Table of Content

15 November 2024, Volume 40 Issue 22

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Treatise

Impact of occupational mental health status on work-related musculoskeletal disorders of workers in the thermal power generation industry in Shanxi Province

JIA Ruizhen, QIN Wenyan, MA Xiaodong, SHEN Xinyu, LI Xiuping, GUO Zhixi

2024, 40(22):  3025-3030. 

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Objective To understand the current situation of occupational mental health status and work-related musculoskeletal disorders（WMSDs） among workers in the thermal power generation industry in Shanxi Province,and to analyze the impact of occupational mental health status on WMSDs,so as to provide a scientific basis for improving their physical and mental conditions. Methods From 2022 to 2023,a multi-stage sampling method was used to survey 1 131 front-line workers in 2 large enterprises,3 medium-sized enterprises,and 10 small enterprises in the thermal power generation industry in Shanxi Province using the occupational stress measurement core scale,the patient health questionnaire,the generalized anxiety disorder scale,and the China musculoskeletal disorders questionnaire to evaluate their occupational mental health status and WMSDs. Results The score of occupational stress[M（P₂₅,P₇₅）] of 1 131 study subjects was 48（43,53）points,and the detection rate of occupational stress was 37.0%（419/1 131）. The score of depressive symptoms was 8（6,11）points points,and the detection rate of those with depressive symptoms was 83.6%（946/1 131）. The anxiety score was 3（1,7）points,and the detection rate of those with anxiety tendency was 41.5%（469/1 131）. The score of WMSDs was 3（1,6）points,and the symptom detection rate of WMSDs was 84.2%（952/1 131）. There were statistically significant differences in the detection rates of WMSDs symptoms among workers of different ages,self-rated health status,occupational stress,depressive symptoms and anxiety（all P<0.05）. Age,education level,self-rated health status,occupational stress and anxiety were the influencing factors of WMSDs（all P<0.05）. Conclusion The detection rate of WMSDs symptoms among workers in the thermal power generation industry in Shanxi Province is relatively high,and their occupational mental health conditions may affect the occurrence of WMSDs.

Mediating role of emotional regulation between spiritual health and occupational burnout among nurses in hepatobiliary surgery

ZHANG Yunzhu, LI Lulu, TANG Juanjuan, YUE Yaxuan, XUE Caiyun

2024, 40(22):  3031-3035. 

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Objective To explore the mediating role of emotional regulation between spiritual health and occupational burnout among hepatobiliary surgery nurses,and provide reference for reducing the level of occupational burnout among nurses. Methods From April to June 2023,a convenience sampling method was used to select 192 hepatobiliary surgery nurses from 6 tertiary hospitals in Nanjing as the research subjects.The spiritual health scale,emotion regulation scale and occupational burnout scale were used for investigation,and the data were analyzed. Results The scores of emotional regulation,spiritual health,and occupational burnout of nurses in the hepatobiliary surgery department were （43.28±8.76）,（85.74±16.32）,and （58.37±12.14）points,respectively. The total score of occupational burnout among hepatobiliary surgery nurses was negatively correlated with the total scores of emotional regulation and spiritual health（r=-0.576,-0.644,both P<0.01）,while the total score of emotional regulation was positively correlated with the total score of spiritual health（r=0.584,P<0.01）.The comparison of emotional regulation scores among hepatobiliary surgery nurses of different ages,marital status,educational level,professional title,and working years showed statistically significant differences（all P<0.05）.The spiritual health scores of hepatobiliary surgery nurses with different ages,educational levels,professional titles,and working years were compared,and the differences were statistically significant（all P<0.05）. The comparison of occupational burnout scores among hepatobiliary surgery nurses of different ages,job titles,working years,and personal monthly income showed statistically significant differences（all P<0.05）. Emotional regulation played a partial mediating effect between the spiritual health and occupational burnout of nurses in hepatobiliary surgery,with a mediating effect of -0.269,accounting for 48.38% of the total effect. Conclusion The spiritual health of hepatobiliary surgery nurses can directly affect their occupational burnout,and can also affect their occupational burnout through emotional regulation. Improving nurses' spiritual health and emotional regulation abilities is beneficial for reducing their occupational burnout level.

Analysis on correlation between work-privacy conflict,occupational stress and occupational burnout among respiratory internal medicine nurses

LIAO Qinghua, WU Wenli, HE Biying, WANG Juanjuan, YU Ting, HAN Yiqiu

2024, 40(22):  3036-3040. 

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Objective To understand the status and correlation of work-private conflict,occupational stress,and occupational burnout among respiratory internal medicine nurses. Methods A random sampling method was used to select respiratory internal medicine nurses from 7 comprehensive hospitals in Xiangyang City from July to August 2023 as the survey subjects. The survey was conducted using the general situation scale,work privacy conflict scale,occupational stress scale and occupational burnout scale,and the data were analyzed. Results The work-privacy conflict score of respiratory internal medicine nurses was （17.96±3.84） points,occupational stress score was （239.05±48.71）points,and occupational burnout score was （62.36±13.15）points. Age,length of service,professional title,marital status,monthly income,and monthly night shifts were the influencing factors of work-privacy conflict among respiratory internal medicine nurses（all P<0.05）. Age,length of service,professional title,marital status,monthly income,and monthly night shifts were the influencing factors of occupational stress among respiratory internal medicine nurses（all P<0.05）. Age,length of service,professional title,monthly income,and monthly night shifts were the influencing factors of occupational burnout among respiratory internal medicine nurses（all P<0.05）. There were positive correlation between work-privacy conflict,occupational stress and occupational fatigue among respiratory internal medicine nurses（r=0.706,0.592,both P<0.01）,and a positive correlation between work-privacy conflict and occupational stress（r=0.635,P<0.01）. Work personal conflict and occupational stress could jointly explain 37.80% variation in occupational burnout among respiratory internal medicine nurses. Conclusion The level of occupational burnout among respiratory internal medicine nurses in Xiangyang City is relatively high,and work-privacy conflict and occupational stress are important influencing factors of occupational burnout. Interventions to improve the work-privacy conflict and occupational stress of respiratory internal medicine nurses are important ways to reduce nurse occupational burnout.

