A self-rated health status and influencing factors among medical staff: A longitudinal study

Self-rated health (SRH) is a crucial subjective indicator reflecting an individual's overall health. Previous studies suggest it closely correlates with actual health status. Healthcare workers play a vital role in health promotion, making it important to explore the association and changes between their SRH and actual health status. This study aims to analyze the characteristics and influencing factors of SRH changes among medical staff using prospective cohort data, providing evidence for improving health self-management in this group.

Healthcare workers meeting the inclusion criteria were selected from the prospective cohort of public officials in Hunan Province. The "Health Self-Assessment Questionnaire" was used to collect demographic information, SRH status, health-related behaviors, and data on chronic diseases and sub-health symptoms. Characteristics and changes in SRH were analyzed, and Spearman's correlation coefficients were used to examine the relationship between SRH and actual health. Multiple Logistic regression was conducted on 2018 and 2020 longitudinal data to identify factors influencing SRH changes.

A total of 3 820 medical staff were included. At baseline in 2018, 29.27% (1 118) health workers reported poor SRH, 62.72% (2 396) reported average SRH, and 8.01% (306) reported good SRH. By 2020, 20.71% (791) reported worsened SRH, 21.62% (826) reported improved SRH, and 57.67% (2 203) reported no change. SRH scores were negatively correlated with the number of chronic diseases (r=-0.063), sub-health symptom scores (r=-0.413), depression scores (r=-0.357), and anxiety scores (r=-0.325) (all P<0.001), with a moderate negative correlation between SRH and sub-health symptoms (r=-0.413, P<0.001). Logistic regression analysis indicated that improved SRH was associated with reduced sub-health symptoms (OR=1.697, 95% CI 1.415 to 2.036), alleviated anxiety (OR=1.391, 95% CI 1.073 to 1.804), reduced binge eating (OR=1.746, 95% CI 1.183 to 2.577), improved dietary structure (OR=1.501, 95% CI 1.222 to 1.843), and better sleep quality (OR=1.560, 95% CI 1.225 to 1.987). Conversely, worsened SRH was associated with increased sub-health symptoms (OR=1.510, 95% CI 1.233 to 1.863), exacerbated depression (OR=1.642, 95% CI 1.235 to 2.183), heightened anxiety (OR=1.385, 95% CI 1.024 to 1.873), prolonged sedentary behavior (OR=2.140, 95% CI 1.564 to 2.929), irregular meals (OR=1.681, 95% CI 1.139 to 2.483), frequent nighttime snacking (OR=2.008, 95% CI 1.067 to 3.778), preference for salty foods (OR=1.564, 95% CI 1.132 to 2.161), poorer dietary structure (OR=1.367, 95% CI 1.126 to 1.660), and deteriorated sleep quality (OR=1.806, 95% CI 1.371 to 2.379).

Healthcare workers' SRH is closely related to their actual health status, particularly with sub-health symptoms. Changes in actual health and health-related behaviors significantly impact SRH variations. Enhancing self-health management awareness and proactive health capacities among medical staff could improve their overall health.