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Article(id=1320438110723355615, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438090615862080, articleNumber=null, orderNo=null, doi=10.11847/zgggws1148369, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1751817600000, receivedDateStr=2025-07-07, revisedDate=1755619200000, revisedDateStr=2025-08-20, acceptedDate=1760630400000, acceptedDateStr=2025-10-17, onlineDate=1792746578149, onlineDateStr=2026-10-23, pubDate=1775750400000, pubDateStr=2026-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792746578149, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792746578149, creator=13701087609, updateTime=1792746578149, updator=13701087609, issue=Issue{id=1320438090615862080, tenantId=1146029695717560320, journalId=1319373219989389464, year='2026', volume='42', issue='4', pageStart='385', pageEnd='512', issueExtLink='null', onlineDate='null', pubDate='1775750400000', pubDateStr='2026-04-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792746573356, creator='13701087609', updateTime=1792748076043, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320444393430040620, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438090615862080, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320444393430040621, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438090615862080, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=429, endPage=434, ext={EN=ArticleExt(id=1320438112392688608, articleId=1320438110723355615, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Impact of heat risk perception on adaptive behavior of older adults: an analysis based on chain mediation effect, columnId=1320427686514770171, journalTitle=Chinese Journal of Public Health, columnName=Survey and Report, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the influencing factors of the heat adaptive behavior of the elderly based on the model of private proactive adaptation to climate change.

Methods

A survey of heat adaptive behavior was conducted among 650 older adults in Guangzhou from June to September 2024. AMOS 26.0 was used to establish a model of the influence on heat adaptive behavior in older adults for analysis of the factors affecting heat adaptive behavior.

Results

A total of 608 valid questionnaires were collected. The fitting index of the model of the influence on heat adaptive behavior of older adults was better than the qualified standard, indicating a good degree of fitting. The results of structural equation modeling test showed that risk experience (β = 0.136, P < 0.001) and social discourse (β = 0.309, P < 0.001) had positive effects on risk perception. Risk perception had a negative effect on maladaptation (β = −0.234, P < 0.01) and a positive effect on adaptive behavior (β = 0.327, P < 0.001). Maladaptation had a negative effect on adaptive behavior (β = −0.103, P < 0.001). Risk perception mediates the effects of risk experience and social discourse on adaptive behavior, with the mediation effect values of 0.045 and 0.101, respectively. The chain mediation between risk perception and maladaptation mediates the effects of risk experience and social discourse on adaptive behavior, with the mediation effect values of 0.003 and 0.007, respectively.

Conclusions

Improving older adults′ awareness of heat risks can lead to more active adoption of heat adaptive behavior, which can thus effectively reduce their vulnerability to the adverse effects of heat and ultimately reduce the heat-related health burden.

, authors=Duo CHEN, Lushi KONG, Jindan ZHANG, Chun FAN, Bei LI, authorsList=Duo CHEN, Lushi KONG, Jindan ZHANG, Chun FAN, Bei LI, authorCompany=null, correspAuthors=Bei LI, authorNote=null, correspAuthorsNote=
LI Bei, E-mail:
, copyrightStatement=Copyright © 2026 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1320438113202189283, articleId=1320438110723355615, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=高温风险感知对老年人适应性行为的影响：基于链式中介效应分析, columnId=1320427686770622717, journalTitle=中国公共卫生, columnName=调查报告与分析, runingTitle=null, highlight=null, articleAbstract=
目的

基于个人主动适应气候变化模型，探讨老年人采取高温适应性行为的影响因素。

方法

2024年6—9月，调查广州市650名老年人的高温适应性行为。采用AMOS 26.0构建老年人高温适应性行为影响模型，分析老年人高温适应性行为影响因素。

结果

回收有效问卷608份。老年人高温适应性行为影响模型拟合指数优于合格标准，拟合度良好。结构方程模型检验结果显示，风险经验对风险感知有正向影响（β=0.136，P<0.001），社会话语对风险感知有正向影响（β=0.309，P<0.001），风险感知对适应不良有负向影响（β= –0.234，P<0.01），风险感知对适应性行为有正向影响（β=0.327，P<0.001），适应不良对适应性行为有负向影响（β= –0.103，P<0.001）。风险感知在风险经验和社会话语对适应性行为中起到中介效应（中介效应值分别为0.045和0.101）。风险感知和适应不良这一链式中介在风险经验和社会话语对适应性行为中起到中介效应（中介效应值分别为0.003和0.007）。

