【作者】 孙文霞；

【导师】 齐艳；

【作者基本信息】 延边大学 ， 护理硕士（专业学位）， 2016， 硕士

【摘要】 目的：了解延吉市脑卒中高危人群健康素养与健康产出现状,探讨脑卒中高危人群健康素养的影响因素,以及健康素养对健康产出的影响,为提高脑卒中高危人群健康素养改善健康产出状况提供依据。方法：采用非实验性研究,利用整群便利抽样法选取延吉市330名脑卒中高危人群,进行健康素养、自我效能、生活质量三方面问卷调查,并对血压、身高、体重、空腹血糖及血脂等健康产出指标进行测量。采用SPSS17.0中文版统计软件进行统计分析,运用频数、百分比描述研究对象的一般人口学特征；均数、标准差、构成比描述研究对象的健康素养、自我效能、生活质量及临床相关指标等健康产出现状；t检验及单因素ANOVA分析研究对象健康素养在一般人口学特征上的差异；单因素方差分析检验研究对象在不同健康素养水平,健康产出的组间差异；Pearson相关性检验分析脑卒中高危人群的健康素养与健康产出(自我效能、生活质量及临床相关指标)之间的相关性；运用多元线性回归分析研究对象健康素养与健康产出的线性关系。结果：(1)脑卒中高危人群健康素养平均得分(167.51±34.80)分,健康素养各维度得分由高到底依次为阅读能力、理解能力、运算能力。其中,健康素养缺乏者占17.6%,临界健康素养占28.5%,健康素养充足者占53.9%。年龄、性别、婚姻、居住状况、职业、文化程度、月收入影响脑卒中高危人群健康素养。(2)脑卒中高危人群健康产出项目中的自我效能略低,平均得分(26.12±7.28)分；生活质量平均得分(83.40±11.54)分；临床相关指标中BMI均值为(24.65±3.39),属于超重状态,血糖均值(6.12±1.50)mmol/L,稍微偏高,总胆固醇(4.94±1.00)mmol/L,甘油三酯(1.77±1.10)mmol/L,低密度脂蛋白(3.00±0.75)mmol/L,高密度脂蛋白(1.40±0.34)mmol/L,均在正常范围内。不同健康素养水平脑卒中高危人群中的自我效能、血糖存在显著性差异(P≤0.05,P≤<0.01),其他指标无差异(P>0.05)。(3)脑卒中高危人群健康素养与自我效能得分呈正相关(r=0.185,P≤0.01)：与生活质量得分也呈正相关(r=0.130,P≤<0.05)；而与血糖呈负相关(r=-0.144,P≤0.01)。(4)脑卒中高危人群健康素养对健康产出有影响,是脑卒中高危人群自我效能、生活质量、血糖的影响因素,随着健康素养水平增高,自我效能得分越高,生活质量越好,血糖控制越好。结论：(1)延吉市脑卒中高危人群健康素养水平处于中等水平,健康产出中自我效能偏低,生活质量均值为(83.40±11.54)分,BMI超重,血糖偏高,血脂指标总体较好。建议延吉市卫生保健人员应积极制定并有效开展科学的健康教育干预策略,积极开展防控措施,逐步提高该类人群健康素养、自我效能、生活质量水平,.降低BMI、血糖指标。(2)年龄、性别、别、婚姻、居住状况、职业、吸烟、饮酒、文化程度、月收入影响脑卒中高危人群的健康素养。(3)脑卒中高危人群健康素养与自我效能、生活质量、血糖有相关性,不同的健康素养水平影响脑卒中高危人群的自我效能、生活质量及血糖。更多还原

【Abstract】 Objective:The aim of this study is to describe the status of health literacy and health outcomes among high risk population of stroke in Yanji; To investigate factors affecting the health literacy of high risk population of stroke and the impact of health literacy on health outcomes; To provide evidences for improving health literacy and promote health outcomes among high risk population of stroke.Methods:This study is a non-experimental study. We applied cluster convenient sampling method to select 330 stroke high risk humans of stroke in Yanji; conducted questionnaire method targeting health literacy, self-efficacy and quality of life; measured the blood pressure, height, weight, biochemical indicators including fasting blood glucose and lipid.Spssl7.0(Chinese version) was used to do the statistical analysis, using frequency and percentage to describe the general demographic characteristics of study objects; using mean, standard deviation and constituent ratio to describe health outcomes status including health literacy, self-efficacy, quality of life and so on; using one-way ANOVA analysis to clear the differences of objects’ health literacy in demographic characteristics; using single factor analysis of variance to test differences on health outcomes between the two groups when objects were at different levels of health literacy; using the Pearson correlation test to analysis the relevance of health literacy and health outcomes (self-efficacy, quality of life)among humans at high risk of stroke; using multiple linear regression analysis to find the linear relationship between health literacy and health outcomes.Results:(1)The average score of health literacy among high risk population of stroke was(167.51±34.80) points; Each dimension of health literacy scores from high to low were the ability of reading, comprehension and calculation; Of 330 people surveyed, approximately 17.6% had inadequate health literacy,28.5% had margin health literacy, while 53.9% had adequate health literacy. Age, gender, marital status, living status, occupation, education level and monthly income affected the health literacy in high risk population of stroke. (2)In the health outcomes among high risk population of stroke, the average self-efficacy score was (26.12± 7.28), lower than the international normal mode; the average score in Quality of life was(83.40± 11.54); in clinical relevant indicators, BM1 was(24.65±3.39),it was on the overweight state; the average glucose was(6.12 ± 1.50),it was slightly high; total cholesterol was(4.94 ± 1.00), triglycerides was(1.77±1.10), low-density lipoprotein was(3.00±0.75), high density lipoprotein was(1.40±0.34),they were within the normal range. There was a significant difference between self-efficacy and blood glucose in high risk population of stroke with different levels of health literacy, (P≤0.05, P≤0.01), no significant difference with other indicators (P>0.05). (3)Health literacy and self-efficacy scores were positively correlated (r=0.185,P≤0.01); Health literacy and scores in quality of life showed a significantly positive correlation (r=0.130, P≤0.05).Health literacy and blood glucose were significantly negatively correlated (r=-0.144, P≤0.01). (4)Health literacy in high risk population of stroke influenced their health outcomes and it was a factor influencing their self-efficacy, quality of life and blood glucose.With increased health literacy level, objects would get higher scores in self-efficacy, better quality of life and superior glucose control.Conclusions:(1)High risk people of stroke in Yanji had middle level of health literacy,their self-efficacy scores were lower than the international normal mode in health outcomes, the average score in Quality of life was(83.40±11.54). BMI belonged to the overweight status, blood glucose was high, and serum lipids were generally good. We recommend relevant departments in Yanji should actively develop and effectively carry out scientific health education intervention strategies and prevention or control measures to gradually improve people’s health literacy, self-efficacy and quality of life,decrease BMI and glycemic index in the mean time.(2)Age, gender, marital status, living status, occupation, smoking, alcohol consumption, education level and monthly income were associated with health literacy in high risk population of stroke.(3)Health literacy in high risk population of stroke was associated with self-efficacy, quality of life and blood glucose. Different levels of health literacy affected the self-efficacy, quality of life and blood sugar in high risk population of stroke.更多还原