| OBJECTIVE:To understand the current situation and influencing factors of public risk perception in public health emergencies,and discuss health promotion countermeasures aiming at enhancing the quality of life(QOL)based on the theory of Traditional Chinese Medicine(TCM)Constitution and the theory of self-leadership.Specifically,this study aims to understand the situation of public risk perception in China during COVID-19 and the influencing factors such as TCM constitution,analyze the impact of self-leadership on risk perception and QOL,explore the relationship between TCM constitution,risk perception and QOL,and the impact of self-leadership on their relationship,and finally summarize health promotion countermeasures and recommendations aiming at enhancing the QOL.METHODS:1.Subjects:A valid sample of 5358 cases(1159 cases in February 2020,3018 cases in February 2021 and 1181 cases in 2022)was obtained from three cross-sectional surveys using the online data collection method with the help of the Questionnaire Star platform.The study followed the Declaration of Helsinki and ethical approval and informed consent was obtained from participants.2.Survey content:(1)Socio-demographic characteristics:It includes gender,age,marital status,education level,and occupation,etc.The questionnaire is self-developed.(2)Characterization of risk perception of the epidemic:It includes information on epidemic prevention,concerns about the epidemic environment,judgements of the likelihood of infection and perception of preventive behavior.The questionnaire is self-developed.(3)Risk perception of the COVID-19:The Perceived Risk of COVID-19 Pandemic Scale(PRCPS)with good reliability and validity was used in the 2021 and 2022 surveys.(4)Self-leadership:A version of the Revised Self-leadership Questionnaire(RSLQ)including 3 strategies,namely behavior focus strategy,constructive thinking pattern strategy and natural reward strategy and 9 dimensions,namely self-observation,self-goal setting,self-reward,self-punishment,self-prompting,natural reward,self-talk,belief and assumption assessment and success anticipation was used.(5)Health-related QOL:World Health Organization Quality of Life-BREF(WHOQOL-BREF),a scale widely used domestically and internationally is used.Through this scale,scores in four domains,namely physiology,psychology,society,and environment,as well as the total QOL score,can be obtained.The total QOL score was used in this study for health-related QOL assessment.(6)Assessment of TCM Constitution:The 3 0-item short version of Constitution in Chinese Medicine Questionnaire(CCMQ-30)with good reliability and validity was used in the 2022 survey,The scale consists of 9 sub-scales,namely gentleness,qi-deficiency,yang-deficiency,yin-deficiency,phlegm-dampness,dampness-heat,blood-stasis,qi-depression and special diathesis.3.Statistical analysis:Continuous variables were expressed as mean ± standard deviation(x±s),and categorical variables were expressed as number of cases(n)and percentage(%).Study 1 used IBM SPSS Amos 24.0 for validated factor analysis(CFA)and correlation analysis between latent variables,and multiple linear stepwise regression models to analyse the factors influencing risk perception.Study 2 used multiple linear regression models to analyse the factors influencing self-leadership,and SPSS process v 3.3 software was used to analyse the factors influencing self-leadership through non-parametric Bootstrap test to moderate the model.Study 3 used SPSS process v 3.3 software and tested the mediated model with moderation by non-parametric Bootstrap,etc.SPSS 23.0 software was used for statistical analysis.SPSS 23.0 software was used for statistical analysis.RESULTS:1.Basic information:In the 2020 survey,there were 1159 participants.A high proportion of participants were female(72.00%),married(55.00%),with a bachelor’s degree or above(95.25%),medical staff(45.64%)or teachers and students(32.27%),with an average age of 34.79±12.13 years old.In the 2021 survey,there were 3018 participants.More of them were women(60.37%),single(54.37%),with a bachelor’s degree or above(82.01%)or teachers and students(39.70%),with an average age of 30.18±10.32 years old.In the 2022 survey,there were 1181 participants.More of them were female(65.71%),married(49.62%),with a bachelor’s degree or above(75.19%),and engaged in commerce,industry and agriculture(46.57%),with an average age of 32.82±12.40 years old.2.TCM constitution and other relevant influencing factors on risk perception(Study 1 using data from the 2020,2021 and 2022 survey sample):(1)The plausibility of characterization of risk perception of the epidemic,including concerns about the epidemic environment,judgments about the likelihood of infection and perceptions of preventive behaviors,as latent variables was verified.It was also verified that people’s concerns about the epidemic environment and judgments of the likelihood of infection positively influenced the perception of preventive behaviors.