(OR=1.795,95%CI:1.097-2.939),with sleep problems(OR=1.948,95%CI: 1.322-2.872),depression(OR=2.351,95%CI:1.318-4.191),and suicidal ideation(OR=2.134,95%CI:1.142-3.987)were risk facorts of disability and functional impairment.Medical treatment(OR=1.833,95%CI:1.219-2.757)and hospitalization(OR=1.904,95%CI:1.314-2.757)may be related to disability and functional impairment(P<0.05).The insurance for urban employees(OR=0.366,95%CI:0.169-0.793)may be a protective factor for disability and functional impairment.Conclusions: 1.283(31%)community residents in this survey had disability and functioning impairments.2.Chronic low back pain/chronic neck pain,arthritis/rheumatic disease,frequent or severe headache,other chronic pain,diabetes,stroke,asthma,accident/injury/poisoning,depression,suicidal ideation,and sleep disorders are risk factors for disability and functioning impairments.3.With medical treatment and hospitalization are related factors for disability and functional impairment.Medical insurance for urban employees may be a protective factor for disability and functioning impairments.