سالمندی سالم؛ تحلیل مقایسه‏ای سبک زندگی ارتقا دهندۀ سلامت مردان و زنان سالمند در شهر شیراز‬‬

مقالۀ پیش رو با استفاده از داده‏های حاصل از پیمایش نمونه‏ای و اجرای «پرسشنامه ساخت‏یافته» در میان سالمندان 60 ساله و بالاتر شهر شیراز در سال 1390 به بررسی مقایسه‏ای سبک زندگی ارتقا دهنده سلامت زنان و مردان سالمند و تبیین تفاوت‏های جنسیتی بر اساس مشخصه‏های اجتماعی و جمعیتی می‏پردازد.‬ نتایج تحلیل‏های دو متغیره بیانگر تفاوت معنادار بین مردان و زنان سالمند در چهار بُعد از شش بُعد سبک زندگی ارتقا دهندۀ سلامت است؛ زنان در ابعادی نظیر مسوولیت سلامت و روابط بین فردی و در مقابل مردان در ابعاد مدیریت استرس و فعالیت جسمانی نمرۀ بالاتری را کسب کردند. در دو بُعد تغذیه و رشد روحی تفاوت معناداری بین دو جنس مشاهده نشد؛ علاوه بر این، وضعیت سلامت خود ادراک و خود کارآمدی سلامت زنان در سطح پایینتری در مقایسه با مردان بوده است. نتایج تحلیل چندمتغیره با استفاده از آزمون تحلیل طبقه‏بندی چندگانه نشان داد که بعد از کنترل متغیرهای اقتصادی و اجتماعی (تحصیلات، اشتغال، و درآمد) جنسیت به طور محسوس و معناداری سبک زندگی ارتقای سلامت را تحت‏تاثیر قرار می‏دهد و زنان میانگین نمرۀ بالاتری را در شاخص سبک زندگی ارتقای سلامت خواهند داشت. به طور خلاصه، نتایج مطالعه نشان داد جدای از ابعاد زیست‌شناختی متفاوت زن و مرد، شرایط اجتماعی نابرابر، رفتارهای سلامت متفاوتی را برای زنان و مردان به‏ همراه دارد.

Healthy Ageing: A Comparative Analysis of Health Promoting Lifestyle among Elderly Males and Females in Shiraz

Extended Abstract#13 #13 1 Introduction#13 Worldwide growth of ageing population has increased debate on healthy ageing in both academic research and day to day discourse. Likewise, due to the change in the population age structure in Iran, research on healthy ageing has developed. According to the main and determinant role of gender on health promotion lifestyle, the aim of this article is to analyze the effect of gender on health promotion lifestyle among older adults.#13 #13 2 Theoretical Framework#13 Three main approaches employed in the research on health promotion life style among older adults include: healthy life style models that are used for all age ranges, theories and models of healthy ageing, and the extensive models and theories of healthy behaviors and health promotion lifestyle. In this study we utilized the third approach and adopted the Pender’s (2006) Health Promotion Model (HPM) to explain the health promotion of the elderly as it comprehensively shows the relation between individuals and their environment. Healthy lifestyle is an individual choice made within the social context and structural limitations such as gender and socio economic status. The effect of gender on the health related behaviors among older adults is well documented (Budesa, Erin, Lauren, 2008 NolenHoesksema, 2006 Ostlinetal, 2006 Segal, Demos, Kronenfeld, 2003 Von Bothmer Fridlund, 2005). Males and females engage differently in health related risky behaviors. Men pay less attention to health promotion behaviors than women (Patel, 2005 Moore, 2010). The literature Also shows although women report diseases more often than men, they live longer (Chiello Hutchison, 2010). This article shows the effect of gender differences in socioeconomic status, selfefficacy, and health status on health promotion lifestyle.#13 3 Methodology#13 The data was collected in 2011 through random sling survey using a structured questionnaire in the city of Shiraz, Iran. There were 86444 people aged 60 and older in 2011. The sle size of this study was 400 older adults (aged 60+). The participants were chosen by proportional stratifiedsling method. Data were gathered through facetoface interviews. According to the aim of this study, gender was the independent variable and health promotion life style was the dependent variable. The effect of gender on health promotion lifestyle was estimated with and without controlling for the socioeconomic variables including age, marital status, occupational status, educational levels, household income and life arrangement, selfreported health status, and selfefficacy. Multi Classification Analysis (MCA) was adopted to examine the effect of gender on health promotion lifestyle with controlling for the effect of other variables. #13 #13 4 Results#13 Results showed significant differences between males and females regarding sociodemographic characteristics. Married men were more likely to be living with their spouse compared to women. This means the rate of widowed women who lived alone was higher than men. The differences may be explained by different patterns of remarriage between men and women which were more common among men. The literacy rate was higher among older men than older women. Among the sled men, half were employed. This figure was only one percent for women. Women were in the lower level of physical and mental health. Men had a significantly higher average score in some items of selfefficacy such as ability to solve health problems and using any means like money and time for their health promotion.#13 Binary analysis indicated significant gender differences in the four out of six subscales of healthpromoting lifestyle. The results showed that females had higher scores of health responsibility and interpersonal relations than their counterparts, while males had higher scores of physical activity and stress management than females. However, there was no significant difference in the two subscales of nutrition and spiritual growth between the genders. The overall healthpromoting lifestyle score was higher for men. MCA showed that health promoting lifestyle scores were significantly associated with gender. When controlling for socioeconomic variables (such as age, education, occupation, income, living arrangement, selfefficacy, and so on), the mean score of health promoting lifestyle was higher for females. #13 #13 5 Conclusion#13 In conclusion, apart from the biological differences between women and men, inequalities in socioeconomic conditions also cause different and unfair consequent healthrelated behaviors among older men and women. In other words, socioeconomic variables can moderate the effect of gender on health promotion life style. Policy makers should be concerned about grounded variables such as gender and socioeconomic status which affect the main determinants of health promotion of lifestyles such as selfefficacy. Therefore, welfare policies focused on equal health promotion for men and women should emphasize equal opportunity and economic resources (especially those related to education and careers) and also consider specific needs and different behaviors of men and women.