(2)Low level of education(β=-0.145,t=-4.728,P<0.001)and occupations such as industry,commerce,and agriculture(β=-0.112,t=-3.658,P<0.001)and concerns about the epidemic environment(i.e.concerns about the health condition of frontline medical workers,β=-0.117,t=-4.286,P<0.001)were negative influencing factors of risk perception.(3)Qi deficiency(β=0.156,t=3.746,P<0.001)and blood-stasis(β=0.009,t=2.377,P<0.05)types were positive influencing factors of risk perception.3.The impact of self-leadership on risk perception and health-related QOL(Study 2 using data from the 2021 and 2022 survey sample):(1)Female,single people,people with higher level of education,teachers and students,and government officials have higher level of self-leadership.Lower level of education leads to low self-leadership(for example,those with high school or less)(β=-0.22,t=-11.11,P<0.001),and males(β=-0.08,t=-5.08,P<0.001)have lower level of self-leadership.The older the person,the higher the self-leadership level(β=0.08,t=4.63,P<0.001);teachers and students(β=0.08,t=4.65,P<0.001)have high level of self-leadership.(2)The effect of self-leadership on risk perceptions revealed that natural rewards(β=-0.14,t=-6.13,P<0.001)was an influencing factor of low risk perceptions;self-punishment β=0.19,t=7.98,P<0.001)was an influencing factor of high risk perceptions.The effect of self-leadership on QOL showed that self-punishment(β=-0.38,t=-17.04,P<0.001)was a negative influencing factor on QOL;belief assumptions and assessments(β=0.17,t=5.28,P<0.001),self-goal setting(β=0.26,t=7.92,P<0.001)and natural rewards(β=0.26,t=7.85,P<0.001)were factors that could positively influenced QOL.(3)In terms of the effect of self-leadership on the relationship between risk perception and QOL,risk perception significantly negatively predicted QOL(β=-0.57,t=-9.35,P<0.001),self-leadership significantly positively predicted QOL(β=0.23,t=14.69,P<0.001),and the interaction term between self-leadership and risk perception significantly positively predicted QOL(β=0.01,t=4.63,P<0.001),indicating that self-leadership exerted a moderating effect on the relationship between risk perception and QOL.4.The relationship between TCM constitution and health-related QOL in public health emergencies(Study 3 using data from the 2022 survey sample):(1)The score of gentleness was negatively correlated with the score of risk perception(r=-0.214,P<0.001),and positively correlated with the score of QOL(r=0.511,P<0.001)and self-leadership(r=0.101,P<0.05).The scores of all eight biased constitution were positively correlated with risk perception(r=0.168 to 0.225,P<0.001)and negatively correlated with score of QOL(r=-0.321 to-0.524,P<0.001).The scores of qi-deficiency,phlegm-dampness,blood-stasis,qi-depression and special diathesis were negatively correlated with self-leadership(r-0.066 to-0.114,P<0.05).(2)Risk perception plays a mediating effect in the relationship between TCM constitution and QOL.The ratio of the mediating effect of risk perception in the relationship between nine types of TCM constitution and QOL to the total effect was 5.17%for gentleness,6.36%for qi-deficiency,10.85%for yang-deficiency,7.50%for yin-deficiency,7.27%for phlegm-dampness,8.21%for dampness-heat,7.44%for blood-stasis,4.98%for qi-depression and 8.88%for special diathesis,respectively.(3)Self-leadership plays a moderating role in the "TCM constitution-risk perception-QOL" relationship.The interaction between risk perception and self-leadership is more significant in the models with yin-deficiency,phlegm-dampness,dampness-heat and special diathesis as independent variables.CONCLUSION:1.Public risk perception in public health emergencies is influenced by people’s occupation,education level,concern about the environment of the epidemic,and biased constitution.It is suggested that appropriate prevention and control strategies should be formulated for different populations,and people with biased constitution should pay more attention to their own risk perceptions and TCM constitution status,control excessive risk perceptions,regulate constitutional bias and promote constitutional gentleness,to avoid negative impacts on health.2.The rational application of self-leadership by the public can play a role in health promotion in public health emergencies.For example,the application of natural reward strategies can reduce the perception of risk and enhance the QOL.3.It is recommended that in response to public health emergencies,the public should be encouraged to actively apply self-leadership strategies to mitigate the negative impact of risk perception and biased constitution to QOL,so as to achieve health promotion and improve public health. |
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