Relation of smoking status to family health and personality traits in residents aged over 18 years in China / 北京大学学报(医学版)

OBJECTIVE@#To explore the relation of smoking status to family health and personality traits in residents aged over 18 years in China by binary Logistic regression analysis, to identify the psychosocial factors that influence tobacco use, and to provide evidence to predict smoking susceptibility based on personality traits and prevent smoking at individual and family levels.@*METHODS@#Residents aged over 18 years in China were selected from "the Survey of Chinese Family Health Index (2021)". General characteristic questionnaire, short-form of family health scale, 10-item big five inventory were used to collect sociodemographic information, family health function and personality traits. And the relation of smoking status to family health and personality traits were analyzed by binary Logistic regression analysis.@*RESULTS@#Totally 10 315 adults were collected, of whom there were 2 171 smokers. The smoking rate was 21.05%, 41.76% of the residents were male, 3.69% female, 20.03% urban, 23.77% rural, 12.60% aged between 18 and 35 years, 27.11% aged between 36 and 59 years, 34.35% aged over 60 years, and the smoking rate varied in gender, location, age, education, marital status, family types, and average household monthly income (P < 0.05). Furthermore, the scores of family health, family social and emotional health processes, family healthy lifestyle, family health resources, family external social support, agreeableness, openness, and neuroticism among smokers were lower than those of the non-smokers (P < 0.05). The results of binary Logistic regression analysis showed that the residents over 35 years old, with low educational level and divorced were the risk factors to smoking (P < 0.05), while female, unmarried, nuclear family, high scores of family social and emotional health processes and family health resources, openness, neuroticism, and agreeableness were the protective factors to smoking (P < 0.05).@*CONCLUSION@#Besides gender, age, location, education, marital status, family types and average household monthly income, family health, and personality traits were also important factors influencing smoking status. Tobacco control based on personality traits and family health is essential, and more convincing research is necessary to determine the relation of tobacco use, tobacco dependence and smoking cessation to family health and personality traits.

To explore medication adherence of patients with type 2 diabetes mellitus using the latent profile analysis based on the Big Five personality theory / 北京大学学报(医学版)

OBJECTIVE@#To explore the personality portraits of patients with type 2 diabetes mellitus (T2DM), its relationship with medication adherence and the influencing factors of medication adherence.@*METHODS@#T2DM patients from 22 community health service stations of 4 community health service centers in Tongzhou district and Shunyi district in Beijing were selected as the research objects. A self-designed questionnaire was used to collect demographic information. The short version of Big Five personality scale was used to collect personality information, and latent profile analysis was used to explore their personality portraits. The medication adherence was evaluated by medication adherence scale, and the difference of medication adherence among the different personality portraits was explored by analysis of variance. The influencing factors of medication adherence were explored by the ordinal Logistic regression model.@*RESULTS@#In the study, 751 T2DM patients were included. Latent profile analysis showed that the T2DM patients in this study could be divided into four types of personality portraits, including introverted and stable type (42.7%), negative type (12.7%), anxiety type (15.3%) and active and responsible type (29.3%). Among them, 75 patients said that they did not use medicine or insulin, 5 patients were lack of data, and finally 671 patients with T2DM were included in the analysis about medication adherence. The analysis of variance showed that there was no significant difference in medication adherence between anxiety type (5.55±1.65) and negative type (5.94±1.53, P=0.089), but the medication adherence score of anxiety type was significantly lower than that of introverted and stable type (6.17±1.46, P=0.001) and active and responsible type (6.09±1.65, P=0.004). Anxiety type and negative type were seen as a whole in the ordinal Logistic regression model named anxiety and negative type. The results showed that compared with anxiety and negative type, the active and responsible type or introverted and stable type was the protective factor for good medication adherence (OR=1.567, 95%CI: 1.096-2.237; OR=1.774, 95%CI: 1.214-2.591), and the education level also affected the medication adherence.@*CONCLUSION@#T2DM can be classified into four types of personality portraits based on Big Five personality theory. The anxiety and negative type after the combination of anxiety type and negative type is the independent risk factor for poor medication adherence. In addition, education level is also the influencing factor of medication compliance.