结论

提升老年人对高温风险的认知水平，能够促使该人群更积极地采取高温适应性行为，进而有效降低其在应对高温不利影响时的脆弱性，最终减轻高温相关的健康负担。

, authors=陈朵, 孔露诗, 张锦丹, 范纯, 李贝*, *, authorsList=陈朵, 孔露诗, 张锦丹, 范纯, 李贝, authorCompany=null, correspAuthors=李贝, authorNote=

陈朵（2000—），硕士在读，研究方向：卫生政策与管理

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李贝，E-mail：
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Risk Analysis, 2013, 33(6): 1049-1065., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1320438113617425380, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438110723355615, xref=null, ext=[AuthorCompanyExt(id=1320438113625813989, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438110723355615, companyId=1320438113617425380, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Health Management, Southern Medical University, Guangzhou 510515, China), AuthorCompanyExt(id=1320438113634202598, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438110723355615, companyId=1320438113617425380, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=南方医科大学卫生管理学院，广州 510515)])], figs=[ArticleFig(id=1320438121615962126, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438110723355615, language=EN, label=Fig.1, caption=Model of influence on heat adaptive behavior of older adults in Guangzhou city, including the influence paths between risk experience, social discourse, risk perception, adaptive behavior, and maladaptation, figureFileSmall=W/PCS1uJPhpjVK5VS+CQZA==, figureFileBig=Tp0WSpyEmdAWYc79YAXO1w==, tableContent=null), ArticleFig(id=1320438121691459599, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438110723355615, language=CN, label=图1, caption=老年人高温适应性行为影响模型

注：a P < 0.001，b P< 0.01。

, figureFileSmall=W/PCS1uJPhpjVK5VS+CQZA==, figureFileBig=Tp0WSpyEmdAWYc79YAXO1w==, tableContent=null), ArticleFig(id=1320438121901174800, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438110723355615, language=EN, label=Tab.1, caption=

Core variables and their measurement indicators

, figureFileSmall=null, figureFileBig=null, tableContent=
核心变量观测项测量指标
风险经验（RE）RE1您的工作受到高温的影响
RE2您的生活受到高温的影响
RE3您所居住的城市遭受过高温攻击
社会话语（SD）SD1您的朋友家人或邻居和您谈论高温风险和适应策略
SD2您从电视或手机等媒体平台收到有关高温风险和适应策略的信息
SD3您从专家那里获得了有关高温风险和适应策略的信息
风险感知（RP）RP1您认为高温会对个人身体或心理健康带来严重损害
RP2您认为高温会威胁个人生命安全
RP3您认为高温会给您所居住的地区带来严重的经济损失
RP4您认为气候变化会加剧未来的高温天气
RP5您认为未来高温天气发生的可能性很高
RP6您的身体或心理健康容易受到高温的损害
适应性行为（AB）
AB1您在高温天气减少外出
AB2您在高温天气大量饮水
AB3您在高温天气穿浅色的衣服
AB4您在高温天气关注天气预报和高温健康保护指南
AB5您在高温天气使用风扇和空调来让室内降温
适应不良（M-AD）M-AD1一切都是由命运决定的，您无能为力应对高温问题
M-AD2您不担心高温，因为高温无法对您造成影响
M-AD3高温与人为影响无关，只与命运有关
), ArticleFig(id=1320438121976672273, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438110723355615, language=CN, label=表1, caption=

