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心血管疾病中高危人群发病风险感知与健康促进生活方式关系的Nomogram模型分析

The relationship between risk perception and health promoting lifestyle profile in population with moderate and high risk of cardiovascular diseases:a Nomogram model analysis

摘要目的:了解心血管疾病(CVD)中高危人群发病风险感知与健康促进生活方式的关系,并构建列线图预测模型,以为临床早期筛查及靶向干预提供依据。方法:采用横断面调查方法,便利选取2022年3—8月浙江大学医学院附属第二医院就诊的272例CVD中高危人群为调查对象,采用一般资料调查表、中文版心血管疾病风险态度和信念量表(ABCD-C)、健康促进生活方式量表-Ⅱ(HPLP-Ⅱ)进行调查,基于多因素回归分析构建CVD中高危人群健康促进生活方式的列线图模型。结果:272例研究对象中,男150例,女122例,年龄(60.59 ± 10.64)岁。ABCD-C总分(56.57 ± 5.69)分,HPLP-Ⅱ总分为(111.92 ± 12.47)分,二者呈显著正相关( r=0.556, P<0.01)。以HPLP-Ⅱ总分中位数(111分)为界分为低水平健康促进生活方式(≤111分)和高水平健康促进生活方式(>111分)2类,并将其作为因变量,吸烟( OR=0.215,95% CI 0.104~0.446)是CVD中高危人群采取健康促进生活方式的障碍因素,已婚( OR=14.237,95% CI 1.963~103.238)、家庭人均月收入≥5 000元( OR=4.101,95% CI 1.369~12.288),心血管疾病预防知识( OR=1.660,95% CI 1.373~2.007)、感知到的益处和身体活动改变意图( OR=1.445,95% CI 1.255~1.663)、感知到的益处和健康饮食改变意图( OR=1.322,1.058~1.654)得分高为促进因素。 结论:CVD中高危人群健康促进生活方式处于中等偏上水平,受吸烟、婚姻和经济状态、心血管疾病预防知识风险态度和信念的影响,应用列线图模型开展早期筛查和重点人群靶向风险沟通,有助于提高其健康行为水平。

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abstractsObjective:To explore the relationship between risk perception and health promoting lifestyle profile in population with cardiovascular disease (CVD), and construct a prediction model for clinical screening and targeted intervention.Methods:A cross-sectional survey method was used to select 272 people at moderate and high risk of CVD from the Second Affiliated Hospital of Zhejiang University School of Medicine from March to August 2022. The general information questionnaire, Chinese version of Attitude and Beliefs about Cardiovascular Disease Knowledge and Risk Questionnaire (ABCD-C), and Health Promoting Lifestyle Profile-II (HPLP Ⅱ) were used. Based on multiple regression analysis, a nomogram model for health promoting lifestyle in high-risk CVD population was constructed.Results:Among 272 participants, male 150 cases, female 122 cases, aged (60.58 ± 10.64) years old. The total ABCD-C score was (56.57 ± 5.69), and the total HPLP Ⅱ score was (111.92 ± 12.47). ABCD-C score was significantly positively correlated with HPLP Ⅱ score ( r=0.556, P<0.01). The median of HPLP Ⅱ total score (111 points) was used as the cut-off point for low level of health-promoting lifestyle (≤111 points) and high level of health-promoting lifestyle (>111 points), and used it as the dependent variable, smoking ( OR=0.215, 95% CI 0.104-0.446) was a barrier factor for participants to adopt healthy lifestyle; being married ( OR=14.237, 95% CI 1.963-103.238), having a family average monthly income higher than 5 000 yuan ( OR=4.101, 95% CI 1.369-12.288), higher score of CVD prevention knowledge ( OR=1.660, 95% CI 1.373-2.007), perceived benefits and intention to change physical activity ( OR=1.445, 95% CI 1.255-1.663), perceived benefits and intention to change healthy diet ( OR=1.322, 95% CI 1.058-1.654) were promoting factors. Conclusions:The health-promoting lifestyle of populations at risk for CVD is above-average, influenced by factors such as smoking, marital and economic status, risk attitudes, and beliefs. Utilizing the nomogram model for early screening and targeted risk communication among key populations may contribute to improving their health behavior.

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