Analysis on current situation of workplace noise hazards in employing units of Haikou City in 2022

CHEN Chuanjie, NIU Yongmao, MENG Xufa, LIN Jian

2024, 40(22):  3041-3045. 

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Objective To investigate the current situation of noise hazards in workplaces of employing units in Haikou City,understand the distribution and exposure of noise workers in the city,and provide technical basis for noise hazard prevention and control strategies. Methods The application data of noise hazards related employing units in Haikou City in 2022 were exported from the "Occupational disease hazard project application system",and the occupational health examination data during the noise operation period in 2022 were exported from the "Occupational disease and health hazard factor monitoring information system". The relevant information was extracted to analyze its epidemiological characteristics. Results There were 319 employing units in Haikou City who engage in noise hazard operations,mainly distributed in Xiuying District（122,38.24%） and Longhua District（94,29.47%）,with small,micro,limited liability companies and manufacturing as the main types,which accounted for 54.23%,37.62%,44.20% and 54.86%,respectively. The limited liability companies（3 027 people,45.53%） and manufacturing companies（4 828 people,72.61%） had the highest number of people exposed to noise. There were statistically significant differences in the noise exposure rates among different regions,scales,economic types,and industries（all P<0.05）. The workplace noise hazard testing was conducted in 294 employing units,with 1 830 detection points and 158 exceeding standard points,and the over-standard rate was 8.63%. There were statistically significant differences in the over-standard rate among different regions,scales,economic types,and industry classifications（all P<0.05）. A total of 31 055 people were exposed to occupational hazards,of which 6 649 were workers exposed to noise,accounting for 21.41%. In 2022,a total of 4 224 people underwent occupational health examinations for noise work,and 607 people had abnormal high-frequency average hearing thresholds in both ears,with an abnormal rate of 14.37%. Conclusions The noise hazards mainly exist in manufacturing enterprises such as small and micro enterprises and limited liability companies. The people exposed to noise hazards is mainly in small and medium-sized enterprises,with a high exposure rate.The abnormal rate of average high-frequency hearing thresholds in occupational health examinations is also high. It is necessary to focus on strengthening noise monitoring in small and medium-sized enterprises and manufacturing industry,and attach importance to the management of population with high-frequency hearing abnormalities.

Influence and risk factors on hearing of customer service staff wearing headphones in a park in Wuhan City

XING Yueqiu, OUYANG Yanqiong

2024, 40(22):  3046-3050. 

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Objective To understand the influence of headphones on the hearing of customer service staff,and further explore the influencing factors of hearing loss. Methods By the convenient sampling method,173 customer service staff from a park who visited the Otolaryngology Head and Neck Surgery Department in Renmin Hospital of Wuhan University,from October 2021 to March 2023 and conducted hearing detection through publicity were selected as the observation group. According to the years of use of headphones,they were divided into three subgroups：36 people in the 0-<3 year group（72 ears）,51 people in the 3-<5 year group（102 ears） and 86 people in the ≥5 year group（152 ears）.52 civilian workers who were not exposed to occupational hazards in the observation group enterprises were selected as the control group. The hearing status of the four groups was compared,and the risk factors for hearing loss were explored. Results The results of pure tone audiometry showed that 14 out of 173 people in the observation group experienced varying degrees of sensorineural hearing loss,accounting for 8.2% of those examined. There was no statistically significant difference in each frequency between the 0-<3 years group and the control group（P>0.05）. There were stati stically significant differences in the hearing threshold at 2.0-8.0 kHz between the 3-<5 years group and ≥5 years group in the observation group and the control group（P<0.05）.There were statistically significant differences in hearing threshold among different subgroups in the observation group（all P<0.05）.The top two highest percentage of self-reported symptoms and hearing conditions of customer service personnel were "sometimes they could hear their coworkers talking but could not hear what was being said clearly"（36.41%）,and "tinnitus"（35.26%）. The hearing damage was related to the volume of headphones used,and the difference was statistically significant（P<0.05）.The number of hearing-impaired ears increased in the observation group as the frequency rose,and the number of impaired ears in the 3-<5 years group in the observation group was more than that in the ≥5 years group,which may be related to the use of headphone volume ≥70% per day. Conclusions The use of earphones by customer service staff mainly causes high-frequency hearing loss,and may also lead to decreased speech recognition rate and tinnitus. The use of headphones by customer service staff for ≥3 years,and the volume ≥70% are risk factors for hearing loss caused by the use of headphones by customer service staff.

Analysis of genetic characteristics of A（H1N1）pdm09 influenza virus in Xinjiang from 2022 to 2023

CHEN Yuan, ZHANG Xuan, Nigedeli Alitengsaier, LI Quanxi, Hundezi Awuxi, MA Xin

2024, 40(22):  3051-3055. 

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Objective To understand the evolutionary characteristics of hemagglutinin（HA） and neuraminidase（NA） gene of A （H1N1）pdm09 influenza virus in Xinjiang from 2022 to 2023,and provide scientific basis for influenza prevention and control. Methods Fifteen A（H1N1）pdm09 influenza strains from 15 influenza surveillance network laboratories in Xinjiang were randomly selected for HA and NA gene sequencing,and gene characteristics were analyzed using MEGA X and BioEdit software. Results The nucleotide homology of HA gene and NA gene of 15 strains of A（H1N1）pdm09 influenza virus was 98.1%-98.9% and 98.7%-99.0%,and amino acid homology was 97.3%-98.5% and 99.1%-99.3%,respectively,compared with the WHO recommended vaccine strain A/Victoria/2570/2019. The phylogenetic tree showed that 15 influenza strains were closely related to vaccine strains and belonged to 6B.1A.5a. A total of 16 amino acid mutation sites were involved in the HA gene,of which only 4 sites were involved in the antigen determinant,namely A203T（15/15） in the Ca region,K71Q（15/15） in the Cb region,P154S（4/15） in the Sa region and E189K（3/15） in the Sb region,and the other 12 sites were changes in non-critical sites. A total of 5 amino acid sites were changed in NA gene,all of which did not belong to the central catalytic site and the auxiliary site around the drug resistance site. Conclusion Although there have been some changes in the HA and NA genes of the A（H1N1）pdm09 influenza virus strain in Xinjiang from 2022 to 2023,the antigenicity of HA and the drug-resistance sites of NA have not undergone critical changes. In the future,it is still necessary to strengthen the monitoring of A（H1N1）pdm09 influenza virus to timely detect the mutant and drug-resistant strains,and provide scientific basis for its effective prevention and control.