核心变量及测量指标

, figureFileSmall=null, figureFileBig=null, tableContent=
核心变量观测项测量指标
风险经验（RE）RE1您的工作受到高温的影响
RE2您的生活受到高温的影响
RE3您所居住的城市遭受过高温攻击
社会话语（SD）SD1您的朋友家人或邻居和您谈论高温风险和适应策略
SD2您从电视或手机等媒体平台收到有关高温风险和适应策略的信息
SD3您从专家那里获得了有关高温风险和适应策略的信息
风险感知（RP）RP1您认为高温会对个人身体或心理健康带来严重损害
RP2您认为高温会威胁个人生命安全
RP3您认为高温会给您所居住的地区带来严重的经济损失
RP4您认为气候变化会加剧未来的高温天气
RP5您认为未来高温天气发生的可能性很高
RP6您的身体或心理健康容易受到高温的损害
适应性行为（AB）
AB1您在高温天气减少外出
AB2您在高温天气大量饮水
AB3您在高温天气穿浅色的衣服
AB4您在高温天气关注天气预报和高温健康保护指南
AB5您在高温天气使用风扇和空调来让室内降温
适应不良（M-AD）M-AD1一切都是由命运决定的，您无能为力应对高温问题
M-AD2您不担心高温，因为高温无法对您造成影响
M-AD3高温与人为影响无关，只与命运有关
), ArticleFig(id=1320438122064752658, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438110723355615, language=EN, label=Tab.2, caption=

Factor loadings, Cronbach′s α, combined reliability, and average variance extracted for risk experience, social discourse, risk perception, adaptive behavior, and maladaptation among 608 older adults in Guangzhou city

, figureFileSmall=null, figureFileBig=null, tableContent=
变量观测项因子载荷Cronbach′s α组合信度（CR）平均方差抽取（AVE）平均得分
风险经验（RE）RE10.7430.8090.8100.5873.71
RE20.762
RE30.792
社会话语（SD）SD10.7270.8180.8210.6073.73
SD20.866
SD30.736
风险感知（RP）RP10.7510.8670.8680.5233.39
RP20.777
RP30.734
RP40.716
RP50.67
RP60.684
适应性行为（AB）AB10.7350.8440.8450.5224.27
AB20.743
AB30.723
AB40.707
AB50.702
适应不良（M-AD）M-AD10.7360.8350.8400.6382.33
M-AD20.739
M-AD30.909
), ArticleFig(id=1320438122140250131, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438110723355615, language=CN, label=表2, caption=

信度分析与聚合效度检验

, figureFileSmall=null, figureFileBig=null, tableContent=
变量观测项因子载荷Cronbach′s α组合信度（CR）平均方差抽取（AVE）平均得分
风险经验（RE）RE10.7430.8090.8100.5873.71
RE20.762
RE30.792
社会话语（SD）SD10.7270.8180.8210.6073.73
SD20.866
SD30.736
风险感知（RP）RP10.7510.8670.8680.5233.39
RP20.777
RP30.734
RP40.716
RP50.67
RP60.684
适应性行为（AB）AB10.7350.8440.8450.5224.27
AB20.743
AB30.723
AB40.707
AB50.702
适应不良（M-AD）M-AD10.7360.8350.8400.6382.33
M-AD20.739
M-AD30.909
), ArticleFig(id=1320438122219941908, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438110723355615, language=EN, label=Tab.3, caption=

Values of CMIN/DF, GFI, IFI, CFI, TLI, NFI, AGFI, and RMAEA in the model of the influence on heat adaptive behavior of older adults in Guangzhou city: structural equation model fitting

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拟合指标指标值合格标准理想标准
CMIN/DF3.9331～31～5
GFI0.896>0.8>0.9
IFI0.908>0.8>0.9
CFI0.907>0.8>0.9
TLI0.893>0.8>0.9
NFI0.880>0.8>0.9
AGFI0.868>0.8>0.9
RMAEA0.070 <0.10 <0.08
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结构方程模型拟合情况

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拟合指标指标值合格标准理想标准
CMIN/DF3.9331～31～5
GFI0.896>0.8>0.9
IFI0.908>0.8>0.9
CFI0.907>0.8>0.9
TLI0.893>0.8>0.9
NFI0.880>0.8>0.9
AGFI0.868>0.8>0.9
RMAEA0.070 <0.10 <0.08
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Standardized path coefficients, standard errors of estimates, critical ratios, P-values, and hypothesis testing results of the influence paths between risk experience, social discourse, risk perception, adaptive behavior, and maladaptation among older adults in Guangzhou: structural equation modeling test results