Factors associated with quality of life in 747 patients with type 2 diabetes in Tongzhou District and Shunyi District of Beijing / 北京大学学报(医学版)

OBJECTIVE@#To investigate the situation of quality of life in patients with type 2 diabetes and its associated factors.@*METHODS@#Questionnaires, physical examination and glycated hemoglobin test were conducted in 747 patients with type 2 diabetes. Hemoglobin A1c (HbA1c) was a proxy for glycemic control, diabetes specific quality of life scale (DSQL) score was a proxy for quality of life. Factors associa-ted with DSQL were analyzed by multiple linear regression and structural equation modeling (SEM).@*RESULTS@#A total of 747 patients were included in this study. The mean HbA1c level was (7.1±1.2)%, with 35.1% reaching the target (262/747). There were significant differences in disease duration, me-dication and use of insulin, smoking, and body mass index (BMI) between the two groups with good and poor glycemic control (P < 0.05). The total score of DSQL was 44.92±13.32, in which average phy-siological factors were the highest, then followed by scores of psychological factors. Multiple linear regression showed that monthly household income, comorbidities, depression, duration of illness, insulin, hospitalization, and self-efficacy were significantly associated with the total score of DSQL (P < 0.05). SEM showed that blood glucose control was significantly associated with the scores of physical factors (0.166), psychological factors (0.076), and social factors (0.124) of DSQL, respectively. Depression had effects on the physical factors (0.342), psychological factors (0.217), and treatment factors (0.050) of DSQL (P < 0.05).@*CONCLUSION@#Glycemic control in our study is relatively poor but the quality of life remains well. More attention should be paid to patients who are male, with long diagnosis duration, poor medication adherence, smoking, with depression and with low diabetes-related skills. In practice, health practitioners should be aware of psychological needs of patients, and offer mental health education to patients and their families, in order to help patients manage blood glucose and improve their quality of life.

Effectiveness evaluation of health belief model-based health education intervention for patients with hypertension in community settings / 中华预防医学杂志

To evaluate the effectiveness of health belief model-based health education intervention in improving blood pressure control of patients with hypertension in community settings. From September 2016 to September 2017, 400 newly diagnosed patients with hypertension were recruited from 6 community healthcare centers with comparable population size and health services in the Shunyi District of Beijing. All community healthcare centers were randomly assigned to the intervention group (206 patients) and the control group (194 patients). Patients in the intervention group received 3 lectures (20-30 min for each) of health belief model-based health education. Patients in the control group received usual care. The basic characteristics, health beliefs, and health literacy were collected, and blood pressure was measured before and after the intervention, respectively. The difference-in-difference model was used to analyze the change of blood pressure and the influencing factors between two groups before and after the intervention. A total of 134 patients in the intervention group and 129 patients in the control group completed the study. After adjusting for the age, gender, family income, medical insurance, chronic diseases and family history, the score of perceived barriers was increased by 1.65 (0.016), and perceived seriousness was decreased by 0.73 (0.018). The systolic blood pressure of patients was decreased by 7.37 mmHg (1 mmHg=0.133 kPa, 0.001) and diastolic blood pressure was decreased by 4.07 mmHg (0.014), respectively. The β (95) values were -7.37 (-11.88,-2.86) and -4.07 (-7.30, -0.84). The perceived susceptibility and self-efficacy had a significant influence on the blood pressure of patients (0.05). Health belief model-based health education intervention could significantly improve the blood pressure control of patients with hypertension in the community settings.

Relationship between the five-factor model of personality traits and self-management attitude of patients with type 2 diabetes / 北京大学学报(医学版)

OBJECTIVE@#To explore the correlation between different personality characteristics and self-management attitude such as medication, exercise and diet in patients with type 2 diabetes mellitus.@*METHODS@#The patients with type 2 diabetes mellitus from 4 Community Healthcare Services and 22 affiliated community stations of Tongzhou District and Shunyi District of Beijing were selected as subjects. The Chinese big five personality inventory and the self-designed scale including the attitudes of medication, exercise and diet were used in the study.@*RESULTS@#In this study, 642 subjects were finally included, among whom the sex ratio of male and female was basically the same, 61.21% were over 61 years old. In this study, different genders had differences in neurotic personality (P<0.05), different age groups had differences in agreeableness and openness (P<0.05), different education levels had differences in openness and extraversion (P<0.05), and different income levels had differences in agreeableness, openness and extraversion (P<0.05). The linear correlation analysis of the five-factor moldel of personality traits with medication, exercise and diet attitude showed that three items of perceived disorders of medication were positively correlated with neuroticism (r=0.125, 0.187, 0.151, P<0.05), four items of perceived disorders of exercise were positively correlated with neurotic personality (r=0.163, 0.129, 0.119, 0.104, P<0.05), and perceived benefits of exercise were positively correlated with conscientiousness (five items, r=0.156, 0.111, 0.131, 0.104, 0.131, P<0.05), agreeableness (two items, r=0.092, 0.078, P<0.05) and extraversion (four items, r=0.079, 0.122, 0.115, 0.123, P<0.05), three items of perceived disorders of diet were positively correlated with neuroticism (r=0.115, 0.137, 0.108, P<0.05), and two items of were negatively correlated with conscientiousness (r=－0.126, －0.161, P<0.05) and agreeableness (r=－0.103, －0.115, P<0.05). In the canonical correlation analysis, according to the formula combination of three groups of typical variables and canonical structure diagrams, neuroticism and agreeableness played major roles in personality traits, and items that represented "obstacles" in medication, exercise, and dietary attitudes played a major role.@*CONCLUSION@#All the five personality traits were correlated with the self-management attitude of type 2 diabetes patients, and different personality traits have an impact on the self-management of patients with type 2 diabetes mellitus. In particular, it is of great significance to understand neuroticism for improving the mental health and quality of life of patients with type 2 diabetes mellitus. Therefore, attention should be paid to the influence of psychological factors in community management of type 2 diabetes and disease self-management, and the personalized care and health education should be carried out according to the personality traits of patients.

