Study On Health Self-management Behavior Of Urban Elderly With The Support Of Family Doctor Contract Service

1.Background According to the seventh Chinese population census,the elderly aged 65 and above account for 75%of the residents in Guangzhou.This shows that Guangzhou has entered an aging society,and The proportion of elderly population increases.One of the negative effects of an aging society is the elderly have a high demand for medical resources,and the economic burden on families and society is also increasing.In the case of an increasing proportion of people at risk of health,this will hinder the improvement of the health level of group residents and the stable development of society.Individual behavior and life style are the key factors affecting the health level of residents.The long-term goal of family doctor contract service is to improve the level of residents’ health,family doctor contract service is also an innovative mode of medical service supply through the establishment of contractual relationship with residents.Guangzhou is the sign for the first family doctor contract service pilot cities,the family doctor contract service signed for for seven years.However,its influence on the health level and health behavior of the elderly is not clear,and the current research is not in-depth.Therefore,it is of great significance to study the importance of family doctor contract service in the aging society and explore the influence path of family doctor contract service on the health self-management behavior of the elderly.2.Objectives ①To understand the status quo of family doctor contract service and health self-management behavior of the elderly in Guangzhou.②Based on the theory of planned behavior,this study compared the differences of health self-management behaviors among people with different service utilization levels,and constructed a path model of the impact of family doctor signing service on health self-management behaviors of the elderly.③ This paper puts forward some policy suggestions to improve family doctors’ability of signing up services and some strategies to improve the health self-management behavior of the elderly in Guangzhou.3.Methods By using literature research method and retrieving relevant literature,this paper systematically combs the research progress of family doctor contract service and health self-management.On the basis of literature research and field research,the questionnaire "Family Doctors Contract Service and Health Self-management Behavior Survey for the elderly in Guangzhou" was compiled by ourselves,and the formal questionnaire was formed by pre-survey and revision.In this paper,690 elderly people over 60 years old in Guangzhou were surveyed by face-to-face questionnaire using the method of typical sampling and convenient sampling.T test,anOVA and Pearson product-moment correlation coefficient were used for difference analysis and correlation analysis.Logistic regression analysis and structural equation model were used to construct the model.The statistical software was SPSS25.0 and AMOS24.0.4.Results The overall utilization level of family doctors’ contracted services for the elderly in Guangzhou was low and the health self-management behavior was medium level.Gender,age,number of children,self-assessment of health status,number of chronic diseases,and family doctor contracted service utilization were the influencing factors of health self-management behavior of the elderly.Attitude,perceived behavioral control,subjective norms and behavioral intention as chain mediating variables in family doctors’ contracted service utilization and health self-management behavior have partial mediating effects.And the model fitting degree of the modified influencing path is better.The theoretical model proposed in this study clearly identifies the influence path between the signed service of family doctors and the elderly’s health self-management behavior,and identifies the "black box" of the use of signed service of family doctors to influence the elderly’s health self-management behavior.Based on the data analysis results,corresponding countermeasures and suggestions were put forward from the three levels of government,community and residents,in order to improve the quality of family doctor contract service,expand the influence of family doctor contract service on health self-management behavior of the elderly from the psychological level,and improve the awareness and level of health self-management of the elderly.