Solid phase extraction-isotope dilution liquid chromatography-tandem mass spectrometry determination of four kinds of alternaria toxins in coix seed and their contamination status

WU Jingwei, GUAN Kun, QIU Fen

2024, 40(22):  3056-3060. 

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Objective To establish a solid phase extraction-isotope dilution liquid chromatography-tandem mass spectrometry for determination of four kinds alternaria toxins in coix seed,and to understand the contamination status of alternarian toxins in coix seed sold in Shenzhen. Methods 5 g of coix seed were extracted by acetonitrile-methanol-sodium dihydrogen phosphate solution after adding with mixed internal standards,cleaned up by solid phase extraction column,and determined by ultraperformance liquid chromatography tandem mass spectrometry. A total of 40 samples of commercially available coix seed were randomly collected from 10 administrative districts of Shenzhen,and the contents of 4 alternaria toxins were detected. Results The correlation coefficients of tenuazonic acid（TeA）,alternariol（AOH）,tentoxin（TEN） and alternariol methyl ether（AME） were found to be greater than 0.999,with detection limits ranging from 0.05-0.50 μg/kg. The recoveries were 70.88%-118.97%,and the relative standard deviations were 1.25%-12.43%. Coix seed on sale in Shenzhen were generally contaminated with various types of alternaria toxins,with an total detection rate of 95.0%（38/40）. TeA was the alternaria toxin with highest detection rate（82.5%,33/40） and highest average concentration（18.69 μg/kg）. Conclusion This method has good sensitivity and accuracy,high precision,and is suitable for detecting alternaria toxin in coix seed. The relevant regulatory authorities should propose targeted prevention and control measures to strengthen the quality management of coix seed in various aspects such as production,storage,transportation,and sales.

Analysis on surveillance results of foodborne diseases in Longquanyi District of Chengdu City from 2019 to 2023

LIU Wenyan, ZHANG Li, LU Qingping

2024, 40(22):  3061-3067. 

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Objective To analyze the epidemic characteristics and patterns of foodborne diseases in Longquanyi District of Chengdu City,provide scientific basis for formulating prevention and control measures and improving early warning capabilities. Methods The foodborne disease surveillance data were collected in Longquanyi District of Chengdu City from 2019 to 2023,and the epidemiological analysis was conducted on case information and pathogen detection results. Results A total of 6 988 cases were monitored,which were mainly concentrated from May to September（57.87%）.Longquan Street had the highest number of cases in the region（40.45%）. The male-to-female ratio was 1∶1.24,with an average age of 28.67 years old.The group of <6 years old had the highest proportion（23.08%）,and the occupation was mainly scattered children（18.78%）,students（15.03%）,housework and unemployment（13.18%）.The majority of clinical symptoms were digestive system（99.44%）.The suspected exposed food types mainly included meat and meat products（29.95%）,fruits and their products（17.93%）,and grains and their products（12.26%）.The time distribution of suspiciously exposed foods showed that the difference in exposure of some food types among different quarters was statistically significant（P<0.05）.Most exposed food processing methods and eating places were home-made（33.32%） and home（72.37%）,respectively.Among the 2 636 cases detected by pathogen testing,the positive rate of intestinal pathogenic bacteria was 3.57%,mainly Salmonella（98.94%）,and Salmonella typhimurium was the most detected（66.07%）. The highest detection rate of Salmonella was found in the second quarter（5.84%）. The highest detection rate was found in the group of <6 years old（4.61%） and scattered children（5.29%）.The positive rate of norovirus was 8.51%,with GII type（52.78%） being the main type,and the detection rate in the fourth quarter was the highest（25.00%）. Conclusion Based on the epidemiological characteristics of foodborne diseases,information of suspected exposed foods and etiological results,the relevant institutions should actively collaborate to implement targeted prevention and control measures to reduce the risk of foodborne diseases.

Analysis on mental health status and influencing factors of some primary and secondary school teachers with visual fatigue in Enshi Tujia and Miao Autonomous Prefecture

MA Fang, TANG Jiao, LIU Xinyi, QIN Nanling

2024, 40(22):  3068-3072. 

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Objective To understand the mental health status of some primary and secondary school teachers with visual fatigue in Enshi Tujia and Miao Autonomous Prefecture,and explore the effects of visual fatigue,occupational stress and mental capital on mental health. Methods A total of 236 primary and secondary school teachers who were diagnosed as asthenopia in the physical examination center of the central hospital of Enshi Tujia and Miao Autonomous Prefecture from January 2020 to October 2022 were selected by convenient sampling method as the survey objects. Visual fatigue scale,occupational stress scale,psychological capital scale and symptom checklist 90（SCL-90） were used to investigate and analyze. Results The visual fatigue score of 236 primary and secondary school teachers in Enshi Tujia and Miao Autonomous Prefecture were （118.24±8.46）points,occupational stress scores were （156.48±12.34）points,psychological capital scores were （88.46±8.32）points,and SCL-90 scores were （198.28±32.46）points. The differences of SCL-90 scores among primary and secondary school teachers with different age,teaching experience,school type,and whether they were class teachers were statistically significant（all P<0.05）.The visual fatigue of primary and secondary school teachers with visual fatigue was positively correlated with occupational stress and SCL-90（r=0.486、0.528,both P<0.01）,and was negatively correlated with psychological capital（r=-0.427,P<0.01）.The occupational stress was negatively correlated with psychological capital（r=-0.495,P<0.01）,and the psychological capital was negatively correlated with SCL-90（r=-0.476,P<0.01）.Visual fatigue,occupational stress,and psychological capital jointly explained 32.40% of the variation of mental health of primary and secondary school teachers with visual fatigue. Conclusion The mental health level of primary and secondary school teachers with visual fatigue in Enshi Tujia and Miao Autonomous Prefecture is relatively low. Visual fatigue,occupational stress,and psychological capital are the main influencing factors of mental health. Reducing the levels of visual fatigue and occupational stress,and improving the level of psychological capital are conducive to improving their mental health level.

