23-летняя динамика (1994−2016 гг.) отношения к своему здоровью, поведенческим характеристикам и профилактике сердечно-сосудистых заболеваний среди женщин 25−44 лет в России/Сибири
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Материалы и методы. В рамках 3-го скрининга программы изучения тенденций и контроля ССЗ «MONICA» и подпрограммы [«MONICA-психосоциальная» (MOPSY)] в 1994 г. обследована случайная репрезентативная выборка 870 женщин в возрасте 25−64 лет (средний возраст 45,4±0,4 года) одного из районов Новосибирска; в возрастной группе 25−44 лет − 284 женщины.
В 2016 г. в рамках скринирующих исследований по бюджетной теме НИИТПМ № гос. рег. 01201282292 обследована случайная репрезентативная выборка 540 женщин в возрасте 25–44 лет того же района Новосибирска. Отношение к своему здоровью, поведенческим характеристикам и профилактике ССЗ изучались с использованием шкалы «Знание и отношение к своему здоровью», валидизированной для российской популяции в рамках программы ВОЗ «MONICA». Для расчета показателей применяли χ2. Критерием статистической значимости использовалась достоверность результата при р<0,05.
Результаты. Анализ показал, что в открытой популяции среди женщин в возрасте 25−44 лет в период 1994–2016 гг. имеет место положительная динамика оценки своего здоровья (21 и 50,7% соответственно). Но, несмотря на это, 50% женщин негативно оценивают свое здоровье, а 96% отмечают вероятность заболеть серьезной болезнью в течение 5−10 лет. Большинство женщин верят в возможности медицины успешно предупреждать и лечить болезни сердца, но доля лиц, использующих ресурсы здравоохранения в профилактических целях, остается крайне низкой и не превышает 10%. В открытой популяции среди женщин в возрасте 25−44 лет за 23 года имеет место нарастание стресса на рабочем месте и тенденции роста изменений семейного положения. Зафиксировали в период 1994−2016 гг. изменения в поведении женщин, ассоциированного со здоровьем: возросла доля лиц, отказавшихся от курения и регулярно делающих физзарядку, улучшилось пищевое поведение.
Заключение. Установили, что среди женщин в возрасте 25−44 лет имеет место положительная динамика по отношению к профилактике поведенческих факторов риска ССЗ. Но, несмотря на это, половина женщин негативно оценивают свое здоровье и незначительно используют ресурсы здравоохранения.
Ключевые слова: эпидемиология, женская популяция, отношение к своему здоровью, поведенческие характеристики, профилактика сердечно-сосудистых заболеваний.
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Purpose. To determine the 23-year dynamics (1994–2016) of attitudes toward one's health, behavioral characteristics and the prevention of cardiovascular diseases in an open population among women 25−44 years old in Russia / Siberia (Novosibirsk).
Material and methods. In the framework of the third screening of the MONICA program for the study of trends and control of cardiovascular diseases and the MONICA-psychosocial (MOPSY) subprogram, in 1994 a random representative sample of women aged 25–64 years of age from one from the districts of Novosibirsk (n = 870, the average age is 45.4±0.4 years); in the age group 25−44 years − 284 persons. In 2016 years. in the framework of screening studies on the budgetary issue of NIITPM No. gos. reg. 01201282292, a random representative sample of women aged 25−44 years old in the same district of Novosibirsk (n = 540) was examined. Attitude to their health, behavioral characteristics and the prevention of cardiovascular diseases were studied using the "Knowledge and attitude to their health" scale, validated for the Russian population under the WHO "MONICA" program. The chi-square test (x2) was used to calculate the indices. The criterion of statistical significance was the reliability of the result at p<0.05.
Results: The analysis showed that in the open population among women aged 25−44 years, there is a positive dynamics in assessing their health (21% and 50.7%, respectively). But, despite this, 50% of women negatively assess their health and 96% note the probability of getting a serious illness for 5−10 years. Most women believe in the ability of medicine to successfully prevent and treat heart disease, but the proportion of people using health resources for preventive purposes remains extremely low and does not exceed 10%. In the open population among women aged 25−44 years for 23 years there is an increase in stress in the workplace and the trend of growth in changes in marital status. Recorded in the period 1994−2016 gg. changes in the behavior of women associated with health: increased the proportion of people who gave up smoking and regularly doing physical exercises, and improved eating behavior.
