老年慢性病患者健康信息寻求行为现状及影响因素路径分析

doi:10.3969/j.issn.1674-8115.2022.06.016

上海交通大学学报（医学版） ›› 2022, Vol. 42 ›› Issue (6): 805-812.doi: 10.3969/j.issn.1674-8115.2022.06.016

• 论著 · 公共卫生 • 上一篇

老年慢性病患者健康信息寻求行为现状及影响因素路径分析

崔培荣¹(), 倪雪萍², 宗明灿¹, 忻笑³, 江雨露¹, 李贤华⁴()

^1.上海交通大学护理学院，上海 200025
^2.上海交通大学医学院附属瑞金医院护理质量控制办公室，上海 200025
^3.上海交通大学医学院附属瑞金医院肿瘤科，上海 200025
^4.上海交通大学医学院附属瑞金医院门诊办公室，上海 200025

收稿日期:2022-01-17 接受日期:2022-05-02 出版日期:2022-06-28 发布日期:2022-08-19
通讯作者: 李贤华 E-mail:peirongcui@sjtu.edu.cn;eliana2005@126.com
作者简介:崔培荣（1990—），女，硕士生；电子信箱：peirongcui@sjtu.edu.cn。
基金资助:
上海交通大学护理学院护理高原学科建设专项基金(hlgy16031kygg)

Status and path analysis of influencing factors on the health information seeking behavior in elderly patients with chronic diseases

CUI Peirong¹(), NI Xueping², ZONG Mingchan¹, XIN Xiao³, JIANG Yulu¹, LI Xianhua⁴()

^1.Shanghai Jiao Tong University School of Nursing, Shanghai 200025, China
^2.Nursing Quality Control Office, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
^3.Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
^4.Outpatient Office, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received:2022-01-17 Accepted:2022-05-02 Online:2022-06-28 Published:2022-08-19
Contact: LI Xianhua E-mail:peirongcui@sjtu.edu.cn;eliana2005@126.com
Supported by:
Special Fund for the Construction of Nursing Plateau Discipline of Shanghai Jiao Tong University School of Nursing(hlgy16031kygg)

摘要/Abstract

摘要：

目的·了解老年慢性病患者健康信息寻求行为的现状、影响因素及其作用路径。方法·2020年10月—2021年9月采用目的抽样法选取上海交通大学医学院附属瑞金医院502例老年慢性病患者为调查对象，采用一般资料调查表、慢性病患者健康素养量表（Health Literacy Management Scale，HeLMS）、慢性病自我效能感量表（Chronic Disease Self-Efficacy Scale，CDSES）、健康信息寻求行为量表（Health Information Seeking Behavior，HISB）进行调查。采用IBM SPSS 26.0软件和Mplus 8.3软件对数据进行分析。结果·老年慢性病患者的健康信息寻求行为总均分为（3.30±0.40）分；单因素分析显示，不同年龄、居住地、学历、月收入、医保类型、健康信息的可理解程度和可信程度、自我效能感、健康素养和是否曾为亲友寻求信息的老年慢性病患者的健康信息寻求行为得分差异具有统计学意义（均P<0.05）；路径分析显示，健康信息的可理解程度、自我效能感、健康素养、健康信息的可信程度、学历、居住地、医保类型、月收入、曾为亲友寻求健康信息可直接影响健康信息寻求行为，直接效应依次为0.479、0.225、0.197、-0.197、0.154、0.145、-0.119、-0.085、0.070（均P<0.05）。月收入、健康信息的可理解程度、健康素养可通过健康信息的可信程度间接影响老年慢性病患者健康信息寻求行为，间接效应依次是-0.036、0.033、0.032（均P<0.05）。结论·老年慢性病患者健康信息寻求行为现状不佳，最重要的影响因素是健康信息的可理解程度，主要影响因素是健康素养、自我效能感、学历、健康信息的可信程度、居住地、医保类型、月收入和曾为亲友寻求健康信息。建议医务人员应了解健康信息寻求行为的特征及其影响因素，加强对健康信息寻求行为的评估并及时实施干预措施，以提高老年慢性病患者的健康信息寻求行为水平。

关键词: 健康信息寻求行为, 影响因素, 路径分析, 慢性病, 老年人

Abstract:

Objective·To understand the status quo, influencing factors and action paths of health information seeking behavior in elderly patients with chronic diseases.

