The Study On Influencing Factors And Mechanisms For Elderly Of Health Promoting Lifestyles Based On Structural Equation Model

Object:The study aimed to explore the manifest factors a nd latent factors which could influence the health promoting lifestyles of the elderly,analyze the mechanism of their effects,and clarify the influence path of them through constructing the structural equation modeling,based on the cross-sectional study of the elderly health promoting lifestyles.The results can provide the basis for forming the elderly health promoting lifestyles intervention strategies and recommendations with relevant policy.Methods:The study selected 9000 elders from 11 cities in Shanxi Province using a multistage random cluster sampling method in each city.A total of 9000 questionnaires were sanded,8526 effective questionnaires were collected,and the effective rate was 94.84%.A self-designed questionnaire of demographic characteristics,the HPLP-C and the SF-36 scales were used as the research instruments.The descriptive analysis was used to analyze the status on health promoting lifestyles of the elderly.Independent sample t-test,One-way analysis of variance and Kruskal-Wallis H test were utilized for comparing the scores from each dimension in different demographic characteristics among the elderly.The exploratory factor analysis was used to extract the latent variables,and Structural equation modeling was used to analyze the influencing factors for the health promoting lifestyles of the elderly and the related mechanism of their effect.Results:The results showed that there were 4901 empty nesters and 3625 non-empty nesters in 11 cities of Shanxi province.53.60% of the e lderly were aged 60 to 70 years old.The number of males(49.72%)and females(50.28%)were equally represented,there were many elderly people living in rural areas than those in urban areas.The total(105.99±19.61)and six dimensions scores in HPLP amon g the participants were all at a moderate level.For the mean scores of each scale,Nutrition was the best,followed by Self-actualization,Interpersonal relations,Stress management,Physical activity and Health responsibility.The results of univariate analysis showed that the HPLP score and six dimensions scores among the elderly had statistically significant differences in Age,Residence,Education,Marriage,Pre-retirement career,BMI,The sources of incomes,Incomes,Medical expenses,Social activity participation,Community satisfaction and Elderly activity center(P<0.05).It was feasible to use structural equation model ing to analyze the influencing factors of health promotion lifestyle of the elderly.After the modification of structural equation mo deling,the fitness index of the model conformed to the criterion,that means the model was reasonable.The path coefficients of four latent variables,including Socioeconomic status,Family support system,Social support system and Health were statistical ly significant.Sort by the total effect: The social support system had a direct effect on health promoting lifestyles with a total effect of 0.518.There were 5 indirect paths in socio-economic status to the health promotion lifestyles and the total effec t was 0.354.Such as Socioeconomic status ?Social support system ?Health promoting lifestyles(indirect effect,0.210);Socioeconomic status ?Health ?Health promoting lifestyles(indirect effect,0.032);Socioeconomic status ?Health ?Social support system ?Health promoting lifestyles(indirect effect,0.013);Socioeconomic status ?Family support system ?Social support system ?Health promoting lifestyles(indirect effect,0.040);Socioeconomic status ?Family support system ?Health ?health promoting lifestyles(indirect effect,0.059).There were two paths in health to health promoting lifestyles(direct effect,0.210): Health ?Health promoting lifestyles(direct effect,0.210);Health ?Social support system ?Health promoting lifestyles(indirect effect,0.083).There were 3 paths in family support system with the total effect of 0.163,including Family support system ?Social support system ?Health promoting lifestyles(indirect effect,0.089),Family support system? Health? Health promoting lifestyles(indirect effect,0.053),Family support system ?Health ?Social support system ?Health promoting lifestyles(indirect effect,0.021).Conclusions:The health promoting lifestyles of the elderly in Shanxi province needs to be improved,especially dimensions of Phys ical activity and Health responsibility.The influencing factors of health promoting lifestyles were various and complicated.For the 4 Latent variables,social support system and health had a direct and indirect effect on elderly health promoting lifestyl e,but socio-economic status and family support system only had an indirect effect.Meanwhile,the other three potential variables were all related to the health promotion lifestyle of the elderly through social support system.It is indicated that we shou ld pay attention to the improvement of physical activity and health responsibility in the elderly's health promoting lifestyle.Based above,we advocated a way to enhance health status and family support to improve health promoting lifestyles that was to increase social support and social activitiy participations in particular as the main idea and to provide more old-age security.