基于“健康中国2020”目标的二维人口健康不公平指数研究

目的：本研究基于“健康中国2020战略”,旨在开发一种可综合评价人口健康公平性的二维指数。这里将公平性定位于“人口健康产出的平等”。方法：应用生态学研究、因子分析等方法对中国31个省、自治区和直辖市的人口健康不公平指数进行测算。之后。对健康不公平指数的信度和效度进行检验。资料主要来源于2003年国家卫生服务调查数据。结果：由8个变量合成的中国人口健康不公平指数（IHI）的中住数为0．27838π（范围：0π～0．39002π）。该指数具有较高的内部一致性（Cronbach α系数＝0．8304）和信度（Spearman相关系数〉0．8．P〈0．05）。IHI与社会剥夺指数（Spearman相关系数＝0．731,P〈0．05）、期望寿命（Spearman相关系数＝-0．569,P〈0．05）和基尼系数（Spearman相关系数=0．805。P〈0．05）间具有较好的相关性。结论：IHI是一种二维、具有较好信度和效度的监测“健康中国2020”战略的指数．它与基尼系数相比在对人口健康公平性的综合评估方面更具优势。该指数还可应用于政策干预效果评价、弱势群体的确定及卫生资源分配等领域。     

高龄老人健康自我评价的变化及影响因素分析

文章通过对三次高龄老人调查数据分析,描述了高龄老人健康自评及其变化,初步分析了部分人口、社会、健康变量对高龄老人健康自评的影响。研究结论是:高龄老人的健康自评具有相对的稳定性,其变化与实际健康状况的变化呈现出较大的一致性;老年人健康自我评价随着客观条件的变化而改变,并不是完全主观的判断。高龄老人的性别、年龄、受教育程度等个人特征对健康自评有影响,但不如健康相关变量那么关键。随着年龄的增长,老年人健康自我评价下降。     

中国老年人隔代照料与 健康后果的实证研究及政策思考

在中国家庭代际关系的研究中,隔代照料这一选题极为重要,隔代照料也是老年和家庭福利政策制定的重要影响因素。老年人隔代照料与健康问题日益受到国内学者的关注,但对两者相关性的深入实证考察较少,仅有的研究也未就隔代照料产生的健康后果达成共识,政策应对亦存局限。为此,本文基于2014年中国老年社会追踪调查(CLASS)截面数据,探讨中国老年人照料孙子女对自身健康产生的后果及几个主要变量之间的交互作用,对其进行量化研究并通过稳健性检验。研究得出三项基本结论:隔代照料的健康后果受到照料强度、子女特征、居住模式及老年人自身罹患慢性疾病状况的影响,在不同的特征状况下呈现不同的健康结果;照料者受教育程度、照料者性别、健在子女数等变量间的交互作用对被解释变量(照料者健康)产生了不同程度的调节作用,成年子女向上的代际支持也对老年照料者的健康发挥了调节作用;使用工具变量(照料者是否享受老年优待政策)进行因果识别在一定程度上克服了解释变量与被解释变量间的内生性问题。最后,本文基于上述实证研究的结果从代际关系视角、社会性别视角和老年婚姻社会功能等方面提出公共政策的应对思考,以期为制定相应的老年和家庭福利政策提供策略和依据。     

中国老年人健康累计赤字指数及其效度分析

通过与国际研究比较,本文发现中国老年人健康累计赤字指数的年龄性别分布与其他国家非常相近。同时,基于中国老年人口健康长寿调查数据,本研究发现不同健康变量所建构的健康累计赤字指数的性别分布很一致,被访老人的某一特征与不同健康累计赤字指数之间的关系模式非常吻合,不同健康累计赤字指数与死亡之间的关系也很一致。这些结果充分揭示健康累计赤字指数的效度较好,且不同人口之间具有较高的可比性。     

老年人口健康生活质量评价原则的探讨

老年人口健康生活质量的评价是社会养老保障决策过程中的重要依据之一。目前 ,尽管各国都进行了许多有关的评价研究 ,但老年人口生活质量的评价还没有较成熟的权威性量表 ,各种方法各有利弊。本文结合传统的老年人健康状态和功能评价 ,以及老年人口的特点 ,探讨了老年人健康状态和功能评价的思路和内容     

