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Article(id=1240977222572503139, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240977214964036360, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202412007, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1732982400000, receivedDateStr=2024-12-01, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773801626103, onlineDateStr=2026-03-18, pubDate=1748102400000, pubDateStr=2025-05-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773801626103, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773801626103, creator=13701087609, updateTime=1773801626103, updator=13701087609, issue=Issue{id=1240977214964036360, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='10', pageStart='1729', pageEnd='1920', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773801624289, creator=13701087609, updateTime=1773825591019, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241077738770068227, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240977214964036360, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241077738770068228, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240977214964036360, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1813, endPage=1817, ext={EN=ArticleExt(id=1240977223059042447, articleId=1240977222572503139, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=A socially embedded structural model of quality of life in urban older adults with comorbidity, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=

Background With the deepening of the aging society, the comorbidity phenomenon increasingly threatens the quality of life of the older adults, but the discussion of its influence mechanism is still incomplete.

Objective

To evaluate the quality of life of the urban older adults with comorbidity from a multi-dimensional perspective, and to verify the influencing factors of the quality of life of the urban older adults with comorbidity by combining the theory of social embeddedness mechanisms.

Methods

The questionnaire data of 465 urban older adults with comorbidity were selected as the study sample. One-way ANOVA and independent samples t-test analysis were used to test the differences of different demographic characteristics in the quality of life of the urban older adults with comorbidity, and AMOS 28.0 was used to construct a social embedding structure model of the quality of life of the urban older adults with comorbidity.

Results

The perceived quality of life among urban older adults with comorbidity was rated at a moderate level. In addition, there were significant differences in the quality of life of urban older adults with comorbidity with different genders, ages, marital status, education level, work status, and retirement status. Social support (β=0.10, P<0.001) and social resources (β=0.20, P<0.001) demonstrated positive effects on the quality of life of urban older adults with comorbidity.

Conclusion

Self-reported quality of life are generally higher among urban older adults with comorbidity. Social scenario has a positive effect on social support, and the quality of life of the urban older adults with comorbidity is indirectly improved by strengthening social support. At the same time, social resources not only directly contribute to the quality of life, but also indirectly have a positive impact through social support paths.

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背景

随着人口老龄化社会的不断加深，共病现象日益威胁着老年人生命质量，然而对其影响机制的讨论尚不完备。

目的

多维视角下评价城市共病老年人生命质量，结合社会嵌入理论验证城市共病老年人生命质量影响因素。

方法

筛选465名共病老年人的问卷数据作为研究样本。运用单因素方差分析和独立样本t检验分析检验不同人口学特征在共病老年人生命质量中的差异，运用AMOS 28.0构建城市共病老年人生命质量的社会嵌入结构模型。

结果

城市共病老年人自觉生命质量处于中等水平。此外，不同性别、年龄、婚姻状态、受教育程度、工作状态、退休状态的城市共病老年人在生命质量的多个维度上均存在显著差异。社会支持（β=0.10, P<0.001）和社会资源（β=0.20, P<0.001）对城市共病老年人生命质量有显著的正向影响。

结论

城市共病老年人自我报告的生命质量普遍较高。社会情景对社会支持具有正向促进作用，且通过强化社会支持，间接提升了城市共病老年人生命质量。同时，社会资源不仅直接促进生命质量，还经由社会支持路径间接产生积极影响。

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张淑娥，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=Dbtrz6TZer589gWxVhyacw==, magXml=UzFLeA1pY41wc8XNct5bhA==, pdfUrl=null, pdf=Ok5hEJqcUKlMGeggER9Hug==, pdfFileSize=784907, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=VCy0yKiybWR3vjHarf5F+w==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=PyPxRkzNDaf+IvS7NnQmZw==, mapNumber=null, authorCompany=null, fund=null, authors=

周欣（2004—），女，本科在读，研究方向：共病管理

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周欣（2004—），女，本科在读，研究方向：共病管理

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周欣（2004—），女，本科在读，研究方向：共病管理

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注：e表示残差。

, figureFileSmall=YyuXPC6IFm0Otx0asSHsNA==, figureFileBig=l4GNtEcLFtG/2zyGs+j0gg==, tableContent=null), ArticleFig(id=1240996919896503240, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222572503139, language=EN, label=Table 1, caption=

