【作者】 叶旭军；

【导师】 李鲁；

【作者基本信息】 浙江大学 ， 劳动卫生与环境卫生学， 2003， 博士

【摘要】 研究目的：城市外来农民工是当前转型时期的社会弱势群体之一，他们社会地位低、劳动强度大、工作时间长、经济收入低、社会保障缺乏、劳动保护条件差。作为城市社会的边缘人群，他们的合法权益往往得不到有效的保障。大部分农民工缺乏基本的医疗卫生服务，其社会经济地位决定了他们的健康状况不容乐观。本研究的目的包括： (1)了解社会转型时期城市外来农民工的人口学特征和社会经济状况。 (2)用健康相关生命质量评价的方法对农民工的健康状况进行定量测量，并与中国的其他人群进行比较。 (3)比较不同社会人口学特征农民工人群生命质量的差异，筛选影响生命质量的主要社会经济因素。 (4)针对健康评价结果，提出改善农民工的健康状况的政策建议。 研究方法： (1)采用定额抽样的方法，在杭州城区的建筑工地、专业市场、厂矿、饭店、社区等地点对外来农民工进行自填式问卷调查，总样本量n=3319。被调查者的要求为：户口在外地农村；在杭州工作3个月以上。问卷内容包括人口学特征、职业、收入、居住情况，两种健康相关生命质量(Health Related Quality of Life，HRQOL)量表即SF-36健康量表(the MOS 36-item Short Form Health Survey)和诺丁汉健康量表(Nottingham Health Profile，NHP)。 (2)SF-36健康量表评价农民工人群的健康相关生命质量。在SF-36健康量表的各维度中，如果某维度半数及以下条目缺失，则用未缺失条目的平均分代替缺失条目分，否则该维度分数值为缺失。计算每一条目的完成情况，每一维度所有条目全部完成的比例，以及维度分数能被计算的比例。分析不同性别、年龄、文 浙江大学博士学住论文（2加3） 化程度、经济收入、劳动时间等人口社会经济学特征农民工人群在S卜36健康量 表各维度得分的差别是否具有统计学意义。 （3）NHP量表评价农民工人群的健康相关生命质量。计算NHP量表中6个维 度的平均分和得分的中位数。并比较分析不同性别、年龄、文化程度、经济收入、 劳动时间等人口社会经济学特征农民工人群在NHP量表各维度得分的差别是否 具有统计学意义。 （4）SF－36与 NHP量表的拟合分析。比较 SF－36健康量表和 NHP量表在评价 农民工人群的健康相关生命质量上的不同之处。主要采用两量表各维度得分的趋 势图以及典型相关分析的方法来分析其在评价同一样本人群健康相关生命质量 的一致性。 （5）社会人口学特征与农民工健康的相关分析。根据 SF－36健康量表的评价结 果，计算农民工人群的生理健康总分和心理健康总分，然后运用单因素分析的方 法分析生理健康总分和心理健康总分与各社会人日学因素的相关；分别作生理健 康总分和心理健康总分的 IngistiC回归分析，研究影响农民工生理健康和心理健 康的主要社会人口学因素。 “）问卷的原始数据用流行病学统计软件EpiDATA 2刀进行录入并核对；然后 用 SPSSll刀 for windows对数据进行分析。 主要结果： （1）城市外来农民工的社会人口学特征：男性占 67．9％，女性占 32．1％；平均 年龄28．8岁，最高年龄73．2岁，最低年龄13．1岁；未婚者比例40．4％，已婚且 配偶在者比例56．8％；受教育程度以初中为主，占49．5％，高中或中专占29．卫％， 小学及以下占15．4％，大专及以上占6刀％；职业主要分布在服务业（27．9％）。 建筑业（26．1％）、工业（23．2％）和商业（13．1％）；平均每周工作时间为59．6’J＼ 时，建筑业的农民工每周工作时间 61小时及以上者占 72．9％；每月经济收入主 要在600－1500元之间，其中22．6％的人月收入为800－1000元，22．3％的人月收 入为1000－1200元，16．2％的人月收入为1200－1500元，10．7％的人月收入为 刀0－799元：平均每年寄回老家的钱为3扬4．4元；47．3％的农民工居住在农民或 居民的出租房内，21石％的人住在工棚中，18二％的人住在用人单位提供的宿舍 里；49．4％的农民工未遇到过失业，一年中有过3个月以下失业者占37石％，失 2 浙江大学博士学位论文（2003） 业半年及以上的人占4．5％。 o）SF36健康量表评价农民工人群的健康状况：SF上6健康量表在本研究的性 能测试结果表明，该量表适用于测量农民工人群的健康相关生命质量；农民工 SF－36各维度均明显低于四川农村居民，其生理职能（RP）、躯体疼痛（BP）、 社会功能（SF）、情感职能（RE）等维度的得分也低于杭州市城市居民，而生理 功?更多还原