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路径标准化路径系数估计值标准误临界比值P值假设检验结果
风险经验→风险感知0.1360.0363.799<0.001支持
社会话语→风险感知0.3090.0397.823<0.001支持
风险感知→适应不良–0.2340.074–3.1470.002支持
风险感知→适应性行为0.3270.0496.714<0.001支持
适应不良→适应性行为–0.1030.029–3.555<0.001支持
), ArticleFig(id=1320438122438045719, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438110723355615, language=CN, label=表4, caption=

结构方程模型检验结果

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路径标准化路径系数估计值标准误临界比值P值假设检验结果
风险经验→风险感知0.1360.0363.799<0.001支持
社会话语→风险感知0.3090.0397.823<0.001支持
风险感知→适应不良–0.2340.074–3.1470.002支持
风险感知→适应性行为0.3270.0496.714<0.001支持
适应不良→适应性行为–0.1030.029–3.555<0.001支持
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高温风险感知对老年人适应性行为的影响：基于链式中介效应分析
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陈朵 , 孔露诗 , 张锦丹 , 范纯 , 李贝 *, *
中国公共卫生 | 调查报告与分析 2026,42(4): 429-434
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中国公共卫生 |调查报告与分析 2026 , 42 (4) : 429 -434
高温风险感知对老年人适应性行为的影响：基于链式中介效应分析
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陈朵, 孔露诗, 张锦丹, 范纯, 李贝*, *
作者信息
  • 南方医科大学卫生管理学院，广州 510515
通讯作者:
李贝，E-mail：
作者简介:

陈朵（2000—），硕士在读，研究方向：卫生政策与管理

Impact of heat risk perception on adaptive behavior of older adults: an analysis based on chain mediation effect
Duo CHEN, Lushi KONG, Jindan ZHANG, Chun FAN, Bei LI
Affiliations
  • School of Health Management, Southern Medical University, Guangzhou 510515, China
    • Corresponding Author:
    LI Bei, E-mail:
出版时间: 2026-04-10 doi: 10.11847/zgggws1148369
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摘要
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目的

基于个人主动适应气候变化模型，探讨老年人采取高温适应性行为的影响因素。

方法

2024年6—9月，调查广州市650名老年人的高温适应性行为。采用AMOS 26.0构建老年人高温适应性行为影响模型，分析老年人高温适应性行为影响因素。

结果

回收有效问卷608份。老年人高温适应性行为影响模型拟合指数优于合格标准，拟合度良好。结构方程模型检验结果显示，风险经验对风险感知有正向影响（β=0.136，P<0.001），社会话语对风险感知有正向影响（β=0.309，P<0.001），风险感知对适应不良有负向影响（β= –0.234，P<0.01），风险感知对适应性行为有正向影响（β=0.327，P<0.001），适应不良对适应性行为有负向影响（β= –0.103，P<0.001）。风险感知在风险经验和社会话语对适应性行为中起到中介效应（中介效应值分别为0.045和0.101）。风险感知和适应不良这一链式中介在风险经验和社会话语对适应性行为中起到中介效应（中介效应值分别为0.003和0.007）。

结论

提升老年人对高温风险的认知水平，能够促使该人群更积极地采取高温适应性行为，进而有效降低其在应对高温不利影响时的脆弱性，最终减轻高温相关的健康负担。

老年人  /  高温  /  风险感知  /  适应性行为  /  个人主动适应气候变化模型  /  广州市
Objective

To explore the influencing factors of the heat adaptive behavior of the elderly based on the model of private proactive adaptation to climate change.

Methods

A survey of heat adaptive behavior was conducted among 650 older adults in Guangzhou from June to September 2024. AMOS 26.0 was used to establish a model of the influence on heat adaptive behavior in older adults for analysis of the factors affecting heat adaptive behavior.

