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OBJECTIVE@#To investigate the status and influencing factors of anxiety tendency among occupational population in China and to examine the joint association between sedentary behavior and physical activity with anxiety tendency.@*METHODS@#The data were from the 2021 Asia Best Workplace (Chinese mainland) program. The Generalized Anxiety Tendency scale was used to assess employees' anxiety status, and Logistic regression was used to analyze the factors influencing anxiety tendency and calculate the odds ratio (OR) within different groups. The OR of sitting for each sitting-physical activity (PA) combination group and within PA strata were calculated to explore the joint association.@*RESULTS@#A total of 11 903 workers with an average age of 32.9 years were included in this study. Among them, 3 562 workers had anxiety tendency (29.9%) and the prevalence of those under 40 years old (30.6%) was significantly higher than the other age group (26.7%). 41.0% of the respondents had the moderated to vigorous physical activity. Their average daily sitting time was 9.4 h, and the percentage of those who exceeded 8 h sitting reached 73.9% in the past week. The analysis of Logistic regression showed that smoking (OR=1.24, 95%CI: 1.23-1.39), longer sedentary time and lower physical activity level were risk factors for anxiety tendency, and longer average daily sleep time (OR=0.56, 95%CI: 0.51-0.61) was a protective factor. The joint association analysis and stratified analysis of physical activity and sedentary behavior with anxiety tendency showed that increased sedentary time combined with decreased physical activity intensity was significantly associated with increased risk of anxiety tendency (range of OR: 1.64-3.14). The threshold for sedentary time in total as a risk factor for anxiety tendency gradually decreased as physical activity intensity increased.@*CONCLUSION@#The anxiety tendency and sedentary behavior among the occupational population should recieve more attention. Lack of physical activity and sedentary behavior are both risk factors for anxiety tendency, and strengthening the intensity of physical activity can attenuate the harmful effects of sedentary behavior on anxiety tendency.
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Adult , Humans , Anxiety/epidemiology , China/epidemiology , Exercise , Sedentary Behavior , SleepABSTRACT
OBJECTIVE@#To understand the relationship between health literacy and patient experience of outpatients in China, and to explore its mechanism.@*METHODS@#The conceptual framework was developed based on Andersen's behavioral model of health services use and health literacy skills framework. An online cross-sectional survey was conducted with snowball sampling method, while the health literacy was measured by self-designed patient health literacy scale, and the patient experience was measured by the Chinese patient experience questionnaire for ambulatory care developed by Peking Union Medical College. And a structural equation model was built to explore the relationship between them and test the mechanism of health literacy influencing patient experience.@*RESULTS@#A total of 2 773 subjects were investigated. The average score of health literacy was (90.72±12.90) points, accounting for 78.89% of the full score, and the dimension of seeking social support had the lowest score. The average score of overall rating of patient experience was (3.71±0.74) points, and the scores of each dimension of patient experience were between 3.56 and 3.80. The model fit indices of structural equation model for overall rating of patient experience among the outpatients were χ2/df=9.29 (χ2=4 107.27, df=442), root mean square error of approximation (RMSEA)=0.055 (< 0.06), comparative fit index (CFI)=0.926 (>0.90), Tucker-Lewis index (TLI)=0.918 (>0.90), standardized root mean square residual (SRMR)=0.061 (< 0.08), the model was acceptable. The variance in patient experience explained by the model was 0.108. The structural equation model analysis results showed that the overall rating of outpatient experience was directly affected by health literacy (β=0.263, P < 0.001), also indirectly affected by health literacy (β=0.012, P < 0.001). In other words, the overall rating increased by 0.275 units for each standard deviation increase of health literacy. Self-evaluated health status mediated the relationship between health literacy and the overall rating of outpatient experience. In terms of diffe-rent dimensions of patient experience, the standardized path coefficient of the total effect of health literacy on patient experience was as follows: Information guidance 0.337, humanistic care 0.319, communication with doctors 0.294, service efficiency 0.240, and hospital environment 0.173.@*CONCLUSION@#The patients with higher level of health literacy were more likely to have a better outpatient experience in China, and the information guidance experience and humanistic care experience were most affected by health literacy. And the communication and information utilization ability had the greatest influence on patient experience.