Simulation results of a structural equation of the influencing mechanism of quality of life in urban older adults with multimorbidity(n=465)

, figureFileSmall=null, figureFileBig=null, tableContent=
拟合指标中文释义拟合标准初始模型修正模型
χ2/df 2与自由度比值1~3良好；>3~5可接受5.583.51
RMSEA(95%CI)近似误差均方根<0.08可接受0.100.07
GFI拟合优度指数>0.90良好0.760.86
AGFI修正拟合优度指数>0.90良好0.710.83
NFI常规拟合指数>0.90良好0.730.83
CFI比较拟合指数>0.90良好0.760.87
TLI增值拟合指数>0.90良好0.730.86
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城市共病老年人生命质量影响机制的结构方程模型的模拟结果（n=465）

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拟合指标中文释义拟合标准初始模型修正模型
χ2/df 2与自由度比值1~3良好；>3~5可接受5.583.51
RMSEA(95%CI)近似误差均方根<0.08可接受0.100.07
GFI拟合优度指数>0.90良好0.760.86
AGFI修正拟合优度指数>0.90良好0.710.83
NFI常规拟合指数>0.90良好0.730.83
CFI比较拟合指数>0.90良好0.760.87
TLI增值拟合指数>0.90良好0.730.86
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城市共病老年人生命质量的社会嵌入结构模型
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周欣 1 , 荀思翰 1 , 陈思雨 1 , 温情雯 1 , 段孝建 2 , 范绕琪 1 , 商佳怡 1 , 孙涛 3 , 时宇 4 , 尹慧 1 , 张淑娥 1
现代预防医学 | 基层卫生服务 2025,52(10): 1813-1817
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现代预防医学 | 基层卫生服务 2025, 52(10): 1813-1817
城市共病老年人生命质量的社会嵌入结构模型
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周欣1, 荀思翰1, 陈思雨1, 温情雯1, 段孝建2, 范绕琪1, 商佳怡1, 孙涛3, 时宇4, 尹慧1, 张淑娥1
作者信息
  • 1.哈尔滨医科大学卫生管理学院，黑龙江省 哈尔滨市 150081
  • 2.哈尔滨医科大学人事处
  • 3.杭州师范大学公共卫生学院
  • 4.天津医科大学公共卫生学院

    • 周欣（2004—），女，本科在读，研究方向：共病管理

通讯作者:

张淑娥，E-mail:
A socially embedded structural model of quality of life in urban older adults with comorbidity
Xin ZHOU1, Si-han XUN1, Si-yu CHEN1, Qing-wen WEN1, Xiao-jian DUAN2, Rao-qi FAN1, Jia-yi SHANG1, Tao SUN3, Yu SHI4, Hui YIN1, Shu-e ZHANG1
Affiliations
  • Department of Health Management, School of Health Management, Harbin Medical University, Harbin 150081, China
出版时间: 2025-05-25 doi: 10.20043/j.cnki.MPM.202412007
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摘要
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背景

随着人口老龄化社会的不断加深，共病现象日益威胁着老年人生命质量，然而对其影响机制的讨论尚不完备。

目的

多维视角下评价城市共病老年人生命质量，结合社会嵌入理论验证城市共病老年人生命质量影响因素。

方法

筛选465名共病老年人的问卷数据作为研究样本。运用单因素方差分析和独立样本t检验分析检验不同人口学特征在共病老年人生命质量中的差异，运用AMOS 28.0构建城市共病老年人生命质量的社会嵌入结构模型。

结果

城市共病老年人自觉生命质量处于中等水平。此外，不同性别、年龄、婚姻状态、受教育程度、工作状态、退休状态的城市共病老年人在生命质量的多个维度上均存在显著差异。社会支持（β=0.10, P<0.001）和社会资源（β=0.20, P<0.001）对城市共病老年人生命质量有显著的正向影响。

结论

城市共病老年人自我报告的生命质量普遍较高。社会情景对社会支持具有正向促进作用，且通过强化社会支持，间接提升了城市共病老年人生命质量。同时，社会资源不仅直接促进生命质量，还经由社会支持路径间接产生积极影响。

城市共病老年人  /  生命质量  /  社会嵌入机制  /  社会支持  /  社会情景  /  社会资源

Background With the deepening of the aging society, the comorbidity phenomenon increasingly threatens the quality of life of the older adults, but the discussion of its influence mechanism is still incomplete.