我国老年人口失能判别及其对健康预期寿命影响分析

老年人口失能水平对健康预期寿命的测算具有重要影响,而不同数据来源的老年人口失能水平存在着较大差异。本文以经过模型生命表调整的2015年1%人口抽样数据所计算的生命表为基础,以2010年人口普查、2015年1%人口抽样调查、2015年CHARLS数据和2014年CLHLS数据为资料来源,探讨老年人口分年龄失能状况及其对健康预期寿命测算结果的影响。老年人失能率较大程度地影响着健康预期寿命及其性别年龄模式。无论是失能的主观评价指标还是客观评价指标,不同数据来源的高龄老人失能率差别较大;CHARLS数据中高龄老人失能率偏倚原因可能产生于调查过程中的系统误差,而非样本规模较小;CLHLS和CHARLS中的问卷访题设计也是影响失能程度判别的重要因素。因此,在理论和应用层面上探讨我国老年人口特别是高龄老人失能水平的差异及其原因,逐步形成共识是学界亟待解决的重要问题。     

老年人的心理特征因素对生活满意度的影响

文章利用2002年全国老年人口健康状况的调查数据,在以往有关社会经济因素、健康因素、人口因素等对老年人生活满意度影响的研究的基础上,引入心理特征变量,通过多元回归模型分析了心理特征因素对老年人生活满意度自评的影响。统计结果显示,在控制了其他影响因素的基础上,老年人的性格、情绪、孤独感及焦虑程度等对生活满意度自评具有一定的影响。此外,在考虑了心理特征因素的影响之后,原有模型中变量的回归系数与p-value值都发生了变化。     

生命早期家庭环境因素对老年健康贡献的区域异质性

生命历程早期是家庭环境对个人影响最为关键的时期，因个人不能改变的早期家庭环境造成的健康差异所导致的健康不平等，需要政府关注和干预。厘清早期家庭环境对老年健康的影响，减少或消除不平等的健康差异，对于实现健康老龄化至关重要。使用中国健康与养老追踪调查(CHARLS)数据，采用Shapley和Fairlie值分解方法，分析早期不同家庭环境因素对老年健康的贡献程度，并比较各类因素对不同区域老年健康影响的异质性。研究发现，早期家庭环境不仅对老年健康的相对贡献最高，而且是导致老年健康区域差异的重要因素。建议在健康中国战略中纳入“早期家庭环境”维度，并将儿童早期发展纳入国家的乡村振兴规划，提供公平和良好的起点，从生命早期和家庭层面推进健康中国建设和健康老龄化。     

我国老年人健康自评影响因素分析

健康自评是研究对象对自身健康的主观感受,是调查中经常运用的变量。健康自评能够反映健康状态的主观和客观两个方面,因此健康自评可以作为评价老年人健康状况的一个重要指标。采用2002年全国老年调查数据,做不同老年人群体的健康自评的差异性分析并进一步探究影响因素。旨在回答我国老年人健康自评的影响因素,对老年人自身和政策制定者提供参考依据。健康的生活方式对健康自评有积极的影响,身体的健康和健康自评有很强的相关性,老年人的社会人口学特征对健康自评影响十分有限。     

疾病和失能对老年人口健康预期寿命的影响--兼论卫生资源在老年人口健康分类投资的方向

本文根据1998年第二次国家卫生服务调查分析数据和常规卫生统计资料,采用Sullivan方法分析了三种在人群中仍有较高发病率的病毒性肝炎、疟疾、结核等传染性疾病及慢性病和失能对中国围老龄期和老龄期人口健康预期寿命的影响,目的是了解不同的非健康状态对老年人口健康水平影响的程度,为中国有限的卫生资源流向提供一些参考信息.     

The Performance of the World Health Organization’s WHOQOL-BREF in Assessing the Quality of Life of Thai College Students

The purpose of this study was to examine the performance of the Thai-version of WHOQOL-BREF in assessing the quality of life (QoL) among Thai college students. The psychometric properties of WHOQOL-BREF were assessed in this study. The self-administered WHOQOL-BREF questionnaire was applied. A total of 407 Thai college students (male age = 20.5 ± 1.2; female age = 20.5 ± 1.2) participated in this study. Item-response distributions, internal consistency reliability, discriminant validity, criterion-related validity and construct validity through confirmatory analysis were analyzed. The findings indicate that the WHOQOL-BREF had acceptable internal consistency (α = 0.73–0.83 across four domains), all items highly correlated with corresponding domain scores (r = 0.53–0.80), the indices of a two-order confirmatory factor analysis (CFA) demonstrate that the data fit the model well with allowing covary of error variances of some items, all items had good property of criterion-related validity and item discrimination and, all three domain scores except the social relationship domain had significant associations with overall QoL or general health. The results suggest that the WHOQOL-BREF was reliable and valid to health professionals in the assessment of the QoL of college-based Thai youth, but some unsuitable items may be deleted in future studies.     

