The Study On Self-rated Health Status And Associated Factors Of Military Personnel In High Altitude Area

ObjectiveIt aims to investigate the status of the self-rated health and associated factors of military personnel in high altitude area, to provide guidance for improving the self-rated health level of military personnel in high altitude area.MethodsBy random and group sampling method, 490 male military personnel with a mean age of 21±3 years in high altitude area were investigated using questionnaires survey from July to August in the year of 2004. Among 490 collected questionnaires, 485 were effective with an effective rate of 98.98%.The following questionnaires were used self-rated health measurement scale, self-compiled life event scale, questionnaire of cognitive appraisal to environment and service in high altitude area, and simplified coping style questionnaire.All data were input into computer to establish a database using Foxpro6.0 and processed using SPSS11.5 software package. The statistical methods were descriptive statistic, t-test, one-way ANOVA, factor analysis, reliability analysis, correlate analysis, regression analysis, and pathway analysis.Results1. The total scores of the self-rated health and its subscale scores among militarypersonnel in high altitude area were higher than the average level (6.00-9.09) , but significantly lower than that of general people in hinterland (P<0.01), except for the factor of Role activity. Among all factors, the difference between the scores of the two groups in the factor of psychological symptom and negative function was the most significant (P<0.01).2. Using item analysis, SRHMS items with the mean score being lower than 6 among military personnel stationed in high altitude area were sorted out. It was found that the low score items in subscale of physical health reflected gastrointestinal symptoms, fatigue, and insomnia; those in subscale of psychological health reflected anxiety, depression, and obsession; those in subscale of social health reflected participation in social activities, seeking help from others.3. There were significant difference in subscale scores in psychological health when the subjects were divided into groups according to their ranks, marriage status and times of entering Tibet respectively among military personnel in high altitude area (P<0.05), but the scores in factors of physical and social health had no significant difference.4. According to various stress level, factors in self-made life event scale affecting self-rated health were adaptive events(1.32+0.72), interrelationship events(1.07+0.86), events from work and environment (1.02+0.73), suddenly occurred event (0.70+0.68) and future problem (0.57 ±0.89). The scores of perceived life events had significantly negative correlation with the total and three subscales scores of the self-rated health among military personnel stationed in high altitude area5. The main factors of cognitive evaluation influencing the self-rated health of military personnel in high altitude area were difficulty in acquiring information (53.6%), less social activities with women (51.8%), monotonous spare-time activities (48.4%), and poor health care service (46.2%). Correlation analysis showed the cognitive appraisal factors were significantly correlated with the self-rated health6. Based on the results of coping style survey, military personnel in high altitude area chose positive strategies (23.3%) more than negative ones (16.2%) when facing stresses. The most common coping strategies they chose were "consoling themselves(41.2%) " and "restraining negative emotion (36.9%)". The scores of coping style had significant correlation with the total and three subscales of the self-rated health.The total and three subscales scores of the self-rated health were taken as the dependent variables respectively, and the item scores of coping style as the independent variables for multiple regression analysis. It was found that at the level of a =0.05, the four coping ways that entered multiple regression equation were "finding out several different methods of solving problems", "accepting reality", "seeking suggestions from friends and comrade-in-arms", and "solving problems by fantastic".7. The total and three subscale scores of self-rated health among military personnel stationed in high altitude area were taken as the dependent variables respectively, and the scores of five factors of life event scale, the scores of three factors of cognitive appraisal to environment and service questionnaire, positive and negative coping scores as the independent variables for multiple regression analysis. It was found that at the level of a=0.05, the factors that entered the multiple regression equation were interrelationship events, suddenly occurred events, three factors of cognitive appraisal to environment and service, positive and negative coping style.8. In this study, it was supposed that life events, cognitive appraisal and coping styles among military personnel in high altitude area would affect their self-rated health and there would be interactions among various factors influencing the self-rated health. Thus, the pathway analysis was used to verify this hypothesis. The result indicated that there were seven pathways affecting self-rated health of military personnel in high altitude area, among which the pathway that interrelationship events indirectly affected self-rated health through the factor of basic need was the most significant.Conclusions1. The general level of the self-rated health and the levels of physical health, psychological health and social health in military personnel stationed in high altitude area were significantly lower than those of common inhabitants. Among all factors, the state of psychological symptom and negative function was the worst. It showed that high altitude environment would have seriously negative effects on the health of military personnel.2. The problems disturbing the state of self-rated health among military personnel in high altitude area include gastrointestinal symptoms, fatigue, and insomnia in subscale of physical health, symptoms of anxiety, depression, and obsession in subscale of psychological health, lacking of participations in social activities and seeking help from friends while facing difficult situation in subscale of social health.3. Psychological health status of active-duty soldiers, unmarried military personnel, and army men first entering Tibet were better than that of petty officers and officers, married ones and those army men entering Tibet more than one time. The general level of the self-rated health among active-duty soldiers is better than that among petty officers and officers.4. For military personnel in high altitude area, the self-rated physical, psychological and social health status are significantly affected by stressful life events, cognitive appraisal and coping styles, which had highest predicting power to psychological health.5. When facing frustration, military personnel in high altitude area choose positive strategies more frequent than negative ones, and the most common coping strategies they choose are "consoling themselves" and "restraining negative emotion". Different coping strategies have different predicting power on self-rated health of military personnel in high altitude area, and the positive strategies promote their self-rated health status, while negative ones have opposite effect on their healthstatus.6. Stressful life events directly affect self-rated health of military personnel in high altitude area, but its indirect action is more obvious through the intermediary of cognitive appraisal and coping styles.Innovations1. It is the first systematical and complete study on the self-rated health status of military personnel in high altitude area in our nation, which explores the influence of life events, cognitive appraisal and coping styles on self-rated health status of military personnel in high altitude area.2. It adopts quantitative methods to analyze the general level of self-rated health status and the levels of physical, psychological and social health in military personnel stationed in high altitude area, and to summarize associated factors of self-rated health of military personnel in high altitude area and the effects of all factors on self-rated health and their mutual relations.Limitations and hypotheses of further studies1. This study is a cross section investigation, so the conclusions are limited, and some findings need further studies.2. The subjects of this study are those stationed in the high altitude area of 3000-4000 meters above sea level. In the following studies, the self-rated health status of military personnel stationed in the areas of over 4000 meters above sea level should be included.