Objective

To evaluate the quality of life of the urban older adults with comorbidity from a multi-dimensional perspective, and to verify the influencing factors of the quality of life of the urban older adults with comorbidity by combining the theory of social embeddedness mechanisms.

Methods

The questionnaire data of 465 urban older adults with comorbidity were selected as the study sample. One-way ANOVA and independent samples t-test analysis were used to test the differences of different demographic characteristics in the quality of life of the urban older adults with comorbidity, and AMOS 28.0 was used to construct a social embedding structure model of the quality of life of the urban older adults with comorbidity.

Results

The perceived quality of life among urban older adults with comorbidity was rated at a moderate level. In addition, there were significant differences in the quality of life of urban older adults with comorbidity with different genders, ages, marital status, education level, work status, and retirement status. Social support (β=0.10, P<0.001) and social resources (β=0.20, P<0.001) demonstrated positive effects on the quality of life of urban older adults with comorbidity.

Conclusion

Self-reported quality of life are generally higher among urban older adults with comorbidity. Social scenario has a positive effect on social support, and the quality of life of the urban older adults with comorbidity is indirectly improved by strengthening social support. At the same time, social resources not only directly contribute to the quality of life, but also indirectly have a positive impact through social support paths.

Urban older adults with comorbidity  /  Quality of life  /  Social embeddedness mechanisms  /  Social support  /  Social scenario  /  Social resources
周欣, 荀思翰, 陈思雨, 温情雯, 段孝建, 范绕琪, 商佳怡, 孙涛, 时宇, 尹慧, 张淑娥. 城市共病老年人生命质量的社会嵌入结构模型. 现代预防医学, 2025 , 52 (10) : 1813 -1817 . DOI: 10.20043/j.cnki.MPM.202412007