Methods·From October 2020 to September 2021, five hundred and two elderly patients with chronic diseases in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were selected by objective sampling method. General Information Questionnaire, Health Literacy Management Scale (HeLMS), Chronic Disease Self-Efficacy Scale (CDSES), Health Information Seeking Behavior Scale were used. IBM SPSS 26.0 software and Mplus 8.3 software were used for statistics analysis.

Results·The total average score of health information seeking behavior of elderly patients with chronic diseases was (3.30±0.40) points. The univariate analysis showed that different ages, residence, education, incomes, types of medical insurance, comprehensibility of health information, credibility of health information, self-efficacy, health literacy, and seeking health information for family members had statistically significant differences (all P<0.05). The path analysis results showed that comprehensibility of health information, self-efficacy, health literacy, education, credibility of health information, residence, type of medical insurance, income, and seeking health information for friends and families can directly affect health information seeking behavior, and the direct effects was 0.479, 0.225, 0.197, -0.197, 0.154, 0.145, -0.119, -0.085, 0.070 (all P<0.05). Income, comprehensibility of health information, and health literacy can indirectly affect the health information seeking behavior of elderly patients with chronic diseases through the credibility of health information, and the indirect effects were -0.036, 0.033, 0.032 (all P<0.05).

Conclusions·The current status of health information seeking behavior among elderly patients with chronic diseases is poor. The most important influencing factor is the understandability of health information, and the main influencing factors are health literacy, self-efficacy, education, credibility of health information, residence, type of medical insurance, income, and seeking health information for friends and family. It is suggested that medical staff should understand the characteristics and influencing factors of health information seeking behavior, strengthen the assessment of health information seeking behavior, and implement timely intervention measures to improve health information seeking behavior of elderly patients with chronic diseases.

Key words: health information seeking behavior, influencing factor, path analysis, chronic disease, the elderly

中图分类号:

R193

崔培荣, 倪雪萍, 宗明灿, 忻笑, 江雨露, 李贤华. 老年慢性病患者健康信息寻求行为现状及影响因素路径分析[J]. 上海交通大学学报（医学版）, 2022, 42(6): 805-812.

CUI Peirong, NI Xueping, ZONG Mingchan, XIN Xiao, JIANG Yulu, LI Xianhua. Status and path analysis of influencing factors on the health information seeking behavior in elderly patients with chronic diseases[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(6): 805-812.

图/表 4

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Item	n（%）	HISB （x±s）	t/χ²	P
Age			2.126	0.035
<75 years old	409 （81.5）	3.32±0.41
≥75 years old	93 （18.5）	3.23±0.35
Gender			0.300	0.849
Male	223 （44.4）	3.30±0.44
Female	279 （55.6）	3.29±0.37
Marriage			1.298	0.195
Married	455 （90.6）	3.31±0.41
Unmarried or other	47 （9.4）	3.23±0.38
Residence			5.716	0.000
Town	228 （82.9）	3.35±0.38
Country	47 （17.1）	3.05±0.45
Education			47.849	0.000
Elementary school and lower	46 （9.2）	2.76±0.39
Junior high school	140 （27.9）	3.25±0.37
High school or technical secondary school	155 （30.9）	3.33±0.33
College degree and above	161 （32.1）	3.46±0.36
Monthly income			2.168	0.023
<5 000 yuan （CNY）	196 （39.0）	3.27±0.44
≥5 000 yuan （CNY）	306 （61.0）	3.35±0.44
Insurance type			2.160	0.034
New rural cooperative medical insurance	68 （13.5）	3.16±0.58
Urban employee/resident basic medical insurance	434 （86.5）	3.32±0.37
Internet access			1.328	0.185
No	110 （21.9）	3.25±0.41
Yes	392 （78.1）	3.31±0.40
Number of chronic diseases			1.636	0.102
1	186 （37.1）	3.26±0.37
≥2	316 （62.9）	3.32±0.42
Disease duration			1.834	0.068
<5 years	153（30.5）	3.25±0.37
≥5 years	349（69.5）	3.31±0.41
Family history			0.219	0.827
No	278 （55.4）	3.30±0.39
Yes	224 （44.6）	3.29±0.43
Have ever been seeking information for families or friends			3.973	0.000
No	237 （47.2）	3.22±0.39
Yes	265 （52.8）	3.37±0.41
Comprehensibility of health information			－11.220	0.000
No	302 （60.2）	3.15±0.38
Yes	200 （39.8）	3.52±0.33
Credibility of health information			－6.658	0.000
No	273 （54.4）	3.19±0.37
Yes	229 （45.6）	3.42±0.41
Health Literacy			－8.758	0.000
Does not have	373 （74.3）	3.21±0.38
Have	129 （25.7）	3.55±0.38
Self-efficacy			－6.531	0.000
Not good	341 （67.9）	3.22±0.40
Good	161 （32.1）	3.46±0.37

