Health behaviour and its determinants in elderly patients with chronic diseases: evidence from Jiangsu Province, China

Abstract

Background: Chronic disease is a major cause of mortality among elderly individuals in China, and treatment is a substantial public health burden. However, behavioural interventions may be more important than mere clinical treatment of these chronic diseases.

Objective: The paper aimed to assess the health behaviour of a sample of elderly individuals with chronic diseases in Jiangsu Province, China and to identify how demographic characteristics influence health behaviour. Furthermore, the group that would likely need the most health intervention was identified.

Design: A version of the Health Promoting Lifestyle Profile II (HPLP-II) was adapted to Chinese to evaluate health behaviours in six dimensions: nutrition, tobacco and alcohol use, physical activity, stress management, health responsibility, and spiritual growth. Multistage random sampling was conducted from October 2020 to May 2021. Questionnaires incorporating the adapted HPLP-II were distributed to 900 elderly patients (i.e., aged 60 and above) with chronic diseases in the three sampled prefectures of Jiangsu Province; of these questionnaires, 791 were completed. Univariate t tests, principal component analysis, and multivariate linear regressions were employed in the analysis.

Results: The average total score of respondents on health behaviour was 73.73. The dimensions (ordered from highest to lowest scores) are as follows: "nutrition", "tobacco and alcohol use", "health responsibility", "spiritual growth", "stress management", and "physical activity". The multivariate linear regression suggested that the determinants (P < 0.05) of health behaviour (total score) were income, sex, age, relationship status, residence, and education.

Conclusions: Elderly patients with chronic diseases in Jiangsu Province generally behaved in a healthy manner. "Physical activity", "stress management", and "spiritual growth" were the dimensions that would most benefit from health intervention, while elderly single/divorced/widowed patients with lower income and less education should be the target group for health intervention.

Keywords: Chronic disease; Determinants; Elderly patient; Health behaviour; Jiangsu Province.