Xin ZHOU, Si-han XUN, Si-yu CHEN, Qing-wen WEN, Xiao-jian DUAN, Rao-qi FAN, Jia-yi SHANG, Tao SUN, Yu SHI, Hui YIN, Shu-e ZHANG. A socially embedded structural model of quality of life in urban older adults with comorbidity[J]. Modern Preventive Medicine, 2025 , 52 (10) : 1813 -1817 . DOI: 10.20043/j.cnki.MPM.202412007
正文
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人口老龄化不断深化及其伴随的慢性病发病率攀升等系列问题给健康中国战略的实施带来严峻挑战[1]。《“十四五”健康老龄化规划》揭示，逾78%的老年人罹患至少一种慢性病，且众多老年人共患两种及以上疾病，即共病状态。共病状态增加了老年人的衰弱风险，进一步导致了老年人机体脆弱性增加[2-3]。近年来，城市共病老年人群体显著扩大[4-5]，对城市医疗资源分配及老年人健康服务质量构成持续影响。共病老年人生命质量的影响因素多元、复杂且相互交织。尽管国内研究已就睡眠时间[6]、服药依从性[7]、健康相关行为[8]等因素对生命质量不同程度的影响进行了相关探讨，但对共病老年人生命质量的社会学机制探究尚显不足。社会嵌入理论为提升老年人生命质量提供理论支撑[9]，该理论可推断社会情景可能激发共病老年人融入社会的意愿。藉此，本研究基于社会嵌入理论，通过多维度社会学因素评估，构建了影响老年人生命质量的社会嵌入结构方程模型，以期系统理解城市共病老年人生命质量的现状及影响机制，为提升共病老年人生命质量提供科学依据与理论参考。
1　对象与方法
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1.1　调查对象
根据横截面样本量的要求确定样本量。计量资料样本量估算公式为，式中α为置信水平[10]，μα代表置信水平α下的μ值，S是指标准差，δ代表的则是标准误差。本研究采取双侧检验，α=0.05，μα=1.96，容许误差文献中建议=[0.25 S,0.5 S]，得出样本量范围约为 62名~246名。考虑问卷调查的回收率和有效率以及量表开发的基本要求，本研究将380确定为最小样本量。于2019年10月—2020年12月，利用多阶段分层抽样的方法，在杭州和哈尔滨两个代表性城市开展面对面问卷调查，调研结果依据统计局老年人口比例进行匹配，经过多阶段调查和数据匹配，最终获得了960份问卷，其中有效问卷为764份，有效回收率达到81.28%，其中共病老年人465人，所有参与者均自愿参与本次问卷调查。本研究已获得哈尔滨医科大学伦理委员会的批准（伦理审查编号：HMUIRB2023038）。
1.2　调查工具
1.2.1　基本人口学特征问卷
采用了团队自制的问卷来收集调查对象的基本信息，其中包括性别、年龄、文化程度、工作情况、经济状况、婚姻状况、居住地址和居住情况等。
1.2.2　生命质量测量
采用被广泛应用的8条目短板（SF-8）来测量和评估老年人生命质量[11]。采用李克特5级计分方式，分数范围为1至5（1=非常好，5=非常差），例如：“你将如何描述你的整体健康状况？”，在研究中采用反向计分，得分越高代表生命质量越低，该工具的Cronbach α系数为0.876。
1.2.3　影响因素测量
（1）社会情景
采用CGSS 2015家庭问卷中的4个题项进行社会情景测量，在中国本土研究中具有良好的可靠性[12]。采用李克特5级计分方式，评分范围从1到5（完全不同意到完全同意）。得分越高，表示社会情景越积极，体验的社会氛围越和谐。本次在城市老年人群体中应用该问卷，得出的Cronbach α系数为0.63。
（2）社会资源
采用6条目的社会资源量表测量城市老年人与他人互动的频率[13]。根据城市老年人的实际情况，对问卷进行了适当的调整。该量表采用李克特5级计分方式，评分范围从1到5（1=从不，5=总是）。得分越高，表示受访者的社会资源越高。在本次城市老年人群体中应用该量表时，得出的Cronbach α系数为0.88。
（3）社会支持
采用由 Zimet于1988 年开发的简版6题项社会支持量表[14]，旨在评估个体领悟到的社会支持程度，涵盖来自家人、朋友以及他人的支持情况。该量表采用李克特5级计分方式，计分范围为1至5（完全不同意至完全同意），得分越高，表明感知到的社会支持水平越高。在本研究中，社会支持量表的Cronbach α为0.88。