Conclusion: It was found that among women aged 25−44 years there is a positive dynamics in relation to the prevention of behavioral risk factors for CVD. But despite this, half of women negatively assess their health and use health resources only slightly.
Key words: epidemiology, female population, attitude to one's health, behavioral characteristics, prevention of cardiovascular diseases.
2. Wasniowska A, Kozela M, A Pajak, et al. Relation between knowledge on cardiovascular disease (CVD) risk factors and the risk of death in urban residents. European Journal of Preventive Cardiology. 2016; 22 (suppl. 1): s178.
3. Awad A, Al-Nafisi H. Public knowledge of cardiovascular disease and its risk factors in Kuwait: a cross-sectional survey. BMC Public Health. 2014; 14: 1131. doi: 10.1186/1471-2458-14-1131.
4. Isaac V, McLachlan CS, PhD, Baune BT, et al. Poor Self-Rated Health Influences Hospital Service Use in Hospitalized Inpatients With Chronic Conditions in Taiwan. Medicine (Baltimore). 2015; 94(36): e1477. doi: 10.1097/MD.0000000000001477.
5. Lim W-Y, Ma S, Heng D, et al. Gender, ethnicity, health behaviour & self-rated health in Singapore. BMC Public Health. 2007; 7: 184. doi: 10.1186/1471-2458-7-184.
6. Krause NM, Jay GM. What do global self-rated health items measure? Med Care. 1994; 32(9): 930-42. doi: 10.1097/00005650-199409000-00004.
7. WHO MONICA Project prepared by Kuulasmaa K. et al. Baseline population survey data book. MONICA Memo 178 A. Helsinki: 1990.
8. MONICA Psychosocial Optional Study. Suggested measurement instruments. WHO Facsimile Urgent 3037 MRC; 1988.
9. Гафаров В.В., Пак В.А., Гагулин И.В., Гафарова А.В., Панов Д.О. Изучение на основе программы ВОЗ «MONICA» информированности и отношения к своему здоровью у женщин в возрасте 25 – 64 лет в г. Новосибирске. Сибирский медицинский журнал (г. Томск). 2010; 25(4): 131-7.[ Gafarov V, Pak V, Gagulin I, Gafarova A, Panov D. Survey of awareness and attitude towards the heath in women aged 25-64 in Novosibirsk: based on WHO program «MONICA». Sibirian medical journal (Tomsk). 2010;25(4):131-7. (In Russ.)]
10. Molarius A, Berglund K, Eriksson C, et al. Socioeconomic conditions, lifestyle factors, and self-rated health among men and women in Sweden. Eur J Public Health. 2007; 17: 125-133. doi: 10.1093/eurpub/ ckl070.
11. Pikhart H, Bobak M, Siegrist J, et al. Psychosocial work characteristics and self rated health in four post-communist countries. J Epidemiol Community Health. 2001; 55(9): 624-30. doi: 10.1136/jech.55.9.624.
12. Witvliet MI1, Arah OA, Stronks K, Kunst AE. Examining self-rated health of young central and eastern Europeans in the context of other world regions. Eur J Public Health. 2014;24(2):314-21. doi: 10.1093/eurpub/ckt040.
13. Witvliet MI, Kunst AE, Stronks K, Arah OA. Variations between world regions in individual health: a multilevel analysis of the role of socio-economic factors. Eur J Public Health. 2012; 22(2): 284-9. doi: 10.1093/eurpub/ckr001.
14. Abebe DS, Tøge AG, Dahl E. Individual-level changes in self-rated health before and during the economic crisis in Europe. International Journal for Equity in Health. 2016: 15:1. doi: 10.1186/s12939-015-0290-8.