【Abstract】 ObjectivesAs one of vulnerable groups in society during the transitional period, rural-to-urban migrant workers are usually compelled with lower social status, intense labor, longer labor hour, lower income, insufficient protection from social security agencies and poor labor protection. As a marginal group, their rights are not effectively protected. Most migrant workers may not receive basic medical services; their relatively low social-economic status determines that their health status is least optimistic. Purposes of this study are thus as follows:(1) To investigate demographic features of migrant workers during China’s economic and structural reforming period and study their social-economic status.(2) To conduct quantitative survey on migrant workers’ health status in virtue of Health Related Quality of Life (HRQOL) evaluation, and compare the outcome with other populations in China.(3) To compare index of HRQOL of migrant workers with different socio-demographic features so as to screen out major socio-demographic factors that influence migrant workers’ health status.(4) To suggest policy reforms hi order to improve migrant workers’ health status according to the findings in this study.Methods(1) Quota sampling is used. 3319 rural-to-urban migrant workers, having been working in Hangzhou City proper for no less than 3 months, were investigated. Questionnaires were distributed to dozens of construction sites, markets, shopping malls, manufacture factories, restaurants and households, and collected. The investigated were required to fill out the MOS 36-item Short Form Health Survey (the Chinese version of SF-36) and Nottingham Health Profile (the Chinese version of NHP), which involve information of their demographic features, occupation, income and living conditions.(2) Migrant workers’ Health Related Quality of Life is evaluated by SF-36. When one half or fewer of the items in a scale were missing, the mean of the non-missing items was used to represent the scale. A scale score was declared missing when more than one half of the items were missing. We calculated the percentage of respondents having completed each item, the percentage of respondents having completed all theitems within each scale and the percentage of respondents for whom scale scores were computable. We also compared each scale score of SF 36 between groups of different socio-demographic features such as sex, age, education, income, labor hours and so on.(3) Migrant worker’s Health Related Quality of Life is evaluated by NHP. We calculated the mean and median of six scales of NHP, and then compare them between different socio-demographic features such as sex, age, education, income, and labor hours.(4) The outcome of HRQOL measured by SF-36 and NHP were compared in this study. The method of canonical correlation analysis was used to study the relationship of SF-36 and NHP. We drew trend curves of scores registered in SF-36 and NHP, and conducted typical analysis of correlation, so as to evaluate the consistency of both forms in judging the same group.(5) Correlation analysis of migrant workers’ socio-demographic features and health status was conducted. We calculated, from the outcomes of SF-36, migrant workers’ scores in Physical Health and Mental Health, and Single Factor Analyses were conducted to find the correlation between PH / MH and varied socio-demographic features. Logistic Regression Analyses were conducted respectively in PH and MH to stydy the major factors affecting migrant workers’ physical health and mental health as far as socio-demographic features are concerned.(6) Raw data derived from the questionnaire were input twice and checked automatically by epidemic statistical package EpiDATA 2.0 and then analyzed by SPSS11.0 for windows.Main Results(1) Socio-demographic features of rural-to-urban migrant workers: male workers occupy 67.9% while female occupy 32.1%; average age is 28.8 with a range from 73.2 to 13.1; sin更多还原