【作者】 孙延波；

【导师】 姚燕；

【作者基本信息】 吉林大学 ， 公共卫生硕士（专业学位）， 2020， 硕士

【摘要】 目的:了解辽宁省居民中医药健康文化素养水平并分析其影响因素,为行政部门制定健康政策提供科学依据。方法:在辽宁省范围内,采用分层多阶段抽样的方法抽取12个县（市、区）15⁶9岁常住居民作为调查对象进行调查。调查使用《中国公民中医药健康文化素养调查问卷》进行。本研究中共发放问卷3350份,收集有效问卷3242份,有效率96.78%。男性占46.4%,女性占53.6%,平均年龄47.95岁。应用EpiData,SPSS22.0进行数据录入和统计分析。对研究中的计数资料使用率或构成比做描述性分析、使用c²检验或秩和检验做差异性分析。多因素分析采用二元Logistic回归模型,在模型中纳入单因素分析中有统计学差异的变量（P<0.05）。结果:1、辽宁省居民中医药健康文化素养总体水平为13.1%。在中医药健康文化素养五个维度中,中医药信息理解能力素养水平最高,为38.8%;居第二位的是居民中医药健康生活方式素养为26.8%;中医药文化常识素养与基本理念素养水平接近,分别为25.4%和25.8%;中医药公众适宜方法水平为3.6%。2、中医药健康文化素养水平单因素分析中,表现出中医药健康文化素养水平城市高于农村（c²=47.277,P<0.001）;年龄中表现为25-35岁和35-45岁有较高水平,55岁以上素养水平较低（c²=28.485,P<0.001）;文化程度中,中医药健康文化素养水平随着文化程度的提高而提高(c²_趋势=141.777,P<0.001);机关事业单位/教师/医务人员水平较高,农民健康素养水平较低（c²=143.515,P<0.001）;年收入中,高收入人群健康文化素养水平高于低收入人群（c²=54.345,P<0.001）。3、五维度中医药健康素养水平单因素分析中,城乡、文化程度、职业、家庭收入为五维度素养水平分布共同存在差异的因素（P<0.001）。中医药文化常识素养水平男性高于女性（c²=4.248,P<0.05）;五维度健康素养除中医药公众适宜方法,其他四维度在不同年龄分组中差异具有统计学意义（P<0.05）,具体表现为25-35岁,35-45岁素养水平较高,<25岁,55-65岁和>65岁素养水平较低。4、多因素Logistic回归显示,中医药健康文化素养总体水平独立影响因素为文化程度和职业。与小学及以下文化程度人群相比,大专/本科及以上人群健康文化素养水平优势比是小学及以下文化程度的2.977倍（95%CI为1.807⁴.906）。农民健康文化素养水平优势比是机关事业单位人员/教师/医务人员的0.288倍（95%CI为0.181⁰.461）。5、多因素分析文化程度为五维度素养共同的影响因素,表现为文化程度越高越易具备中医药素养;性别为中医药健康生活方式素养和中医药文化常识素养共同的影响因素,均表现为男性比女性更易具备文化素养;除中医药公众适宜方法素养外,职业是其余四维度素养的共同影响因素,表现为农民较机关事业单位人员/教师/医务人员更不易具备文化素养;家庭年收入是,中医药健康生活方式素养、中医药信息理解能力素养共同的影响因素,表现为高收入人群较低收入人群更易具备文化素养;城乡是中医药公众适宜方法素养独立影响因素,表现为城市居民较农村居民更易具备文化素养。结论:1、辽宁省居民的中医药健康文化素养水平13.1%,与发达地区相比仍有较大差距。2、在五个维度中,中医药公众适宜方法水平仅为3.6%。3、辽宁省居民的中医药健康文化素养及五维度素养的主要影响因素为性别、文化程度、职业、家庭年收入。中医药健康文化知识与技能普及的重点人群是低文化程度人群、农民和学生、低收入群体。更多还原