Subject(s)
Humans , China , Cross-Sectional Studies , Health Literacy , Outpatients , Patient Outcome Assessment , Surveys and QuestionnairesABSTRACT
Objective To understand the influence path of occupational health knowledge, behavior and lifestyle, and utilization of workplace health service on chronic diseases of teachers in a district of Beijing. Method A self-designed questionnaire was used among teachers in a district of Beijing through path analysis. Results The prevalence rate of chronic diseases in occupational population was 51.5%. The top three diseases were lumbar or spinal diseases (19.0%), hypertension (12.5%) and gastroenteritis (11.1%). The rate of overweight and obesity increased with age, and male teachers were higher than that of female teachers which was statistically significant ( 2=119.313，P<0.001).Overweight-obesity, health related knowledge and utilization of workplace services made direct effects on chronic diseases. Healthy behaviors and lifestyles made indirect effects on chronic diseases by overweight-obesity. Conclusions The teachers’ health in this district was not bad. It is recommended that we should pay attention to the population of teachers, especially the male so that to prevent and control the incidence of overweight and obesity, improve their health knowledge level and develop healthy habits, and increase the input of health resources in the workplace.
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Objective To explore the path and effect of family cohesion, family adaptability and health remind on health behavior improvement of chronic disease patients, so as to provide evidences for the family-centered chronic disease management. Methods Data of all 1 134 patients with chronic diseases was selected from the national sample survey database. t-test was used to compare family cohesion, family adaptability, health remind and health behavior improvement between different groups, and Pearson correlation was used to analyze the correlation between variables. In the process of path analysis, parameters were estimated by maximum likelihood. Results Among the 1 134 chronic diseases patients, male accounted for 41.4%, and female accounted for 58.6%. The average age of participants was (53.6±10.0) years old. The score of health behavior improvement was (1.89±1.20). Path analysis showed that family cohesion had indirect effects on behavior improvement (effect size=0.072); family adaptability had both direct and indirect effects on behavior improvement (effect size=0.156); Health remind had direct effect on behavior improvement (effect size=0.357). Conclusions The high-level family cohesion and adaptability can improve patients’ health behavior by improving the health remind. It is suggested that family-centered health management services for chronic disease patients should emphasize the participation of family members as well as the improvement of family function.
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OBJECTIVE@#To provide autonomy support from three dimensions based on self-determination theory (SDT), i.e. professional support, peer support, family support, and to investigate whether this intervention can improve diabetes self-management behavior and glycemic control of diabetic patients, and to analyze the influencing factors of the effect.@*METHODS@#Using convenient sampling method, three communities were selected respectively in Beijing. Each community selected health service stations with similar conditions as different intervention groups. The diabetic patients managed by the station who were eligible for inclusion were recruited into this intervention group. The community stations were divided into three groups. The routine intervention group only issued knowledge manuals and conducted health management according to the requirements of basic public health services. Peer support groups were divided into small groups and carried out doctor-led group activities. Based on doctor-led peer support activities, the doctors and peers were trained to provide autonomy support based on self-determination theory, and their family members were trained in the form of manuals to provide autonomy support, forming a concerted support of the three dimensions. Activity processes and materials were also designed based on SDT. The intervention duration was 3 months, and the main evaluation indexes were HbA1c and patients' self-management behaviors, skills, knowledge, and self-efficacy scores.@*RESULTS@#Before and after the intervention, the HbA1c of routine intervention group were 7.40%±1.37%, 7.30%±1.18%. The HbA1c of peer support group before and after the intervention were 7.33%±1.15% and 7.13%±1.27%. The HbA1c of autonomy support group before and after the intervention were 7.42%±1.22% and 6.78%±0.80%. Before and after the intervention, the self-management score in routine intervention group was 10.54±2.28 and 10.80±2.15, the score in peer support group was 11.09±1.89 and 11.40±1.78, the score in autonomy support group was 10.34±1.99 and 11.10±1.65, respectively. The HbA1c and self-management score increased higher in autonomy support group than in the other two groups. After intervention, the control rate in autonomy support group was higher than in the other two groups. According to the multi-factor analysis, the value of HbA1c after intervention was positively related to the baseline HbA1c, and negatively related to self-management behavior. The value in autonomy support group was higher than in routine intervention group. Baseline self-management behavior, self-efficacy, knowledge, skill, family support, autonomy support, peer support and age were positively correlated with the change of behavior.@*CONCLUSION@#self-management behavior intervention based on self-determination theory can effectively promote self-management behavior and glycemic control of diabetic patients, and the effect is better than single peer support activities.