15. Gafarov V, Gafarova A. WHO programs: “Register acute myocardial infarction”, “MONICA” – dynamics acute cardiovascular accidentat years 1977-2009 in general population aged 25-64 years in Russia. Russian Journal of Cardiology. 2016; 132 (4): 129-135. doi: 10.15829/1560-4071-2016-4-eng-129-134.
16. MacDonald C, Moriarty H, Mann S. Patients Have a Positive Perception of Screening for Cardiovascular Risk. Heart, Lung and Circulation. 2008; 17(Suppl. 3): S202.
17. Prus SG. Comparing social determinants of self-rated health across the United States and Canada. Soc Sci Med. 2011; 73(1): 50-9. doi: 10.1016/j.socscimed.2011.04.010.
18. Weyers S, Peter R, Boggild H, et al. Psychosocial work stress is associated with poor self-rated health in Danish nurses: a test of the effort–reward imbalance model. Scandinavian Journal of Caring Sciences. 2006; 20 (1): 26–34. doi: 10.1111/j.1471-6712.2006.00376.x.
19. Новосибирская область. 2015 год: краткий статистический сборник. Территориальный орган Росстата по Новосибирской области. Новосибирск: Новосибирскстат; 2016. Доступно по: http://novosibstat.gks.ru/wps/wcm/connect/rosstat_ts/novosibstat/ru/publications/official_publicatio... Ссылка активна на 11.01.2017. [ Novosibirskaya oblast'. 2015 god: kratkij statisticheskij sbornik. Territorial'nyj organ Rosstata po Novosibirskoj oblasti. Novosibirsk: Novosibirskstat; 2016. Available from: http://novosibstat.gks.ru/wps/wcm/connect/rosstat_ts/novosibstat/ru/publications/official_publicatio... This link is available on 11.01.2017. (In Russ.)]
20. WHO global report on trends in prevalence of tobacco smoking 2015. World Health Organization. Geneva: WHO Press, 2015.
21. Statistics on Obesity, Physical Activity and Diet. Health and Social Care Information Centre; West Yorkshire, England: The Contact Centre, 2015.
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1. Wu S, Wang R, Zhao Ya, et al. The relationship between self-rated health and objective health status: a population-based study. BMC Public Health. 2013; 13: 320. doi: 10.1186/1471-2458-13-320.
2. Wasniowska A, Kozela M, A Pajak, et al. Relation between knowledge on cardiovascular disease (CVD) risk factors and the risk of death in urban residents. European Journal of Preventive Cardiology. 2016; 22 (suppl. 1): s178.
3. Awad A, Al-Nafisi H. Public knowledge of cardiovascular disease and its risk factors in Kuwait: a cross-sectional survey. BMC Public Health. 2014; 14: 1131. doi: 10.1186/1471-2458-14-1131.
4. Isaac V, McLachlan CS, PhD, Baune BT, et al. Poor Self-Rated Health Influences Hospital Service Use in Hospitalized Inpatients With Chronic Conditions in Taiwan. Medicine (Baltimore). 2015; 94(36): e1477. doi: 10.1097/MD.0000000000001477.
5. Lim W-Y, Ma S, Heng D, et al. Gender, ethnicity, health behaviour & self-rated health in Singapore. BMC Public Health. 2007; 7: 184. doi: 10.1186/1471-2458-7-184.
6. Krause NM, Jay GM. What do global self-rated health items measure? Med Care. 1994; 32(9): 930-42. doi: 10.1097/00005650-199409000-00004.
7. WHO MONICA Project prepared by Kuulasmaa K. et al. Baseline population survey data book. MONICA Memo 178 A. Helsinki: 1990.
8. MONICA Psychosocial Optional Study. Suggested measurement instruments. WHO Facsimile Urgent 3037 MRC; 1988.
9. Gafarov V, Pak V, Gagulin I, Gafarova A, Panov D. Survey of awareness and attitude towards the heath in women aged 25-64 in Novosibirsk: based on WHO program «MONICA». Sibirian medical journal (Tomsk). 2010;25(4):131-7. (In Russ.)