【Abstract】 Objective:To understand the level of Chinese medicine health literacy of Liaoning residents and analyze its influencing factors,so as to provide scientific basis for the administrative departments to formulate health policies.Method:In Liaoning Province,permanent residents aged 15 to 69 from 12 counties(cities and districts)were selected for investigation by multi-stage sampling method.The content of the survey is the questionnaire of Chinese citizens’health and cultural literacy of traditional Chinese medicine.In this study,a total of 3350 questionnaires were distributed,3242 valid questionnaires were collected,effective rate was96.78%.46.4%of them were male,53.6%were female,and the average age was 47.95years old.EpiData software and SPSS 22.0 statistical software were used for double data entry and data analysis.The count data was described by ratio or composition ratio,the difference analysis was carried out by means of 2-test or rank sum test.Multivariate analysis was conducted by binary logistic regression model,the model included variables with statistical differences in single factor analysis(P<0.05).Result:1.The overall level of Chinese medcine health literacy of Liaoning residents is13.1%.In the five dimensions of Chinese medicine health culture literacy,the literacy level of Chinese medicine information understanding is the highest,38.8%;the literacy level of Chinese medicine health lifestyle is 26.8%;the literacy level of Chinese medicine culture common sense is close to the basic concept literacy of Chinese medicine,25.4%and 25.8%respectively;the public appropriate method level of Chinese medicine is 3.6%.2.In the single factor analysis of the level of Chinese medicine health literacy,it shows that the level of Chinese medicine health literacy in cities is higher than that in rural areas(c~2=47.277,P<0.001);25-35 years old and 35-45 years old have a higher level,while residents over 55 years old have a lower level(c~2=28.485,P<0.001);in the education,the health literacy level of traditional Chinese medicine increases with the improvement of the education level(c~2趋势=141.777,P<0.001);the level of government institutions/teachers/medical staff is higher,and the farmers is lower(c~2=143.515,P<0.001);in the annual income,the level of high-income group is higher than that of low-income group(c~2=54.345,P<0.001).3.In the single factor analysis of five-dimensional Chinese medicine health literacy level,urban and rural areas,education level,occupation and family income are the factors of common differences in five-dimensional literacy level distribution(P<0.001).The literacy level of traditional Chinese medicine culture in men is higher than that in women(c~2=4.248,P<0.05);the five-dimensional health literacy except for the public appropriate method of traditional Chinese medicine,the other four dimensions have statistical significance in different age groups(P<0.05),showing that the literacy level of 25-35 years old,35-45 years old is higher,<25years old,55-65 years old and>65 years old is lower.4.Multivariate logistic regression shows that the independent influencing factors of the overall level of Chinese medicine health literacy are education level and occupation.Compared with the primary school and below,the health literacy level advantage ratio of college/undergraduate and above is 2.977 times(95%CI:1.807-4.906)of the primary school and below.The level of health literacy of farmers is 0.288 times higher than that of the staff/teachers/medical staff in government institutions(95%CI,0.181-0.461).5.Multi factor analysis shows that the higher the level of education,the more likely to have the quality of traditional Chinese medicine;gender,the more likely to have the quality of traditional Chinese medicine;gender,the more likely to have the quality of healthy lifestyle of traditional Chinese medicine and common sense of traditional Chinese medicine culture,both show that men have more cultural literacy than women;in addition to the public appropriate method literacy of traditional Chinese medicine,the occupation is the other four-dimensional literacy The common influencing factors are that the farmers are less likely to have cultural literacy than the staff of government agencies/institutions/teachers/medical staff;the family annual income is the common influencing factors of Chinese medicine healthy lifestyle literacy and Chinese medicine information understanding literacy,and the high-income people are more likely to have cultural literacy than the low-income people;the urban and rural areas are independent of Chinese medicine public appropriate method literacy The influencing factors are that urban residents are more likely to have cultural literacy than rural residents.Conclusion:1.The level of Chinese medcine health literacy of Liaoning residents is 13.1%,which is still far behind that of developed areas.2.Among the five dimensions of Chinese medicine health literacy,the level of public appropriate methods of Chinese medicine is only 3.6%.3.The main influencing factors of Chinese medcine health literacy and five-dimensional literacy of Liaoning residents are gender,education level,occupation and annual family income.The key population for the popularization of knowledge and skills of Chinese medicine health culture is low educated people,farmers and students,and low-income groups.更多还原