Analysis of basic immunization status and influencing factors of cerebrospinal meningitis vaccine among children aged 6-35 months in different birth cohorts in a certain district of Beijing

TANG Ying, WANG Fengshuang, LI Chunlong, PENG Xiaoran

2024, 40(22):  3073-3077. 

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Objective To investigate the basic immunization status of children aged 6-35 months in different birth cohorts with cerebrospinal meningitis vaccine in a district of Beijing,and to explore the influencing factors of the full course immunization status of children with epidemic cerebrospinal meningitis vaccine. Methods The "Beijing Immunization Planning Information Management System" was used to query and export the basic immunization data of children born from July 1,2017 to February 28,2022.The trend of change in the vaccination rates of group A meningococcal polysaccharide vaccine（MPV-A） and group A and C meningococcal polysaccharide conjugate vaccine（MPCV-AC） were described,and adverse events following immunization（AEFI） and standardized outpatient data were sorted out. Multivariate analysis was conducted on the influencing factors of the entire process vaccination of meningococcal vaccine in eligible children. Results The basic immunization coverage rate of children's meningitis vaccine in a district of Beijing was 98.58%,of which the basic immune coverage rate of MPCV-AC was increasing year by year（χ²_Trend=487.08,P<0.01）. Children with registered residence in Beijing,children living in urban areas,girls,MPCV-AC meningococcal vaccination,AA outpatient vaccination,the frequency of weekly outpatient days in their outpatient clinics >3,the number of registered outpatient clinics >3,and the number of vaccinations in their outpatient clinics >3 had a high completion rate of basic immunization of meningococcal vaccines[OR（95%CI）=0.37（0.35-0.39）、0.81（0.74-0.88）、1.07（1.01-1.12）、5.45（1.34-22.23）、1.12（1.00-1.25）、1.22（1.12-1.34）、1.02（1.01-1.29）、1.18（1.06-1.31）]. Conclusion The coverage rate of basic immunization against epidemic cerebrospinal meningitis among children aged from 6 to 35 months is relatively high. The focus of vaccination promotion can be placed on migrant children and rural areas,and the vaccination work in outpatient clinics serving small population can be strengthened to improve the basic immunization level of meningococcal vaccine in the whole district.

Analysis on current status and influencing factors of respiratory infectious disease protection ability of medical staff in Beijing

LI Zihan, YAO Xi, JIA Huixue, SUN Xinying

2024, 40(22):  3078-3082. 

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Objective To investigate the status and influencing factors of respiratory infectious disease protection ability of medical staff from different types of hospitals in Beijing,find out the weak points and put forward targeted suggestions to promote the improvement of respiratory infectious disease protection ability of medical staff. Methods A total of 284 medical staff were selected from 6 hospitals in Beijing and a self-designed questionnaire was used to investigate their respiratory infectious disease protection ability. The first survey was completed from October to November 2021,the review was completed from April to May 2023,and the data were analyzed. Results The average score of respiratory infectious disease protection ability among 284 medical staff in Beijing was （61.1±10.5）points. Univariate analysis showed that there were statistical differences in the scores of medical staff with different age,working years,hospital type,hospital grade,exposure risk and post（all P<0.05）. Multiple linear regression analysis showed that working years,hospital grade and post were independent factors influencing the respiratory infectious disease protection ability of medical staff（R²=0.268,F=12.507,P<0.01）. Conclusion There is still much room for improvement in the overall respiratory infectious disease protection ability of medical staff from different types of hospitals in Beijing. Special attention should be paid to medical staff with shorter working years,lower hospital grades and lower requirements for respiratory infectious disease protection ability. Managers should strengthen training for medical staff with different working years and posts to improve their respiratory infectious disease protection ability,so as to prevent respiratory infection risks comprehensively and ensure the health and life safety of medical staff.

Analysis of epidemiological characteristics and disease burden of other infectious diarrhea in Yantian District of Shenzhen City from 2010 to 2022

LIN Kai, LI Xuemei, LIU Yawen, GU Lisi, XU Zhendong, HUANG Renzhan

2024, 40(22):  3083-3087. 

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Objective To analyze the epidemiological characteristics and the disease burden of other infectious diarrhea in Yantian District of Shenzhen City from 2010 to 2022,and provide evidence for formulating effective prevention and control measures. Methods Descriptive analysis was used to describe epidemiological characteristics of other infectious diarrhea reported by China's Disease Control and Prevention Information System.Space-time aggregation detection on the community scale was conducted,a joinpoint regression model was used to analyze the change trend of morbidity,and the epidemiological burden of disease was estimated by years of years lived with disability（YLDs）. Results The average annual incidence of other infectious diarrhea in Yantian District of Shenzhen City from 2010 to 2022 was 203.99/100 000,and the average annual incidence rate（156.10/100 000） from 2020 to 2022 was lower than that of 2010 to 2019（218.33/100 000）,and the difference was statistically significant（P<0.01）. The ratio of incidence rate between men and women was 1.36∶1,The highest incidence was in the 0-<5 year old group（2 445.22/100 000）,and cases were mainly scattered children（63.85%）. The onset time showed a certain seasonality,with two peaks in winter and summer. Rotavirus infection was the main cause in 80.27% of the population.The community with high incidence was the area behind Yantian Port（LLR=99.01,RR=5.64,P<0.01）. The results of Joinpoint regression analysis showed that the overall reported incidence rate from 2010 to 2022 showed a downward trend,but the difference was not statistically significant（AAPC=-3.83%,P>0.05）,and the incidence rate of the 0-1 year old group from 2010 to 2022 showed a significant decline and the difference was statistically significant（APC=-6.89%,P<0.05）.Disability-adjusted life year（DALY） attributed to infectious diarrhea was 19.10 years,and the burden of disease was the greatest in the 0-<5 year old group（7.66 years）. Conclusion From 2010 to 2022,other infectious diarrhea remained an epidemic in Yantian District of Shenzhen City,and comprehensive control and prevention measures needed to be carried out for different characteristic populations and high-risk communities.