1.3　变量的选择与定义
在构筑的结构方程模型中，生命质量、社会情景为外生潜变量，社会资源和社会支持为内生潜变量，见图2。初始模型的拟合结果显示，各路径均具有统计学意义，但拟合适配度并未达到理想状态的值。由于研究所使用的数据量较大，所以χ2/df值偏大，但小于0.5，且其他拟合优度指标均接近或超过理想值，故此模型在可接受的范围内，详见表1。
1.4　质量控制
采用量表均为成熟量表，并在医疗卫生领域广泛运用。为保证调查问卷的质量，在整个过程中都进行了质量控制，前期通过专家评估和焦点小组讨论反馈修订问卷；中期培训调查员并进行真实有效的数据采集；后期剔除不符合标准的问卷，进行双录入和审核以确保数据质量。
1.5　统计学方法
采用SPSS 26.0进行描述性统计分析、单因素方差分析、独立样本t检验分析，并运用Word绘制生命质量占比柱状图。使用AMOS 28.0构建城市共病老年人生命质量的影响机制模型。采用LSD方法，采取双侧检验。中介分析采用偏差校正Bootstrap方法。检验水准α=0.05。适配度指标：GFI、AGFI、NFI、CFI、TLI理想值接近或大于0.9，RMSEA及95%可信区间小于0.08。
2　结果
收起
2.1　城市共病老年人生命质量多维描述评价
2.1.1　城市共病老年人生命质量各维度均值与标准差
城市共病老年人一般健康题项得分为（3.53±0.79）分，身体功能题项得分为（3.73±0.94）分，身体角色题项得分为（4.09±0.87）分，身体疼痛题项得分为（4.08±0.74）分，活力题项得分为（3.62±0.88）分，社会功能题项得分为（4.37±0.79）分，心理健康题项得分为（4.46±0.74）分，情绪角色题项得分为（4.50±0.72）分。
2.1.2　城市共病老年人生命质量得分占比描述
为了直观展示城市共病老年人生命质量的水平，绘制了城市共病老年人生命质量占比柱状图。结果显示，大部分城市共病老年人自觉生命质量处于中等水平, 见图1。
2.2　城市共病老年人生命质量多维现状描述
分析结果显示，不同性别的城市共病老年人在生命质量的心理健康和情绪角色维度上存在显著差异，女性的心理健康和情绪角色高于男性（M＝4.55，t=2.64，P<0.05；M＝4.56，t=1.90，P<0.05）。在不同年龄阶段，城市共病老年人生命质量在身体功能、身体角色和活力维度上亦表现出显著差异（F=8.81，P<0.05；F=5.60，P<0.05；F=5.86，P<0.05）。此外，依据婚姻状态的不同，城市共病老年人在生命质量的身体功能、身体疼痛、活力、社会功能维度上表现出显著差异（F=7.54，P<0.05；F=4.81，P<0.05；F=5.64，P<0.05；F=3.56，P<0.05）。不同教育水平的城市共病老年人在生命质量的身体功能、身体角色、身体疼痛、活力和心理健康维度上同样显示出显著差异（F=6.30，P<0.05；F=3.41，P<0.05；F=4.19，P<0.05；F=5.70，P<0.05；F=1.31，P<0.05）。并且，不同工作状态的城市共病老年人在身体功能维度上表现出显著性差异（F=5.78，P<0.05）。关于退休状态，不同退休状态的城市共病老年人在生命质量的身体功能、身体角色、身体疼痛、社会功能、心理健康、情绪角色维度上也呈现出显著差异（t=3.27，P<0.05；t=2.39，P<0.05；t=3.82，P<0.05；t=1.85，P<0.05；t=1.90，P<0.05；t=1.07，P<0.05）。
2.3　城市共病老年人生命质量影响因素的社会嵌入机制
基于社会嵌入模型，构建了城市共病老年人生命质量影响因素的社会嵌入初始模型，初始模型数据见表1。经修正后，其结果如图2。
根据标准化影响效应系数结果，社会资本对生命质量具有直接效应和间接效应；社会支持对生命质量具有直接效应；社会资源对社会支持具有直接效应；社会情景对社会支持具有直接效应。
3　讨论
收起
3.1　城市共病老年人生命质量的多维现状分析
本研究与其他研究结果一致：城市共病老年人生命质量总体处于中上水平且呈上升态势[15]。尽管部分城市共病老年人生理健康负担因身体机能衰退有所加重，但其心理状态相对稳健，在社会支持等方面表现出较强适应能力。且不同社会特征的共病老年人生命质量存在差异，其中，女性、年轻、已婚、受教育程度较高、工作状态良好及已退休的城市共病老年人展现出更高的生命质量。具体而言，女性因具备更广泛的社会支持和情绪表达能力，更注重健康管理，从而在面对挑战时能够获取更多的支持。年轻老年人的健康状况较好，社会参与度高，这些因素都有利于提升其生命质量。已婚老年人能从配偶处获得情感和照护支持，其生命质量更高[16]。教育水平高的城市共病老年人信息获取与学习能力更强，可获取健康资讯提升其生命质量。工作状态显著影响城市共病老年人生命质量，有工作者优于无工作者，全职工作者高于兼职者。此外，研究表明自主创业者健康指标亦较好[17]。良好职业背景为老年人奠定坚实的经济基础，退休后仍积极参与社会活动并承担医疗开销，这有助于进一步提升其生命质量。