Results

A total of 608 valid questionnaires were collected. The fitting index of the model of the influence on heat adaptive behavior of older adults was better than the qualified standard, indicating a good degree of fitting. The results of structural equation modeling test showed that risk experience (β = 0.136, P < 0.001) and social discourse (β = 0.309, P < 0.001) had positive effects on risk perception. Risk perception had a negative effect on maladaptation (β = −0.234, P < 0.01) and a positive effect on adaptive behavior (β = 0.327, P < 0.001). Maladaptation had a negative effect on adaptive behavior (β = −0.103, P < 0.001). Risk perception mediates the effects of risk experience and social discourse on adaptive behavior, with the mediation effect values of 0.045 and 0.101, respectively. The chain mediation between risk perception and maladaptation mediates the effects of risk experience and social discourse on adaptive behavior, with the mediation effect values of 0.003 and 0.007, respectively.

Conclusions

Improving older adults′ awareness of heat risks can lead to more active adoption of heat adaptive behavior, which can thus effectively reduce their vulnerability to the adverse effects of heat and ultimately reduce the heat-related health burden.

older adults  /  heat  /  risk perception  /  adaptive behavior  /  model of private proactive adaptation to climate change  /  Guangzhou city
陈朵, 孔露诗, 张锦丹, 范纯, 李贝. 高温风险感知对老年人适应性行为的影响：基于链式中介效应分析. 中国公共卫生, 2026 , 42 (4) : 429 -434 . DOI: 10.11847/zgggws1148369
Duo CHEN, Lushi KONG, Jindan ZHANG, Chun FAN, Bei LI. Impact of heat risk perception on adaptive behavior of older adults: an analysis based on chain mediation effect[J]. Chinese Journal of Public Health, 2026 , 42 (4) : 429 -434 . DOI: 10.11847/zgggws1148369
正文
