Bustos-Vázquez Eduardo, Fernández-Niño Julián Alfredo, Astudillo-Garcia Claudia Iveth
Escuela de Salud Pública de México, Cuernavaca, México.
Biomedica. 2017 Apr 1;37(0):92-103. doi: 10.7705/biomedica.v37i3.3070.
Self-rated health is an individual and subjective conceptualization involving the intersection of biological, social and psychological factors. It provides an invaluable and unique evaluation of a person's general health status.
To propose and evaluate a simple conceptual model to understand self-rated health and its relationship to multimorbidity, disability and depressive symptoms in Mexican older adults.
We conducted a cross-sectional study based on a national representative sample of 8,874 adults of 60 years of age and older. Self-perception of a positive health status was determined according to a Likert-type scale based on the question: "What do you think is your current health status?" Intermediate variables included multimorbidity, disability and depressive symptoms, as well as dichotomous exogenous variables (sex, having a partner, participation in decision-making and poverty). The proposed conceptual model was validated using a general structural equation model with a logit link function for positive self-rated health.
A direct association was found between multimorbidity and positive self-rated health (OR=0.48; 95% CI: 0.42-0.55), disability and positive self-rated health (OR=0.35; 95% CI: 0.30-0.40), depressive symptoms and positive self-rated health (OR=0.38; 95% CI: 0.34-0.43). The model also validated indirect associations between disability and depressive symptoms (OR=2.25; 95% CI: 2.01- 2.52), multimorbidity and depressive symptoms (OR=1.79; 95% CI: 1.61-2.00) and multimorbidity and disability (OR=1.98; 95% CI: 1.78-2.20).
A parsimonious theoretical model was empirically evaluated, which enabled identifying direct and indirect associations with positive self-rated health.
自我评估健康状况是一种个人主观概念，涉及生物、社会和心理因素的相互作用。它对一个人的总体健康状况提供了一种非常宝贵且独特的评估。
提出并评估一个简单的概念模型，以理解墨西哥老年人的自我评估健康状况及其与多种疾病并存、残疾和抑郁症状的关系。
我们基于一个具有全国代表性的样本开展了一项横断面研究，该样本包含8874名60岁及以上的成年人。根据一个李克特式量表，基于“您认为您目前的健康状况如何？”这一问题来确定对积极健康状况的自我认知。中间变量包括多种疾病并存、残疾和抑郁症状，以及二分法的外生变量（性别、有伴侣、参与决策和贫困）。使用具有对数链接函数的一般结构方程模型对所提出的概念模型进行验证，以评估积极的自我评估健康状况。
发现多种疾病并存与积极的自我评估健康状况之间存在直接关联（比值比=0.48；95%置信区间：0.42 - 0.55），残疾与积极的自我评估健康状况之间存在直接关联（比值比=0.35；95%置信区间：0.30 - 0.40），抑郁症状与积极的自我评估健康状况之间存在直接关联（比值比=0.38；95%置信区间：0.34 - 0.43）。该模型还验证了残疾与抑郁症状之间的间接关联（比值比=2.25；95%置信区间：2.01 - 2.52），多种疾病并存与抑郁症状之间的间接关联（比值比=1.79；95%置信区间：1.61 - 2.00）以及多种疾病并存与残疾之间的间接关联（比值比=1.98；95%置信区间：1.78 - 2.20）。
对一个简约的理论模型进行了实证评估，该模型能够识别与积极的自我评估健康状况的直接和间接关联。