Item	n（%）	HISB （x±s）	t/χ²	P
Age			2.126	0.035
<75 years old	409 （81.5）	3.32±0.41
≥75 years old	93 （18.5）	3.23±0.35
Gender			0.300	0.849
Male	223 （44.4）	3.30±0.44
Female	279 （55.6）	3.29±0.37
Marriage			1.298	0.195
Married	455 （90.6）	3.31±0.41
Unmarried or other	47 （9.4）	3.23±0.38
Residence			5.716	0.000
Town	228 （82.9）	3.35±0.38
Country	47 （17.1）	3.05±0.45
Education			47.849	0.000
Elementary school and lower	46 （9.2）	2.76±0.39
Junior high school	140 （27.9）	3.25±0.37
High school or technical secondary school	155 （30.9）	3.33±0.33
College degree and above	161 （32.1）	3.46±0.36
Monthly income			2.168	0.023
<5 000 yuan （CNY）	196 （39.0）	3.27±0.44
≥5 000 yuan （CNY）	306 （61.0）	3.35±0.44
Insurance type			2.160	0.034
New rural cooperative medical insurance	68 （13.5）	3.16±0.58
Urban employee/resident basic medical insurance	434 （86.5）	3.32±0.37
Internet access			1.328	0.185
No	110 （21.9）	3.25±0.41
Yes	392 （78.1）	3.31±0.40
Number of chronic diseases			1.636	0.102
1	186 （37.1）	3.26±0.37
≥2	316 （62.9）	3.32±0.42
Disease duration			1.834	0.068
<5 years	153（30.5）	3.25±0.37
≥5 years	349（69.5）	3.31±0.41
Family history			0.219	0.827
No	278 （55.4）	3.30±0.39
Yes	224 （44.6）	3.29±0.43
Have ever been seeking information for families or friends			3.973	0.000
No	237 （47.2）	3.22±0.39
Yes	265 （52.8）	3.37±0.41
Comprehensibility of health information			－11.220	0.000
No	302 （60.2）	3.15±0.38
Yes	200 （39.8）	3.52±0.33
Credibility of health information			－6.658	0.000
No	273 （54.4）	3.19±0.37
Yes	229 （45.6）	3.42±0.41
Health Literacy			－8.758	0.000
Does not have	373 （74.3）	3.21±0.38
Have	129 （25.7）	3.55±0.38
Self-efficacy			－6.531	0.000
Not good	341 （67.9）	3.22±0.40
Good	161 （32.1）	3.46±0.37

Item	χ²	χ²/df	TLI	CFI	SRMR	RMSEA
Index	2.601	2.601	0.934	0.997	0.010	0.056
Reference	‒	1－5	>0.90	>0.90	<0.05	<0.08

Item	χ²	χ²/df	TLI	CFI	SRMR	RMSEA
Index	2.601	2.601	0.934	0.997	0.010	0.056
Reference	‒	1－5	>0.90	>0.90	<0.05	<0.08

Variable	Direct effect	Indirect effect	Total effect	Total effect ranking
Seeking health information for friends and families	0.070	‒	0.070	9
Comprehensibility of health information	0.479	0.033	0.512	1
Credibility of health information	0.154	‒	0.154	5
Education	-0.197	‒	-0.197	4
Residence	0.145	‒	0.145	6
Monthly income	-0.085	-0.036	-0.121	7
Insurance type	-0.119	‒	-0.119	8
Self-efficacy	0.225	‒	0.225	3
Health literacy	0.197	0.032	0.230	2

老年慢性病患者健康信息寻求行为现状及影响因素路径分析

Status and path analysis of influencing factors on the health information seeking behavior in elderly patients with chronic diseases

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