Life satisfaction in persons with schizophrenia living in the community

Subjective well-being is an increasingly common indicator of adequacy of psychiatric services. An easy-to-administer assessment tool of subjective well-being that is conceptually sound, valid, and reliable is needed for use in persons with schizophrenia. The purpose of this paper was to validate the 5-item Satisfaction with Life Scale (SWLS)-Taiwan version for persons with schizophrenia living in the community. Specifically, the internal consistency reliability, construct validity and criterion-related validity were examined. Data were obtained from a total of 443 patients with schizophrenia at multiple areas of Taiwan. Item analysis and confirmatory factor analysis were performed. The results revealed that the SWLS had good international consistency reliability and suggested a single-factor structure in life satisfaction among this patient group. The SWLS has good criterion-related validity with the brief World Health Organization Quality of Life Assessment (WHOQOL-BREF). It is concluded that the SWLS is a sound measurement to be used with persons with schizophrenia living in the community.     

A Validity and Reliability Study of the Multidimensional Trust in Health-Care Systems Scale in a Turkish Patient Population

The importance of trust within health care is widely acknowledged. Measuring patients’ trust in health care systems may contribute to plans for the financing, delivery, and outcomes of health services. Although many scales are available to measure patient trust, less attention has been paid to the multidimensional nature of trust in health care systems. The purpose of this methodological study was to adapt the Multidimensional Trust in Health-Care Systems Scale into Turkish and to evaluate its psychometric properties for a Turkish patient population. The scale was adapted into Turkish through a translation and back-translation process. The content validity of the scale was assessed using expert approval. The psychometric properties of the scale were investigated by collecting data from 232 hospitalised patients in Ankara during theperiod of 1 January–30 December 2010. An exploratory factor analysis identified that the eigenvalues for the three factors of the scale were 7.30, 2.61, and 1.21; these three factors explained 65 % of the variance. A confirmatory factor analysis indicated a sufficient model fit for the construct validity of the scale. Cronbach’s α for the total scale was 0.87, as well as 0.91, 0.82, and 0.61 for the three subscales; the Spearman-Brown split half reliability coefficient was 0.67. Despite the low internal consistency of the subscale 3, evidence from this study supports the validity and reliability of the Multidimensional Trust in Health-Care Systems Scale. This instrument can be used to measure multiple aspects of trust in the health care system; however, as trust is a contextual phenomenon, further work is needed to test the psychometric properties of this scale both in Turkish and different cultures.     

高龄老人健康长寿因素研究

通过访谈方法,收集62位90岁以上健康长寿老人的身心健康、生活方式、社会关系、地理环境等方面的资料,在分析调查结果的基础上,概括出身体内部重要器官健康、较强的自身抵抗力、顺其自然的心态、友好的人际关系、荤素搭配的饮食结构、良好的睡眠习惯、优越的居住地自然地理环境等因素,是这次调查的老人中比较明确的有利于健康长寿的因素。     

Can the Web-Form WHOQOL-BREF be an Alternative to the Paper-Form?

The purpose of this study was to test whether the web version is an alternative to the paper version of the short version of the World Health Organization Quality of Life assessment (WHOQOL-BREF). Two studies were conducted. Study 1 used crossover self-controlled trials with 80 participants to compare the web and paper versions and to determine the test–retest reliability of the web version. Study 2 used data from 1,016 web participants to analyze the internal consistency and concurrent and construct validity of the web version. The correlations of domain scores between the web and paper versions ranged from 0.71 to 0.85. Dependent t tests showed no significant differences in domain scores between these two versions. The intra-class correlation coefficients (ICC) for test–retest reliability of web version ranged from 0.79 to 0.91. The Cronbach’s α for internal consistency reliability ranged from 0.60 to 0.83. Multiple regression models indicated that the web version has good concurrent validity. Confirmatory factor analysis (CFA) for the second-order hierarchical factor model also supported the construct validity of the web version. The web version of the WHOQOL-BREF can be the alternative to the paper version for health-related quality of life (HR-QOL) evaluation.     