3.2　城市共病老年人生命质量的社会嵌入路径阐释
结合社会嵌入理论证实社会情景、社会支持、社会资源对共病老年人生命质量的影响。研究结果显示，社会支持对提升城市共病老年人生命质量具有显著正面效应。同时，社会互动机制对城市共病老年人的社会联结及身份认同感具有积极作用，也有利于进一步提升其生命质量[18]。与社会网络理论观点一致，社会互动有助于形成的健全社会支持网络能够为城市共病老年人提供来自多方的情感支持、实际帮助及信息指导，成为影响其生命质量的因素[19]。研究结果也表明，社会情景对城市共病老年人生命质量具有直接正面效应，且经由社会支持路径产生间接正面影响。可见积极的社会情景有助于城市共病老年人有效管理个人健康，减轻对安全问题的忧虑[20]，进而改善其生命质量。研究结果还提示社会资源对城市共病老年人生命质量具有直接正面效应，并经由社会支持路径产生间接影响，其中社会支持扮演了部分中介角色。社会资源被确认为提升主观幸福感的核心要素，其丰富性能够满足城市共病老年人的基本医疗需求，继而提升其生命质量。资源保存理论为研究结果提供可解释依据，高水平社会资源的支持下，城市共病老年人能够更有效地整合与利用这些资源，实现资源的积极维护与增值，从而建立更广泛的社会支持与和谐的人际关系网络，进而增强其社会功能与提高其身心健康水平。此外，社会资源的积累与运用不仅可能有利于促进城市共病老年人形成健康的生活方式，还可能有助于其在人际资本中收获更多的社会支持与情感支撑，这对提升其生命质量具有积极作用。
4　小结
收起
从多维人口学特征角度出发，对城市共病老年人生命质量进行了综合评估，结果显示，女性、较年轻、已婚、教育水平高、保持良好工作状态及已退休的城市共病老年人展现出更高的生命质量。本研究验证共病老年人生命质量的社会嵌入理论机制，社会支持能够正向预测城市共病老年人生命质量，社会情景通过社会支持环境介导而影响城市共病老年人生命质量，丰富社会资源增加社会支持物质基础进而提升城市共病老年人生命质量。采用横断面设计可能导致问卷调查结果受主观因素影响。此外，本研究仅揭示了社会情景、社会支持、社会资源与生命质量之间的相关性，尚需纵向研究来进一步确立其因果关系。
基金
收起
  • 国家自然科学基金项目(72374057)
  • 黑龙江省自然科学基金项目(LH2024G004)
  • 中国博士后科学基金第17批特别资助(2024T170207)
  • 中国博士后科学基金第74批面上资助“地区专项支持计划”项目(2023MD744209)
  • 黑龙江省博士后面上项目(LBH-Z23233)
  • 2023年度黑龙江省省属本科高校“优秀青年教师基础研究支持计划”（自然科学）(YQJH2023029)
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2025年第52卷第10期
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doi: 10.20043/j.cnki.MPM.202412007
  • 接收时间：2024-12-01
  • 首发时间：2026-03-18
  • 出版时间：2025-05-25
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  • 收稿日期：2024-12-01
基金
国家自然科学基金项目(72374057)
黑龙江省自然科学基金项目(LH2024G004)
中国博士后科学基金第17批特别资助(2024T170207)
中国博士后科学基金第74批面上资助“地区专项支持计划”项目(2023MD744209)
黑龙江省博士后面上项目(LBH-Z23233)
2023年度黑龙江省省属本科高校“优秀青年教师基础研究支持计划”（自然科学）(YQJH2023029)
作者信息
    1.哈尔滨医科大学卫生管理学院，黑龙江省 哈尔滨市 150081
    2.哈尔滨医科大学人事处
    3.杭州师范大学公共卫生学院
    4.天津医科大学公共卫生学院

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