Analysis on status quo and influencing factors of professional self-concept,self-disclosure and self-harmony among nurses in 4 traditional Chinese medicine hospitals in Shaanxi Province

GAO Xiaoxi, LIU Yanmei, HE Quanzhen, SUN Mingzhu, CHENG Fan, BAI Congcong

2024, 40(22):  3088-3092. 

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Objective To investigate the status quo of professional self-concept,self-disclosure and self-harmony among nurses in 4 traditional Chinese medicine hospitals in Shaanxi Province and analyze the influencing factors. Methods A total of 574 nurses from different departments of 4 hospitals of traditional Chinese medicine in Shaanxi Province（Shaanxi Provincial Hospital of Traditional Chinese Medicine,Xi'an Hospital of Traditional Chinese Medicine,Yan'an Hospital of Traditional Chinese Medicine and Yulin Hospital of Traditional Chinese Medicine） were selected as the research objects by convenience sampling method from March to August 2023. General information questionnaire,professional self-concept of nurses instrument（PSCNI）,distress disclosure index（DDI） and self consistency and congruence（SCCS） were used to investigate,and the data were analyzed. Results The total scores of PSCNI,DDI and SCCS were （89.88±13.08）,（39.90±6.38） and （109.40±13.99）points,respectively. PSCNI was positively correlated with DDI and SCCS（r=0.453,0.232,both P<0.01）,and DDI was positively correlated with SCCS（r=0.492,P<0.01）. Professional title,average monthly income and PSCNI were the main influencing factors of self-disclosure of nurses in 4 traditional Chinese medicine hospitals（all P<0.05）. Conclusions The self-disclosure of nurses in 4 traditional Chinese medicine hospitals in Shaanxi Province is in the middle level and needs to be further improved. It is suggested that the hospital should increase verbal or group communication activities,listen to the inner needs of nurses,solve their own problems,and expand the development space of nurses,so as to improve the level of self-disclosure of nurses in hospitals of traditional Chinese medicine.

Mediating effect of meta-mood between negative life events and neglect of care in elderly caregivers

WU Xiaomeng, DOU Haoying, ZHANG Lanrui, ZHAO Dongqing

2024, 40(22):  3093-3098. 

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Objective To understand the mediating effect of meta-mood between negative life events and neglect of care among elderly caregivers,so as to provide a reference for managers of elderly care institutions to formulate strategies to reduce neglect of care. Methods From July to November 2023,a convenience sampling was used to conduct a questionnaire survey among 479 caregivers in Beijing elderly care service institutions. The investigation was carried out with the general information questionnaire,life event scale,trait meta-mood scale and elderly caregivers' neglect assessment scale,and the data were analyzed. Results The average score of negative life events among elderly caregivers was（0.73±0.38）points,the average score of neglect of care was （4.25±0.43）points,the average score of meta-mood was （3.68±0.54）points.Among them,the average score of mood attention was （3.54±0.54）points,the average score of mood discrimination was （3.66±0.65）points,and the average score of mood recovery was （3.95±0.78）points. Negative life events were correlated with each dimension of meta-mood and neglect of care（all P<0.05）. Meta-mood had a partial mediating effect between negative life events and care neglect（β=-0.082,P<0.05）,and the mediating effect accounted for 58.16% of the total effect. Conclusion Negative life events can not only directly affect the care neglect of elderly caregivers,but also indirectly affect the care neglect through meta-mood. Institutional managers need to pay more attention to the negative life events of nursing assistants,take a variety of ways to improve the meta-mood ability,and reduce the occurrence of neglect of care.

Multiple mediating effects of after-work shaping and perceived stress on toxic leadership behavior and organizational loyalty of medical staff in cardiology department

YU Qiao, ZENG Li

2024, 40(22):  3099-3104. 

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Objective To explore the multiple mediating roles of perceived stress and after-work shaping in the influence mechanism of toxic leadership behavior on organizational loyalty of medical staff in cardiology department. Methods In September 2023,a cross-sectional study design was used to conveniently select medical staff in the department of cardiology from five grade-A tertiary hospitals in Sichuan Province as the research object. A total of 297 cardiology medical staff were investigated by general information questionnaire,toxic leadership behavior questionnaire,organizational loyalty questionnaire,perceived stress questionnaire and after-work shaping questionnaire. Build a chain mediation model using the PROCESS plugin. Results The scores of toxic leadership behavior,organizational loyalty,perceived stress and after-work shaping of 297 medical staff in the cardiology department from grade-A tertiary hospitals were （74.97±16.69）,（40.57±11.92）,（29.42±8.73） and （27.11±7.12） points,respectively. The indirect effect of toxic leadership behavior of medical staff in cardiology department on organizational loyalty was established,with a total indirect effect of 0.473,accounting for 43.29% of the total effect. The specific mediating effects of after-work shaping and perceived stress on toxic leadership behavior accounted for 23.14% and 13.55%,respectively,and the chain mediating effect of the two accounted for 6.59%. Conclusion The multiple mediating effects of perceived stress and after-work shaping between toxic leadership behavior and organizational loyalty are established. It is suggested that hospital managers should pay more attention to medical staff with high level of toxic leadership behavior,reduce perceived stress,improve the level of after-work shaping,and then improve their organizational loyalty.

Survey on current status of resilience of standardized training nurses and analysis of related factors

MA Yanfei, LI Xixi, ZHANG Yaqing, LI Xiaoya, TU Huali, WANG Chunyan

2024, 40(22):  3105-3108. 

