School of Health Services Management, Southern Medical University, Guangzhou, Guangdong, China.
Center for Health Management and Policy Research, Shanxi Medical University, Taiyuan, Shanxi, China.
Health Qual Life Outcomes. 2019 Nov 8;17(1):168. doi: 10.1186/s12955-019-1222-x.
With the disintegration of the extended family in recent years, the empty-nest phenomenon is increasingly common in China and the health of empty nesters is attracting more attention. Lifestyles, accounting for 53% in determining death, play a vital role in improving the health of individuals. However, it was rarely studied in promoting the health of empty nesters. In this study, we proposed a "SMG" model in empty nesters, including the self-management, mutual management, and group management, to implement health-promoting lifestyles interventions among empty nesters to provide an effective means to improve their lifestyles and health.
We conducted a prospective intervention on 350 empty nesters in three communities located in Taiyuan, China. One hundred sixty-seven empty nesters were randomly assigned to the intervention group with SMG-based health-promoting lifestyles interventions used for 7-months, and 183 were randomly assigned to the control group with no measures imposed. The Health-Promoting Lifestyle Profile (HPLP-C) was used to rate the lifestyles of empty nesters. Generalized estimation model was used to analyze the differences between the intervention and control groups over time, adjusted for education and employment.
After 7 months of health-promoting lifestyles intervention, HPLP-C score and each dimension score in the intervention group all increase from baseline. There were significant differences after intervention associated with time and group interaction effects in aspects of HPLP-C (mean score = 8.838, 95%CI:6.369-11.306), self-realization (mean score = 1.443, 95%CI:0.352-2.534), Health responsibility (mean score = 1.492, 95%CI:0.477-2.508), physical activity (mean score = 1.031, 95%CI:0.572-1.491), nutrition (mean = 0.827, 95%CI:0.177-1.476), interpersonal relations (mean = 2.917, 95%CI:2.365-3.469) and stress management (mean score = 0.729, 95%CI:0.131-1.327). And education is contributing to the effect of the health-promoting lifestyle intervention (Estimate:8.833, p < 0.001).
SMG-based health-promoting lifestyles intervention in empty nesters effectively improved the lifestyles of empty nesters, and the outcome was affected by education. Lifestyle change requires ongoing intervention, and community service centres must be involved in implementing the "SMG" model to provide ongoing support and improve the effect of interventions among empty nesters.
Chinese Clinical Trial ChiCTR1800015884. Registration date: 26-04-2018. Retrospectively registered.
近年来,随着大家庭的解体,空巢现象在中国日益普遍,空巢老人的健康问题越来越受到关注。生活方式在决定死亡方面占 53%,对个体健康起着至关重要的作用。然而,在促进空巢老人健康方面,这方面的研究却很少。本研究提出了空巢老人的“SMG”模式,包括自我管理、相互管理和群体管理,为空巢老人实施健康促进生活方式干预,为改善他们的生活方式和健康提供有效手段。
我们在中国太原的三个社区对 350 名空巢老人进行了前瞻性干预。167 名空巢老人被随机分配到干预组,采用基于 SMG 的健康促进生活方式干预,干预时间为 7 个月,183 名空巢老人被随机分配到对照组,不采取任何措施。采用健康促进生活方式量表(HPLP-C)评价空巢老人的生活方式。采用广义估计方程分析干预组和对照组随时间变化的差异,调整教育和就业因素。
经过 7 个月的健康促进生活方式干预,干预组 HPLP-C 评分和各维度评分均从基线开始增加。干预后,HPLP-C(均数得分=8.838,95%置信区间:6.369-11.306)、自我实现(均数得分=1.443,95%置信区间:0.352-2.534)、健康责任(均数得分=1.492,95%置信区间:0.477-2.508)、体育活动(均数得分=1.031,95%置信区间:0.572-1.491)、营养(均数得分=0.827,95%置信区间:0.177-1.476)、人际关系(均数得分=2.917,95%置信区间:2.365-3.469)和压力管理(均数得分=0.729,95%置信区间:0.131-1.327)方面的得分均有显著差异,与时间和组间交互作用有关。教育对健康促进生活方式干预的效果有贡献(估计值:8.833,p<0.001)。
基于 SMG 的健康促进生活方式干预可有效改善空巢老人的生活方式,且干预效果受教育程度的影响。生活方式的改变需要持续的干预,社区服务中心必须参与实施“SMG”模式,提供持续的支持,提高空巢老人干预的效果。
中国临床试验 ChiCTR1800015884。注册日期:2018 年 4 月 26 日。回顾性注册。