农村慢性阻塞性肺疾病高危人群健康行为与健康心理控制源的相关性研究

摘要

背景慢性阻塞性肺疾病（ COPD）是一种行为相关性疾病，其在我国农村发病率及病死率均较高，而健康行为对预防COPD的发生具有重要意义。健康心理控制源理论认为，健康内控性越高，健康行为越好。目的探讨农村COPD高危人群健康行为状况和健康心理控制源特征，并探讨二者间的关系。方法2014年11月12—15日，采用便利抽样法选取大庆市所辖肇州县五一村、五二村40岁以上的COPD高危人群作为调查对象。采用一般情况调查表、健康促进生活方式量表（ HPLPⅡ）、多维度健康状况心理控制源量表（ MHLC）对其进行问卷调查。结果共发放问卷185份，回收有效问卷176份，有效回收率为95.1％。HPLPⅡ得分（92.7±11.2）分，营养维度得分（20.1 ±2.8）分，健康责任维度得分（13.7±2.6）分，自我实现维度得分（14.5±2.6）分，人际关系维度得分（19.3±3.2）分，压力应对维度得分（15.0±2.5）分，运动维度得分（9.8 ± 2.8）分；MHLC中内控性量表（ IHLC）得分（23.6 ±5.0）分，健康权威控制量表（PHLC）得分（22.7±4.4）分，机遇量表（CHLC）得分（21.6 ±4.7）分。常模资料：IHLC得分（26.0 ± 5.0）分，PHLC得分（20.0 ± 5.5）分，CHLC得分（15.0 ± 6.0）分。农村COPD高危人群IHLC得分低于常模（ t ＝-4.69，P ﹤0.05），PHLC、CHLC 得分高于常模（ t ＝16.80，P ﹤0.05；t ＝2.62，P ﹤0.05）。IHLC得分与营养、健康责任、压力应对、运动维度得分呈正相关（ P﹤0.05）；PHLC得分与自我实现维度得分呈正相关（P﹤0.05）；CHLC得分与健康责任、人际关系、运动维度得分呈负相关（P﹤0.05）。结论农村COPD高危人群健康行为处于一般水平，心理控制源外控倾向显著，且心理控制源内控性与营养、健康责任、压力应对、运动相关；心理控制源外控倾向与健康责任、人际关系、运动相关。%Background Chronicobstructivepulmonarydisease(COPD)isabehavior-relateddisease.Its morbidity and mortality are high in the countryside of China. Health behavior is of great significance in the prevention of COPD. The health locus of control ( HLOC ) theory suggests that the higher internal control of health is, the better health behaviorsare.Objective Todiscussthehealthbehaviorsconditionsofruralhigh-riskCOPDpopulations,andthe characteristicsofHLOC,andtoexploretherelationsbetweenthem.Methods From12thto15thNovemberin2014,COPDhigh-risk populations aged over 40 in Wuyi village and Wu'er village of Zhaozhou county that under administration of Daqing were selected as the research objects by convenience sampling method. Questionnaire survey of these subjects was conducted by general situation questionnaire,Health Promotion Lifestyle Profile ( HPLP Ⅱ), Multidimensional Health Locus of Control ( MHLC ) scale.Results Atotalof185questionnairesweresentout,and176validquestionnaireswererecovered.Theeffectiveresponse rate was 95. 1%. The scores of HPLP Ⅱ, and the dimensional scores of nutrition, health responsibility, self - realization, interpersonal relationships,stress coping,exercise were(92. 7 ± 11. 2),(20. 1 ± 2. 8),(13. 7 ± 2. 6),(14. 5 ± 2. 6), (19. 3 ±3. 2),(15. 0 ±2. 5),and(9. 8 ±2. 8)respectively;in the results of MHLC,the scores of internal HLC(IHLC), powerful others HLC ( PHLC ), and chance HLC ( CHLC ) were ( 23. 6 ± 5. 0 ), ( 22. 7 ± 4. 4 ), and ( 21. 6 ± 4. 7 ) respectively. Norm data:the scores of IHLC,PHLC and CHLC were(26. 0 ± 5. 0), (20. 0 ± 5. 5)and(15. 0 ± 6. 0) respectively. The IHLC score of rural high-risk COPD populations was lower than that of the norm(t= -4. 69,P﹤0. 05), the scores of PHLC and CHLC were higher than those of the norm(t=16. 80,P﹤0. 05;t=2. 62,P﹤0. 05). IHLC score was positively correlated with the dimensional scores of nutrition, health responsibility, stress coping, and exercise ( P ﹤0. 05);PHLC score was positively correlated with the dimensional score of self -realization(P ﹤0. 05);CHLC score was negatively correlated with the dimensional scores of health responsibility,interpersonal relationships,and exercise(P﹤0. 05). Conclusion Thehealthbehaviorsofruralhigh-riskCOPDpopulationsremainsatanordinarylevel,locusofcontrolpresents significantly external control tendency,and IHLC is related with nutrition,health responsibility,stress coping,and exercise;CHLC is related with health responsibility,interpersonal relationships and exercise.