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在全球气候变暖的总体趋势下，极端高温天气发生的广度和频度都在不断增加，且我国气候变暖速率高于全球平均水平[1]。2023年11月，世界气象组织发布的研究报告指出，在所有的极端气候中，极端高温所造成的死亡率最高，与高温相关的死亡率可能比目前的纪录要高30倍[2]。由于缺乏生理、社会、认知和行为资源，老年人更容易受到高温暴露造成的负面健康后果。老年人易遭受高温相关的健康负担包括中暑、糖尿病、高血压、缺血性心脏病、心力衰竭和心律失常、肺部疾病、精神障碍以及意外受伤[3]。从2000年到2018年，全球65岁以上老年人与极端高温相关的死亡率增加了53.7%，2018年死亡人数达到296 000例[4]。《柳叶刀全球倒计时报告》指出，如果将全球温度升高上限设定在2 °C，2041—2060年，全球65岁以上老年人与高温相关死亡率预计将比1995—2014年高出370%[5]。此外，国家统计局发布的数据显示，2023年，我国60岁及以上人口占比为21.1%，65岁及以上人口占比为15.4%[6]，我国老年人数量庞大。人口老龄化增加了人们应对极端高温气候的脆弱性[7]，高温对未来健康的严重影响很大程度上取决于人们目前的适应能力和行动，而适应将是当前形势下人类应对气候变化的主要战略[8]。目前已有学者运用不同的理论探讨气候变化下适应性行为的影响因素[9–10]，包括计划行为理论（theory of planned behavior, TPB）、价值观信念规范理论（value-belief-norm theory, VBN）、保护动机理论（protection motivation theory, PMT）和个人主动适应气候变化模型（model of private proactive adaptation to climate change, MPPACC）。相较于其他理论模型，MPPACC涵盖了与气候变化适应相关的背景因素，并深入了解人们对气候影响的看法。由于气候变化的不利影响与老年人特有的因素相互作用，老年人这一脆弱群体更值得关注。然而，目前关注影响老年人采取高温适应性行为的认知因素的研究较少。基于此，本研究运用MPPACC理论模型探讨影响老年人高温适应的因素，以期减少高温给老年人带来的健康负担。
1　对象与方法
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1.1　对象
选取广州市作为研究区域。广州市属于典型的亚热带气候，夏季炎热潮湿。根据《广州气候公报2023》，2023年广州全市平均高温日数（日最高气温≥35 ℃）为42.7 d，较常年平均偏多18.4 d，高温天数不断增加。2024年6—9月，课题组采用随机抽样法在广州市荔湾、越秀、海珠、天河、白云、黄埔、番禺、花都、南沙、从化、增城11个区选取老年人作为研究对象。采用自行编制的调查问卷进行面对面调查。本研究经南方医科大学医学伦理委员会审核同意（审查编号：南医伦审〔2024〕51号）。所有调查对象均签署知情同意书。
1.2　研究内容
1.2.1　理论基础
本研究以由Grothmann T等于2005年提出的MPPACC作为理论基础[8]。MPPACC主要基于PMT（以健康为重点），被认为是更适合气候变化相关威胁的背景研究。该模型采用气候界的语言，并从PMT中删除了被认为不适用于环境的各种元素，旨在通过解析关键认知过程，阐明个体在气候威胁背景下适应性行为差异的心理机制。本研究主要考虑风险经验和社会话语这两个认知因素对高温适应性行为的影响。
1.2.2　研究假设
1.2.2.1　风险经验
评估过去风险体验的严重性[8]。由于经验是认知的基础，经历环境问题可以在塑造环境感知方面发挥重要作用[11]。人们对灾害的风险感知受到自身灾害经历的影响，这种个人经历可以减少他们的冷漠、一厢情愿和否认态度，从而导致他们风险感知的增加[12]。基于此，本研究提出H1假设：风险经验对风险感知有正向影响。
1.2.2.2　社会话语
从社区或社区内部收到的信息表明，社会话语是影响个体风险感知的一个决定性因素，个人的认知总是取决于行为者的社会物理背景[8]。例如，老年人对高温风险的看法受到他们在媒体、朋友、同事、邻居或公共机构中听到的有关高温信息的影响和塑造。当风险事件发生后，个体经历以及群体间的直接或间接沟通交流是风险感知得以强化的初始原因，经由个体的直观感觉（包括个体经历、媒体信息等）、非正式网络等渠道得以扩散传播，传播过程中由社会放大站（如政府组织、新闻媒体、咨询机构等）和个体放大站（包括偏好过滤、信息解读、直觉揭思、风险学习等）进一步加强风险信号[13]。基于此，本研究提出H2假设：社会话语对风险感知有正向影响。
1.2.2.3　风险感知
衡量个人如何看待某个事件是否可能发生的风险，从而最终驱动相关的适应性行为[8]。风险评估是基础过程，包括个人对于暴露威胁的可能性（可能性感知）和暴露后果的严重程度（严重性感知）的评估。根据风险评估过程的结果，一个人对威胁做出反应，可以区分两种一般类型的反应：适应和适应不良。适应性反应是那些防止损害的响应，当风险评估较高时发生适应性行为，可以防止身体和经济伤害。适应不良的反应只能防止一个人因感知到危险而产生的负面情绪，它们不能防止对人的身体或经济伤害。基于此，本研究提出H3和H4假设，即，H3：风险感知对适应性行为有正向影响；H4：风险感知对适应不良有负向影响。
1.2.2.4　“适应不良”反应