Prediction of 3-mouth glycemic control in type 2 diabetes mellitus based on machine learning algorithm / 中华疾病控制杂志

Objective To evaluate the efficiency of Logistic regression algorithm and random forest algorithm in prediction of blood glucose control in patients with type 2 diabetes mellitus (T2DM) after 3 months, and explore the influencing factors of blood glucose control. Methods The data was extracted from baseline survey and follow-up information of patients with T2DM in Shunyi and Tongzhou Districts. The patient’s 3-month glycosylated hemoglobin which was more than 6.5% was chosen as the outcome categorical variable. The random forest algorithm and Logistic algorithm were used to establish the prediction model. The predictive efficiency was evaluated with the area under receive operating characteristic curve (AUC) and accuracy rate. Results Factors affecting the patient’s glycemic control included baseline fasting plasma glucose(P<0.001), duration of disease(P<0.001), smoking(P=0.026), static activity time(P=0.006), body mass index(overweight P=0.002, obesity P=0.011), bracelet use(P=0.028), and diabetes diet(P=0.002).The Logistic regression prediction model had an AUC of 0.738, a sensitivity of 72.9%, a specificity of 68.1%, and an accuracy of 71.2%. The random forest model had an AUC of 0.756, a sensitivity of 74.5%, a specificity of 69.5%, and an accuracy of 72.8%. Conclusions The efficiency of random forest is better than Logistic regression model, which can be applied to the prediction of blood glucose control and assist the management of diabetic patients.

Influential factors of leisure exercise among patients with type 2 diabetes mellitus based on the planned behavior theory / 中华疾病控制杂志

Objective This study applied the theory of planned behavior to investigate the leisure exercise situation among patients with type 2 diabetes mellitus (T2DM) and its influencing factors. Methods The questionnaire was self-designed based on the theory of planned behavior, which had good reliability and validity. Structural equation modeling was used to estimate the determinants of leisure exercise and the potential intermediate effect. Results 774 patients with T2DM were enrolled in this study. 52.6% were over 60 years old. The median amount of leisure exercise was 0.0 thousand-step equivalent with quartile of (0.0, 2.0). Structural equation modeling showed that the effects of attitude (β=0.080) and intention (β=0.277) on leisure exercise were significant. Besides, perceived behavioral control (β=0.180) had an indirect effect on exercise through intention. Conclusions In general, most patients with type 2 diabetes have insufficient amount of exercise. Improving attitude, control and intention to exercise would be one crucial part of exercise health education among patients with T2DM.

A comparative study on safe sexual behavior and its intention among college students in Beijing between 2006 and 2016 / 中华疾病控制杂志

Objective To compare the changes of safe sexual behavior and its intention among college students in Beijing between 2006 and 2016, and to provide evidence for reproductive health education for prevention and control of sexually transmitted diseases (STDs). Methods By a stratified random sampling method,a questionnaire survey was conducted among college students in Beijing in 2006 and 2016 respectively. Results The rate of sexual behaviors declined ( 2=81.150,P<0.001), while the percentage of homosexual behavior among respondents in 2016 was higher than that in 2006( 2=12.115,P<0.001). Meanwhile, the age of first sexual intercourse (t=12.009, P<0.001) and the intention of safe sexual behavior declined( 2=10.375,P<0.001). In both surveys, the proportion of risk behaviors among students who ever had sexual behavior was higher than that of students never had sexual behavior. Multivariate linear regression analysis showed that the intention of safe sexual behavior among college students was associated with gender, age, self-efficacy of condom use, UNGASS index, visiting entertainment places and browsing pornographic information on the Internet(all P<0.05).Conclusions Compared with 2006, the safe sexualbehavior, intention and their risk factors among college students in Beijing changed greatly in 2016. The contents and approaches of intervention related to STDs and reproductive health should be changed according to the current situation in order to improve the intention of safe sexual behavior among college students and to control the occurrence of STDs.