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Objective To understand the current situation of resilience of standardized training nurses and explore its related factors,aiming to provide partial data reference for the formulation of management policies for standardized training nurses. Methods In November 2023,a convenience sampling method was used to select 204 standardized training nurses from four comprehensive hospitals in Mianyang City as the survey subjects. A current situation survey was conducted using general information forms,medical staff resilience scales,psychological capital scales,and simplified coping style scales,and the data were analyzed. Results The resilience score of 204 standardized training nurses who participated in the survey was （68.17±12.36）points. Among the scores of each dimension,the decision-making and coping score was （23.72±3.68）points,the interpersonal connection score was （16.17±3.55）points,the rational thinking score was （14.06±3.66）points,and the flexible self-adaptation score was （14.23±3.17）points. The comparison of the resilience scores among standardized training nurses of different age,education backgrounds,professional titles,average monthly wages,and average monthly night shifts showed statistically significant differences（all P<0.05）. There was a statistically significant difference between the resilience,the psychological capital,and positive coping styles（all P<0.05）. Multiple linear regression analysis showed that there was a statistically significant difference in the resistance of standardized training nurses with different educational backgrounds,levels of psychological capital,and positive coping styles（all P<0.05）. Conclusion The resilience level of standardized training nurses in Mianyang City needs to be improved. Nursing managers can carry out relevant psychological training to enhance their resilience level,promote the individual career development of standardized training nurses,and ensure the stable development of the nursing team.

Evaluation of the effectiveness of nationwide healthy lifestyle action in Pengzhou City from 2018 to 2022

LI Na, CHEN Xiaofang, WU Xia

2024, 40(22):  3109-3113. 

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Objective To understand the trend of knowledge and behavior changes in healthy lifestyle among residents aged 15 and above in Pengzhou City,scientifically evaluate the implementation effect of the national healthy lifestyle action,and provide a basis for further action. Methods The Sichuan Province national health lifestyle action evaluation questionnaire was used,and 400 people were selected through multi-stage stratified random sampling in Pengzhou City from 2018 to 2022 to complete the survey. A total of 2 000 valid questionnaires were collected. The promotion points,lecture sessions,distribution of promotional materials,and number of recipients of education for the national health lifestyle action and major chronic disease theme promotion activities from 2018 to 2022 were statistically analyzed. Results The awareness rate of the national health lifestyle action,the awareness rate of related health knowledge,and the formation rate of healthy lifestyle behaviors were statistically analyzed,totaling 22 indicators. Among them,the knowledge awareness rate and behavior formation rate of 19 indicators showed an upward trend （all P<0.05）.In terms of knowledge awareness,there had been a significant increase in "risk of diseases associated with smoking" （growth rate of 285.71%）,"awareness of the 'three reductions and three enhancements' content"（growth rate of 135.71%）,and "awareness of the national healthy lifestyle campaign"（growth rate of 117.39%）. In terms of behavior formation rate,there had been a significant increase in "frequent/every use of oil control pots"（growth rate of 700.00%）,"an increase in weekly exercise frequency compared to 1 year ago"（growth rate of 144.44%）,and "conscious control of body mass"（growth rate of 96.00%）. Conclusion From 2018 to 2022,the implementation of the national healthy lifestyle program in Pengzhou City has achieved significant results.Although there have been fluctuations in the awareness and behavior formation of the national health lifestyle action and related health knowledge,the overall trend is upward. The grasp of knowledge on reducing salt,oil,healthy waist circumference,and healthy body mass is not ideal,and the use of health support tools is also low. Considering the actual situation in Pengzhou City,investment in on-site education activities should be strengthened.

Establish an air quality health index based on the outpatient volume of respiratory diseases

XU Yandan, ZHANG Jingwei, LI Wei, ZHU Jianming, XU Mingjia

2024, 40(22):  3114-3117. 

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Objective To explore the construction of air quality health index（AQHI） for respiratory diseases in Jinshan District of Shanghai City. Methods Daily outpatient visits for respiratory diseases,data of air pollutants[fine particulate matter（PM_2.5）,inhalable particles（PM₁₀）,SO₂,NO₂,O₃],and meteorological data（air pressure,temperatureand relative humidity） were collected from two comprehensive hospitals in Jinshan District of Shanghai City from 2017 to 2022. The AQHI based on respiratory diseases was calculated using a generalized additive model. Results The four pollutants had different impacts on the number of daily outpatient visits：PM_2.5,NO₂,SO₂ and O₃ had the greatest impact on the number of daily outpatient visits when the lag time was 3,3,9 and 0 days,respectively.For every 10 μg/m³ increase in PM_2.5,NO₂,SO₂ and O₃ concentrations,the excess risk（ER） was 1.07%（95%CI：0.61%-1.55%）,1.89%（95%CI：0.95%-2.84%）,16.14%（95%CI：11.30%-21.19%）,and 0.76%（95%CI：0.43%-1.09%）.According to the results of single and double pollutants,PM_2.5,NO₂,SO₂ and O₃ were selected to establish AQHI. From 2017 to 2022,AQHI showed a "right skewed distribution",with 98.95% days with AQHI<6,and 40.76% days with AQHI of 3 and 22.82% days with AQHI of 4. Conclusion Air pollutants in Jinshan District of Shanghai City have an effect on the number of outpatient visits for respiratory diseases. AQHI can well reflect the health risk of air pollution exposure to respiratory system.

Exposure level and health risk assessment of perchlorate in drinking water in Hohhot City in 2023

ZHANG Haiyan, SUN Zhuoran, BAO Yulan, LIU Chunbo

2024, 40(22):  3118-3122. 

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Objective To investigate the perchlorate concentration levels of concentrated water supply in Hohhot City and small concentrated water supply factories in its five counties in wet season in 2023,conduct the preliminary evaluation of the health risks caused by perchlorate through drinking water in Hohhot City. Methods A total of 81 tap water samples from 13 centralized water supply plants in the urban area of Hohhot City and small centralized water supply plants in five counties and district during the wet season in 2023 were collected.The water samples were measured using ultra-high performance liquid chromatography tandem mass spectrometry to obtain the content level of perchlorate in the drinking water of Hohhot City. Using the water environmental health risk assessment model recommended by the US Environmental Protection Agency（EPA）,the non-carcinogenic risk hazard quotient of perchlorate was calculated,and the health risks caused by perchlorate to the population through drinking water in Hohhot was preliminarily evaluated. Results The results of 81 water samples collected during the wet season in 2023 were all below the limit value of 0.07 mg/L specified in China's drinking water hygiene standards with a detection concentration range of ND-34.69 μg/L,with M（P₂₅,P₇₅） of 0.15（0.15,0.79）μg/L,and a detection rate of 40.7%. The exposure levels of perchlorate for different populations were as follows：0.003 7-0.006 0 μg/（kg·d） in urban areas,0.0034-0.004 6 μg/（kg·d） in rural areas,the hazard quotient was 0.005 2-0.008 5 in urban areas and 0.003 4-0.004 6 in rural areas. The exposure was the highest in the 6-<11 age group among different age groups. Conclusion The exposure risk of perchlorate through drinking water in Hohhot area is within an acceptable range.