包括回避反应（例如，否认威胁、一厢情愿、宿命论）和“错误”适应，这些适应实际上增加了气候变化所带来的损害[8]。本文主要考虑回避型适应不良。已有研究表明，回避型适应不良会抑制适应意向[14]。基于此，本研究提出H5假设：适应不良对适应性行为有负向影响。
1.3　纳入与排除标准
1.3.1　纳入标准
（1）在广州市居住时间≥6个月；（2）年龄≥60岁；（3）沟通、交流能力正常，能理解风险感知和适应性行为等内容；（4）自愿参与本研究并签署知情同意书。
1.3.2　排除标准
（1）认知功能或运动功能障碍患者；（2）其他严重心、脑血管疾病及精神障碍患者；（3）失明及语言、行动或读写、理解能力障碍者；（4）依从性差及不愿意配合问卷调查者。
1.4　自编调查问卷与质量控制（表1）
参考已有的研究[8,15]，本研究自行编制的调查问卷主要包括两个部分：第一部分是老年人人口学特征，包括性别、年龄、文化程度和自评健康状况；第二部分是老年人高温风险感知和适应性行为调查：包括风险经验、社会话语、风险感知、适应性行为和适应不良。采用Likert 5级评分法，答案选项“非常不同意”“不同意”“一般”“同意”“非常同意”依次计1～5分。自编调查问卷经由气象学和社会科学相关领域专家审查、完善。调查过程中，先由调查员充分告知本研究目的、方法、内容及意义，待老年人签署知情同意书后进行面对面调查，并全面检查老年人所填写的内容。调查过程中有疑问时及时询问并核实，发现遗漏项目及时补充，调查完成后仔细核查回收的调查问卷内容是否符合标准。
1.5　统计分析
采用Epi Data 3.1软件录入数据，采用双录入核对方式以确保数据录入的准确性。首先，采用Cronbach′s α和组合信度（CR）评价自拟调查问卷的信度，以Cronbach′s α和CR均>0.80表示可以接受和信度良好；采用聚合效度评价自拟调查问卷的效度，以平均方差提取值（AVE）>0.50表示可以接受和聚合效度良好[16]。其次，运用AMOS 24.0软件检验结构方程模型，分析观测变量与潜变量之间的关系，并使用Bootstrap法检验中介效应。Bootstrap样本量设置为5 000，置信区间设置为95%，如果所得间接效应的置信区间不包含0，则表示中介效应显著。
2　结　果
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2.1　人口学特征
共发放问卷650份、回收有效问卷608份，有效回收率93.54%。608份问卷中，老年男性280人（占46.05%）、女性328人（占53.95%）；年龄60～<70岁432人（占71.05%），70～<80岁125人（占20.56%），>80岁51人（占8.39%）；文化程度：小学33人（占5.43%），初中198人（占32.57%），高中（中专）157人（占25.82%），大专166人（占27.30%），本科及以上54人（占8.88%）。自评健康状况：非常差25人（占4.11%），差56人（占9.21%），一般233人（占38.32%），好198人（占32.57%），非常好96人（占15.79%）。
2.2　结构方程拟合指数（表2、3）
所有测量变量的验证性因子分析。各变量的Cronbach′s α、CR均>0.8，AVE均大于0.5，可以认为量表整体具有较好的信度和聚合效度。本研究模型拟合指数优于合格标准，拟合度良好。
2.3　结构方程模型检验结果（图1、表4）
运算模型的相关数据得到潜在变量的数据统计关系。结构方程模型检验结果显示，风险经验对风险感知有正向影响（β=0.136，P<0.001），支持研究假设H1；社会话语对风险感知有正向影响（β=0.309，P<0.001），支持研究假设H2；风险感知对适应不良有负向影响（β= –0.234，P<0.01），支持研究假设H3；风险感知对适应性行为有正向影响（β=0.327，P<0.001），支持研究假设H4；适应不良对适应性行为有负向影响（β= –0.103，P<0.001），支持研究假设H5。
2.4　中介效应结果
进一步探讨老年人高温适应性行为的影响机制，风险感知分别在风险经验和社会话语对适应性行为中起到中介效应，中介效应值分别为0.045和0.101。风险感知和适应不良这一链式中介在风险经验和社会话语对适应性行为中起到中介效应，中介效应值分别为0.003和0.007。
3　讨　论
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老年人暴露在高温下的风险正在增加，衰老会削弱身体通过出汗和血管舒张等过程调节温度的能力，老年人更容易患上与热相关的疾病，例如中暑、热衰竭和脱水。老年人群中常见的慢性疾病（如心血管、呼吸系统和肾脏疾病）通常能加剧这种损害，这些疾病会进一步阻碍体温调节并增加脱水的风险[17]。此外，许多老年人服用影响身体应对高温能力的药物，例如利尿剂、β受体阻滞剂和抗胆碱能药。老年人经常受到多药治疗的影响，这些药物组合和相互作用，对老年人的热脆弱性有未知的影响。由于气候变化的影响是不可避免的，且在某种程度上不可逆转，在当前形势下，适应将是人类应对气候变化的主要战略[18]。为减少高温为老年人带来的健康负担，了解老年人的行为和影响其适应的因素是增强高温适应能力的关键。