Reimagining the General Health Questionnaire as a measure of emotional wellbeing: A study of postpartum women in Malta

BackgroundPostpartum health has been subject to a focus on psychological morbidity, despite positive associations between postpartum recovery and maternal emotional wellbeing. There are currently many validated tools to measure wellbeing and related concepts, including non-psychiatric morbidity. The General Health Questionnaire, 12 items (GHQ-12) is one such instrument, widely used and validated in several languages. Its use in postpartum settings has been documented with disagreement about the instrument's utility in this population, particularly in relation to scoring method and threshold. The GHQ-12 has never been translated into Maltese. This study explored the psychometric properties of the GHQ-12 in a Maltese postpartum population to consider if the use of a different scoring method (visual analogue scale) in the GHQ-12 can determine postpartum wellbeing.MethodsOne hundred and twenty-four postpartum women recruited from one hospital in Malta completed the translated and adapted GHQ-12 as a wellbeing measure (GHQ-12(WB)) at four postpartum time points. The psychometric properties of the GHQ-12(WB) were explored using confirmatory factor analysis, discriminant and divergent validity and reliability analysis.ResultsThe GHQ-12(WB) demonstrated good divergent and known-groups validity and internal consistency. No models offered a good fit to the data. The overall consistent best-fit to the data was an eight item, two factor model (GHQ-8). Model fit improved across all models in terms of CFI at 13 weeks.ConclusionFindings generally support the reliability and validity of the Maltese version of the GHQ-12(WB). Model fit changes over time reflect the dynamic nature of postpartum recovery. Further evaluation of the GHQ-8(WB) is recommended.     

Short happiness and affect research protocol (sharp)

Issues in the measurement of subjective well-being (SWB) include the relative balance between scale brevity and measurement accuracy. Because accuracy is expected to vary negatively with the length of a scale, the brevity/accuracy trade-off has pragmatic implications for survey research. This article begins by examining minimal psychometric criteria to evaluate short measures of SWB. These criteria include content validity (i.e., four basic categories are cited), criterion validity, internal consistency, and test-retest reliability. Several measures frequently used in large-scale surveys are shown to fail against one or more of these criteria. Consequently, a new brief measure was developed and shown to satisfy all the criteria. It is termed the Short Happiness and Affect Research Protocol (SHARP). This measure contains 12-items derived from the Memorial University of Newfoundland Scale of Happiness (MUNSH), with the content balanced over positive and negative, and short-term (affective) and long-term (dispositional) components. The internal consistency, temporal stability, and criterion validity coefficients for the SHARP are comparable to those of the MUNSH, which is among the most accurate measures of self-reported SWB.     

Development of Science Anxiety Scale for Primary School Students

The principal aim of the study is to develop a new scale Science Anxiety Scale and to examine its the psychometric properties and construct validity of the Science Anxiety Scale in a sample of 797 primary school students. Exploratory factor analysis was applied and found to have a two-dimensional structure. Confirmatory factor analyses provide evidence for a solid two-dimension structure reflecting the theorized construct: personal and environmental. Also, for convergent validity, item reliability, construct reliability and average variance values were calculated and it was found that item reliability and construct reliability values generally provided the required criteria. The average variance extracted value had a value below the criteria value for both sub-dimensions. Discriminant validity was above the criteria value in all dimensions. The reliability of the Science Anxiety Scale scales appeared to be satisfactory, with good internal consistency. The Science Anxiety Scale was found to be reliable and valid for the Turkish primary student context with a few exceptions.     

Toward an index of gender equality

This paper develops a Gender Equality Index (GEI) that is modelled in its thinking and implementation on the Consumer Price Index (CPI). The GEI was computed using annual Ontario data on seven socioeconomic indicators for the years 1975 to 1984. The analysis supports the following conclusions: (1) that it is possible to indentify a subset of indicators that have face validity as measures of relative gender equality; (2) that factor analysis is a useful means for evaluating the construct validity of gender equality; (3) that the resulting GEI reveals a strong upward trend toward gender equality in the latter half of the 1970's and the early 1980's and (4) that this trend has flattened in 1984.     

21世纪上半叶我国各级学校适龄人口数量变动趋势分析

在人口预测结果的基础上 ,本文分析了我国 2 1世纪上半叶各级学校适龄人口数量的变动趋势。结果表明 :( 1)在不同的人口预测方案下 ,2 1世纪上半叶我国各级学校教育适龄人口的规模将有较大的差别 ;( 2 ) 2 1世纪上半叶 ,我国各级学校的适龄人口数量都将有较大幅度的减少 ,这为我国未来教育事业进一步发展创造了较好的条件 ;( 3)尽管各级学校的适龄人口数都会减少 ,但是 ,各级学校适龄人口规模减少的过程并不是同步的 ;( 4 )下世纪上半叶 ,我国的适龄人口规模虽然从总的趋势上讲将减少 ,但是 ,这种减少的过程不是始终如一的 ,中间伴随有相当大的波动 ;( 5)在适龄人口总规模趋于减少的同时 ,城镇和乡村适龄人口规模的变动方向并不相同。