Xiao Jing, Huang Binjun, Shen Huan, Liu Xiuli, Zhang Jie, Zhong Yaqing, Wu Chuanli, Hua Tianqi, Gao Yuexia
Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China.
Department of Health Promotion, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu, China.
PLoS One. 2017 Nov 27;12(11):e0187275. doi: 10.1371/journal.pone.0187275. eCollection 2017.
Seafarers have reported impaired health and health-related quality of life (HRQOL). Social support might increase HRQOL, but little is known about this association among Chinese seafarers. The aim of this study was to describe social support and explore its association with HRQOL among Chinese seafarers.
A cross-sectional survey was conducted in the ports of Nantong and Rugao, China, from April to December 2013. A total of 917 Chinese seafarers were interviewed on social support, mental distress, perceived occupational stress, and HRQOL using the following self-administered questionnaires: The Social Support Rating Scale, Self-rating Depression Scale, Occupational Stress Questionnaire, and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Hierarchical linear regression modelling was used to analyze the association between seafarers' subjective level of social support and their HRQOL.
Of the 917 male Chinese seafarers included in the study, 40.7% perceived high levels of social support, and 39.1% were highly satisfied with their overall quality of life (QOL). Hierarchical regression analysis showed significant associations between level of social support and all health dimensions in the WHOQOL-BREF, even after adjusting for depressive symptoms, occupational stress, occupational activities, sleep duration, and other relevant covariates. Compared with the medium or low level social support group, seafarers with a high level of social support had better QOL scores in the general facet health and QOL (β = 2.43, p<0.05), and the physical health (β = 3.23, p<0.001), psychological health (β = 5.56, p<0.001), social relation (β = 6.07, p<0.001), and environment domains (β = 4.27, p<0.001). In addition, depression, occupational stress, occupational activities, and sleep duration were found to be determinants of seafarers' HRQOL.
Chinese seafarers have poorer HRQOL than the general population, but social support has a significant positive effect on their HRQOL. Efforts to improve social support should be undertaken.
海员报告了健康受损及与健康相关的生活质量（HRQOL）下降情况。社会支持可能会提高HRQOL，但对于中国海员群体中这种关联的了解甚少。本研究的目的是描述中国海员的社会支持情况，并探讨其与HRQOL之间的关联。
2013年4月至12月在中国南通和如皋港进行了一项横断面调查。使用以下自填式问卷对917名中国海员进行了关于社会支持、心理困扰、感知职业压力和HRQOL的访谈：社会支持评定量表、自评抑郁量表、职业压力问卷以及世界卫生组织生活质量简表（WHOQOL-BREF）问卷。采用分层线性回归模型分析海员主观社会支持水平与其HRQOL之间的关联。
在纳入研究的917名中国男性海员中，40.7%的人感知到高水平的社会支持，39.1%的人对其总体生活质量（QOL）高度满意。分层回归分析显示，即使在调整了抑郁症状、职业压力、职业活动、睡眠时间及其他相关协变量后，社会支持水平与WHOQOL-BREF中的所有健康维度之间仍存在显著关联。与中等或低水平社会支持组相比，高水平社会支持的海员在总体健康和QOL方面（β = 2.43，p<0.05）、身体健康方面（β = 3.23，p<0.001）、心理健康方面（β = 5.56，p<0.001）、社会关系方面（β = 6.07，p<0.001）以及环境领域（β = 4.27，p<0.001）的QOL得分更高。此外，抑郁、职业压力、职业活动和睡眠时间被发现是海员HRQOL的决定因素。
中国海员的HRQOL低于一般人群，但社会支持对其HRQOL有显著的积极影响。应努力改善社会支持。