本研究结果显示，风险经验对风险感知有正向影响。一系列自然灾害的研究表明，在灾害中遭受损失的人随后更有可能提高对此类灾害的风险感知，并采取减少风险的行动[19–20]。Carlton S J等[21]也认为，气候相关风险的经验是风险显著性的维度之一，直接影响对环境风险的感知。尽管有学者认为，个人对灾难的记忆会随着时间的推移而逐渐减弱。但最近的一项研究表明，人们通常可以重振他们的灾难记忆[22]。社会话语也对风险感知有正向影响。老年人听到谈论高温和适应策略的次数越多，他们就越能意识到高温的严重性和易发性。人们对气候变化的感知主要依赖于专家、媒体、权威机构等发布的气候信息，气候变化信息对气候变化风险感知有显著的正向影响[23]。Curtis A F等[24]对50岁及以上的中老年群体调查发现，暴露于更多的新冠疫情信息中以及对信息依赖度高的中老年群体对新冠病毒的感知严重性也会更高。
本研究结果显示，风险感知对适应性行为有正向影响。风险感知是适应的一个重要心理维度，较高的风险感知可能预示着更好的适应。风险感知是适应和行为改变的重要预测因子[25]。当人们意识到高温的易发性和严重性时，不发生适应性行为的可能性较低。然而，面对高温的高风险后果，仍有老年人没有采取高温适应性行为。首先，由于老年人生理能力随着自然衰老过程的下降而变得不敏感，导致部分老年人的高温风险感知较低，这部分老年人无法意识到自己处于高温威胁之中，也未改变他们的行为[26]。第二，阻止老年人采取适应性行为的另一个障碍是老年人不知道应该如何改变自己的行为。第三，部分老年人虽具备高温风险感知，但受客观条件限制无法采取适应性行为。例如，低收入群体难以负担空调购买或高额电费；低学历老年人可能因理解困难而无法有效利用高温预警信息；失能老年人也可能因行动不便无法自主采取避暑措施。第四，一些适应不良的老年人认为面对高温威胁没有必要改变，宁愿维持现状。宿命论的特征是认为人无法控制事件或拥有改变事件的能力[27]。此外，感知悖论表明，尽管有些人了解风险，但他们将责任转移给其他人，而不是自己采取行动[28]。
在高温期间，老年人作为脆弱群体更容易受到健康威胁，因此，需要更多关注该群体以提升其适应能力。为应对这一挑战，本研究提出以下建议：第一，社区利用其广泛的社会网络传播高温风险信号，将官方预警转化为熟人之间的可信提醒，从而有效提升老年的高温风险意识；第二，社区工作人员有针对性地提醒老年人过往的高温经历，将抽象的历史风险经验具象化；第三，相关学者应评估老年人对高温的健康脆弱性，以提高脆弱人群的适应能力。
本研究的主要贡献体现在三个方面：其一，运用MPPACC模型探讨老年人采取高温适应性行为的影响因素；其二，丰富了MPPACC模型在高温适应方面的实证研究；其三，为制定高温应对策略提供了科学依据。然而，本研究也存在一定的局限性，由于采用了自我报告的形式，回忆偏倚无法控制。本研究为横断面调查，只考察老年人在某个时间点的感知和行为，意味着无法对其进行因果推断；同时，由于本次调查的样本量较少，无法对老年人不同人口学特征进行更为细致的分析。

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doi: 10.11847/zgggws1148369
  • 接收时间：2025-07-07
  • 首发时间：2026-10-23
  • 出版时间：2026-04-10
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  • 收稿日期：2025-07-07
  • 修回日期：2025-08-20
  • 录用日期：2025-10-17
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    南方医科大学卫生管理学院，广州 510515

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
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红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
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光柄菇属 Pluteus 5 2.39
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