Application of multi-group structural equation model in comparative study of HBM related to recreational physical activity among population with high risk of chronic diseases and healthy people / 北京大学学报(医学版)

OBJECTIVE@#To explore mechanism of health beliefs by application of health belief model (HBM) and structural equation modeling (SEM) with regard to recreational physical activity (PA), to identify the differences of among population with high risk of chronic diseases and healthy people, and to provide the specific interventions of recreational physical activity and reference for health relevant policy-making in the future.@*METHODS@#A total of 2 736 residents with high risk of chronic diseases and 1 514 healthy people were involved. A questionnaire survey, physical examination and biochemical examination were conducted. The questionnaire based on HBM had acceptable validity and reliability. The proposed model based on the total sample size of the two groups was developed using the structural equation modeling and multi-comparison in the ways of appearance and parameters were also validated.@*RESULTS@#The median amount of recreational (PA) among population with high risk of chronic diseases and healthy people were 0.0 thousand-step equivalent with quartile of (0.0, 4.6) and 0.0 thousand-step equivalent with quartile of (0.0, 4.0) respectively. The results of SEM suggested that the direct effects of perceived objective barriers (β=-0.245), perceived subjective barriers (β=-0.057), cues to action (β=-0.043) and self-efficacy (β=0.117) on recreational (PA) were significant. Self-efficacy was the most important mediator. The multi-group comparisons indicated that the models of the two groups had the same appearance but the parameters between them were significant (δ χ2=27.4, P<0.05). The multi-group structural equation model (MSEM) indicated that two paths from cues to action and from perceived subjective barriers to recreational (PA) were not statistically significant among the population with high-risk of chronic diseases. In the two groups, one path coefficient from perceived objective barriers to subjective barriers (P=0.007) was statistically significant (P<0.05).@*CONCLUSION@#The recreational (PA) levels of both groups were lower. Health beliefs on recreational (PA) of the two groups played different roles and some paths were also different. Therefore, specific interventions and strategies should be developed for different people. For residents with high risk of chronic diseases, much more attention should be paid to reduce the objective and subjective barriers of recreational physical activity and to improve self-efficacy so as to delay or prevent the occurrence of chronic diseases and then to improve the quality of life of this kind of population.

A survey on respiratory infectious diseases related health literacy and health behavior in Fengtai district, Beijing / 中华预防医学杂志

<p><b>OBJECTIVE</b>This study aims to survey respiratory infectious disease related health literacy (RIDHL) and health behavior (RIDHB) among residents in Fengtai district, Beijing, analyze impact factors of RIDHL , explore the association between RIDHL and RIDHB.</p><p><b>METHODS</b>Multistage sampling was employed and 1100 respondents were surveyed by self-designed questionnaires, which including social-demographic characteristics and evaluation of RIDHL and RIDHB. The survey results were described, the impact factors of RIDHL and the association between RIDHL and RIDHB were analyzed by analysis of variance or covariance.</p><p><b>RESULTS</b>A total of 998 qualified questionnaires were recollected with the effective rate of 90.7%. The respondents aged from 15 to 65, scored (71.3 +/- 19.0) points in RIDHL test. Of those respondents, 25.7% (256/998), 43.2% (432/998) and 31.1% (310/998) were evaluated as low( <60 points), medium (60 - 85 points), and high level ( > 85 points) of RIDHL, respectively. There were significant difference in RIDHL scores between registered and non-registered residents, who scored (74.1 +/- 18.9) and (68.4 +/- 18.8) points, respectively (P < 0.01). RIDHL sections were ranked as audiovisual (77.6%, 4647/5988), internet using (75.2%, 2251/2994), reading (74.6%, 3724/4990), map using (68.3%, 4090/5988) and quantitative (65.5%, 5230/7984) according to the accurate rates from high to low. Analysis of variance or covariance showed that RIDHL scores were significantly different among respondents with different ages, nationalities, educational levels, occupations, and incomes (P < 0.01), yet no significant differences among those with different genders and marital status (P > 0.05). Respondents scored (69.7 +/- 15.5) points in RIDHB test. The RIDHB scores ((64.5 +/- 15.0), (70.4 +/- 15.6), (72.5 +/- 14.9) points, respectively) increased among residents with low, medium and high level of RIDHL (P < 0.01).</p><p><b>CONCLUSION</b>Residents in Fengtai district, Beijing possessed medium level of RIDHL. The non-registered residents showed lower RIDHL than registered residents. Ages, nationalities, educational levels, occupations, and incomes were impact factors of RIDHL. People with higher level of RIDHL also showed a higher level of RIDHB.</p>