Research on the impact of social media dependence on real interpersonal relationships among college students

HU Yinhua, LUO Yalan, CHEN Dandan

2024, 40(22):  3123-3126. 

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Objective To explore the mediating role of online social anxiety in social media dependence and alienation,as well as in social media dependence and interpersonal relationship distress. This study aims to deeply analyze the impact path of college students' social media dependence on alienation and real interpersonal distress,and to propose feasible countermeasures and suggestions to guide college students to use social media reasonably and cultivate good interpersonal relationships. Methods From February to March 2023,a combination of stratified sampling and two-stage unequal probability sampling was used to select 860 college students from 46 universities at different levels in Jiangxi Province. Data was collected through online and offline questionnaires,and the data were analyzed. Results The direct impact of social media dependence on alienation was significant,with a 95%CI excluding 0 and an impact effect value of 0.212. The direct impact of social media dependence on real interpersonal distress had not been verified,with a 95%CI containing 0. The mediating effect of online social anxiety between social media dependence and alienation was significant,with a 95%CI excluding 0 and an impact effect of 0.417. The mediating effect of online social anxiety between social media dependence and real interpersonal distress was significant,with a 95%CI excluding 0,and an impact effect of 0.467. Conclusion Social media dependence can significantly affect alienation and cause interpersonal distress in reality,mainly through the mediating effect of online social anxiety. Online social anxiety plays a partial mediating role between social media dependence and alienation,and a complete mediating role between social media dependence and real interpersonal distress.

Visual comparative analysis and meta-analysis of risk factors for falls in elderly people in elderly care institutions at home and abroad

LIU Sijia, LI Yanming, SHA Siyuan, ZHAO Aizhong, WANG Shengnan

2024, 40(22):  3127-3133. 

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Objective To understand the current situation and trend of research on falls among elderly people in elderly care institutions at home and abroad,and systematically analyze the risk factors of falls among elderly people in elderly care institutions,so as to provide a theoretical basis for formulating preventive measures for the elderly in elderly care institutions. Methods Citespace software was used to visually analyze the current situation and trend of the research on falls among elderly people in elderly care institutions in databases of China National Knowledge Infrastructure（CNKI） and Web of Science. The relevant literature on fall risk factors of elderly people in elderly care institutions was retrieved from CNKI,CBM database,Wanfang database,VIP database,Pubmed,Web of Science,Cochrane Library and Eambase databases from the database establishment to January 2023. Literature was screened and evaluated according to the criteria,and Review Manager 5.3 was used for statistical analysis. Results The visualization analysis showed an overall increasing trend in the number of research papers on falls among elderly people in elderly care institutions at home and abroad. At present,the domestic research on elderly falls in elderly care institutions focused on risk factors and safety management,and the target population was the frail elderly,and the hotspots included smart old-age care and care methods. Foreign countries focused on post-fall treatment,exploring the causes and adverse consequences of physical and psychological damage caused by falls. A total of 15 relevant literatures were included in the meta-analysis,with a cumulative sample size of 11 588 cases. The results showed that age,gender,cognitive impairment,vision abnormality,taking multiple drugs,balance ability,comorbidities of chronic diseases,history of falls,psychiatric drugs,and hypertension were associated with falls in elderly people in elderly care institutions,and the differences were statistically significant（all P<0.05）. Conclusion It is necessary to improve the in-depth integration and communication among fields in China,discover the fall risk of elderly people in elderly care institutions according to the predictability of risk factors,and use intelligent means to reduce the incidence of falls in elderly people in elderly care institutions for early prevention. At the same time,pay attention to the psychological and physiological prognostic effects of elderly people after falling in elderly care institutions,and improve the whole process management of fall risk events for elderly people in elderly care institutions.

Meta-analysis of the incidence of occupational low back pain among nurses in China

WANG Liping, LI Guixiang, LIU Jiayi, DIAO Yanjun, ZHUO Yu

2024, 40(22):  3134-3140. 

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Objective To analyze the incidence of occupational low back pain among nurses in China. Methods CNKI,Wanfang,VIP,China biomedical literature database,Web of Science,Embase,PubMed databases were searched from May 2013 to May 2023 to collect the literature related to the occurrence of occupational low back pain in Chinese nurses. The data were extracted according to the inclusion/exclusion criteria,and the risk of bias was evaluated. The meta-analysis software used Stata 16. Results A total of 31 studies including 29 688 nurses were included. The results of meta-analysis showed that the incidence of occupational low back pain among nurses in China was 70.7%（95%CI：66.1%-75.2%）. The results of subgroup analysis showed that gender,age,marital status,obesity,seniority,professional title,educational background,department,work intensity,stooping and other factors had a certain impact on the incidence of occupational low back pain among nurses in China. Conclusion The incidence of occupational low back pain among nurses in China is relatively high. It is recommended that hospital managers and nurses themselves pay attention to it,take targeted intervention measures,improve the work environment,establish protective mechanisms,reduce the incidence of occupational low back pain among nurses,improve the quality of nursing,and ensure patient safety.

Health Management and Research

Problems and strategies of DRGs payment among discharged patients with psoriasis in a grade-A tertiary hospital in Tianjin

ZHANG Xi, GU Xuening, ZHANG Min, GAO Yi, WANG Qingyue

2024, 40(22):  3141-3144. 