10. Molarius A, Berglund K, Eriksson C, et al. Socioeconomic conditions, lifestyle factors, and self-rated health among men and women in Sweden. Eur J Public Health. 2007; 17: 125-133. doi: 10.1093/eurpub/ ckl070.
11. Pikhart H, Bobak M, Siegrist J, et al. Psychosocial work characteristics and self rated health in four post-communist countries. J Epidemiol Community Health. 2001; 55(9): 624-30. doi: 10.1136/jech.55.9.624.
12. Witvliet MI1, Arah OA, Stronks K, Kunst AE. Examining self-rated health of young central and eastern Europeans in the context of other world regions. Eur J Public Health. 2014;24(2):314-21. doi: 10.1093/eurpub/ckt040.
13. Witvliet MI, Kunst AE, Stronks K, Arah OA. Variations between world regions in individual health: a multilevel analysis of the role of socio-economic factors. Eur J Public Health. 2012; 22(2): 284-9. doi: 10.1093/eurpub/ckr001.
14. Abebe DS, Tøge AG, Dahl E. Individual-level changes in self-rated health before and during the economic crisis in Europe. International Journal for Equity in Health. 2016: 15:1. doi: 10.1186/s12939-015-0290-8.
15. Gafarov V, Gafarova A. WHO programs: “Register acute myocardial infarction”, “MONICA” – dynamics acute cardiovascular accidentat years 1977-2009 in general population aged 25-64 years in Russia. Russian Journal of Cardiology. 2016; 132 (4): 129-135. doi: 10.15829/1560-4071-2016-4-eng-129-134.
16. MacDonald C, Moriarty H, Mann S. Patients Have a Positive Perception of Screening for Cardiovascular Risk. Heart, Lung and Circulation. 2008; 17(Suppl. 3): S202.
17. Prus SG. Comparing social determinants of self-rated health across the United States and Canada. Soc Sci Med. 2011; 73(1): 50-9. doi: 10.1016/j.socscimed.2011.04.010.
18. Weyers S, Peter R, Boggild H, et al. Psychosocial work stress is associated with poor self-rated health in Danish nurses: a test of the effort–reward imbalance model. Scandinavian Journal of Caring Sciences. 2006; 20 (1): 26–34. doi: 10.1111/j.1471-6712.2006.00376.x.
19. Новосибирская область. 2015 год: краткий статистический сборник. Территориальный орган Росстата по Новосибирской области. Новосибирск: Новосибирскстат; 2016. Доступно по: http://novosibstat.gks.ru/wps/wcm/connect/rosstat_ts/novosibstat/ru/publications/official_publicatio... Ссылка активна на 11.01.2017. [ Novosibirskaya oblast'. 2015 god: kratkij statisticheskij sbornik. Territorial'nyj organ Rosstata po Novosibirskoj oblasti. Novosibirsk: Novosibirskstat; 2016. Available from: http://novosibstat.gks.ru/wps/wcm/connect/rosstat_ts/novosibstat/ru/publications/official_publicatio... This link is available on 11.01.2017. (In Russ.)]
20. WHO global report on trends in prevalence of tobacco smoking 2015. World Health Organization. Geneva: WHO Press, 2015.
21. Statistics on Obesity, Physical Activity and Diet. Health and Social Care Information Centre; West Yorkshire, England: The Contact Centre, 2015.
1 Научно-исследовательский институт терапии и профилактической медицины, Новосибирск, Россия;
2 Межведомственная лаборатория эпидемиологии сердечно-сосудистых заболеваний, Новосибирск, Россия
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V.V. GAFAROV1,2, D.O. PANOV1,2, E.A. GROMOVA1,2, I.V. GAGULIN1,2, A.V. GAFAROVA1,2, E.A. KRYMOV1,2
1 FSBI Institute of Internal and Preventive Medicine, Novosibirsk, Russia;
2 Collaborative laboratory of Cardiovascular Diseases Epidemiology, Novosibirsk, Russia