Malinauskiene Vilija, Malinauskas Romualdas
Department of Physical and Social Education, Lithuanian Sports University, 44221 Kaunas, Lithuania.
Children (Basel). 2024 Oct 16;11(10):1244. doi: 10.3390/children11101244.
We investigated the predictors of poor SRH in a representative sample of Lithuanian mainstream school students in grades 7-8. We also checked for gender differences in the associations between SRH and depressive symptoms and other predictors.
A total of 2104 7th-8th-grade students participated (response rate 73.95%) and were asked about depressive symptoms, psychosomatic health complaints, negative acts at school, feeling at school, family stress and violence, sense of coherence, self-esteem, and lifestyle. We used a hierarchical regression analysis including a variety of self-rated health predictors.
Boys scored significantly higher on physical activity and smoking, whereas girls scored significantly higher on SRH, depressive symptoms, psychosomatic health complaints, and family stress and violence, though the significance was lost in the hierarchical regression. Depressive symptoms were the strongest predictor of poor SRH (standardized = 0.309, < 0.001), though other investigated predictors were also significant but had lower effect sizes. Strong evidence was found supporting the buffering role of sense of coherence in the relationship between depressive symptoms and SRH (standardized = -0.266, < 0.001).
We can conclude that the magnitude of the relationship between depressive symptoms and self-rated health is dependent on the levels of sense of coherence. We did not find gender differences in those associations. As poor SRH is easy to determine, especially with a one-item question, the cases of poorly rated health should be detected early and corrected by interventions in order to prevent poor health outcomes in the future.
我们在立陶宛主流学校7至8年级学生的代表性样本中调查了健康自评状况不佳的预测因素。我们还检查了健康自评状况与抑郁症状及其他预测因素之间关联的性别差异。
共有2104名7至8年级学生参与（应答率73.95%），他们被问及抑郁症状、心身健康问题、在学校的负面行为、在学校的感受、家庭压力与暴力、连贯感、自尊和生活方式。我们使用了包含各种自评健康预测因素的分层回归分析。
男孩在体育活动和吸烟方面得分显著更高，而女孩在健康自评状况、抑郁症状、心身健康问题以及家庭压力与暴力方面得分显著更高，不过在分层回归中这种显著性消失了。抑郁症状是健康自评状况不佳的最强预测因素（标准化系数 = 0.309，P < 0.001），尽管其他调查的预测因素也具有显著性，但效应量较低。有强有力的证据支持连贯感在抑郁症状与健康自评状况关系中的缓冲作用（标准化系数 = -0.266，P < 0.001）。
我们可以得出结论，抑郁症状与自评健康之间关系的强度取决于连贯感水平。我们在这些关联中未发现性别差异。由于健康自评状况不佳易于确定，尤其是通过一个单项问题，健康评级差的情况应尽早被发现并通过干预加以纠正，以预防未来出现不良健康后果。