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Objective Psoriasis is a common autoimmune disease,which brings great economic burden to patients' families and society. Currently,many regions implement payment by diagnosis related groups（DRGs）.By analyzing the real data of discharged patients with psoriasis in a grade-A tertiary hospital in Tianjinin 2021,this study aims to propose a DRGs negotiation plan for win-win results among medical insurance,hospitals and patients. Methods The hospitalization costs of patients who were first diagnosed with psoriasis（ICD10 code：L40） in the Hospital Affiliated to Tianjin Academy of Traditional Chinese Medicine in 2021 were extracted,and compared with the DRGs payment standard published by the Tianjin medical insurance department,and SPSS 24 statistical software was used for analysis. Results In 2021,the total hospitalization cost of psoriasis patients was 8 376 310.23 yuan,and the average cost was 13 007.14（7 011.46,17 562.32）yuan.Among them,the self-funded part of the single room fee was 152 560.00 yuan,accounting for 1.86% of the total income.If it was calculated according to the DRGs payment method, all 645 people would have been divided into JS1 group,including 27 people in JS11 group,421 people in JS13 group and 197 people in JS15 group,the total payment amount would have been 7 053 413.35 yuan,which the income was 1 322 896.88 yuan less to actual expenses,a loss of 15.79%. After removing the rate cases,there was no statistically significant difference the two payment methods both in JS11 group and JS15 group,but the fee-for-service in JS13 group was statistically significant higher than that paid by DRGs（P<0.01）,and higher than that in JS11 group with more serious complications,which was contrary to the payment principle of DRGs.The difference in hospitalization costs among different types of psoriasis was statistically significant（F=23.716,P<0.01）. There was no statistically significant difference in the cost between erythrodermic psoriasis and pustular psoriasis,while psoriasis vulgaris had the highest number of cases and the lowest average cost. The psoriasis vulgaris accounted for 63.60% in JS11 group,81.30% in JS13 group and 94.40% in JS15 group,and the difference was statistically significant（χ²=25.395,P<0.01）,but there was no statistical significance between JS13 group and JS11 group（P>0.025）. Conclusions As the single room fee is included in the payment scope of DRGs,it will increase the loss of the hospital and crowd out the cost of disease treatment,so we suggest that it should continue to be charged at self-payment. Based on the ICD10 diagnostic code and textbook,psoriatic arthritis and psoriatic juvenile arthritis are adjusted into the JS1 group. According to the skin lesion characteristics of psoriasis,it is recommended to refer to other skin damaging diseases,fully consider the severity of psoriasis,and adjust the payment level.

Overview

Research progress on occupational exposure and protection of hazardous drugs among medical personnel

LI Changkun, WANG Silu, DONG Weihua

2024, 40(22):  3145-3150. 

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Occupational exposure to hazardous drugs among certain medical personnel during their work processes has drawn considerable attention due to resulting health risks. The impact of hazardous drugs on the health of healthcare workers includes but are not limited to increased cancer risk and adverse reproductive outcomes. Therefore,this paper summarizes the research progress on occupational exposure and protection of hazardous drugs for medical personnel,mainly including occupational exposure pathways,monitoring of occupational exposure risks,the impact of hazardous drugs on health,occupational safety protection measures,barriers in the safe handling of hazardous drugs,and policies for the occupational exposure safety management of hazardous drugs,in order to provide reference for the future development of hazardous drug protection research.

Research progress on multidimensional assessment tools for frail elderly patients

GAO Fang^1a,2, HONG Hanhan^1b, FENG Yue², RUAN Xu³, YANG Yajuan^1a

2024, 40(22):  3151-3155. 

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Frailty has evolved from a single emphasis on physical frailty to a more comprehensive multidimensional concept encompasses physical frailty,psychological frailty,cognitive frailty,social frailty,and environmental frailty.This article provides a review of five dimensions：physical condition,psychological condition,cognitive ability,social support,and home environment,and introduces the assessment scales that can be used for multidimensional elderly patients with frailty in the current study. By comparing and analyzing the basic characteristics and application of various scales,medical staff can use this as a reference to select appropriate scales for evaluating elderly patients with frailty.

Research progress on application of social capital in the field of mental health

JIA Wenjing, ZHANG Weibo, HE Siyuan, CAI Jun

2024, 40(22):  3156-3159. 

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Social capital is a trust,norms and networks that can enhance social efficiency which is an important source of self-regulation and monitoring for individuals. Related studies have shown that social capital is an important factor affecting mental health. Starting with the concept of social capital,this paper expounds the mechanism of social capital in the field of mental health and its impact on mental health outcomes,and provides a summary and discussion of it. Social capital has an impact on the field of mental health through the main mechanisms of resource mobilization,establishment of informal relationships,cultivation of trust and maintenance of reciprocal relationships,but it also faces problems such as imprecise measures and scattered focus,which makes the development of follow-up systematic assessment tools and mechanism research particularly important.

Research progress on the second victim experiences and support of nurses

WANG Yue, AI Shanshan, NIU Pengli, XIAO Wenjun, XU Guojun

2024, 40(22):  3160-3163. 

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As an important group in the medical and health care system,nurses also suffer from different degrees of physical and mental distress when they experience patient safety incidents,known as the second victims,which seriously affects their professional identity. How to improve the negative emotions experienced by nurses' second victims and establish a comprehensive support system are important issues that nursing managers should pay attention to. Therefore,this paper reviews the concept and recovery path of the second victim,the current situation of nurses' second victim experience and support,influencing factors,and intervention strategies,in order to promote the stability of the nursing team and provide a reference for nursing managers to formulate interventions to improve the psychological distress of nurses' second victims.

Research progress on risk factors of chronicmultimorbidity

ZHOU Yiran, Gulijiayina Aiken, LU Yaoqin

2024, 40(22):  3164-3168. 

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In recent years,chronic multimorbidity has intensified with the continuous socio-economic development and increase in life expectancy of the population,placing a heavy burden on individuals and their families,as well as on the health care system and society as a whole,and has become a public health problem that urgently needs to be addressed on a global scale. The occurrence and development of multimorbidity are often the result of multiple factors,and a full understanding of their risk factors is important for promoting health management,improving clinical decision-making,optimizing healthcare resource allocation,and developing public health strategies. Therefore,this paper summarizes relevant studies from home and abroad to review the risk factors associated with chronic multimorbidity from four aspects：sociodemographic characteristics,lifestyle,socioeconomic status,and disease factors,in order to provide a basis for their comprehensive prevention and control.