【摘要】：目的:本研究的目的在于分析廣州市村衛(wèi)生室發(fā)展現(xiàn)狀及健康教育服務(wù)現(xiàn)狀,同時分析村衛(wèi)生室開展健康教育服務(wù)的影響因素,提出廣州市村衛(wèi)生室健康教育推進對策,為提高村衛(wèi)生室的健康教育服務(wù)質(zhì)量、促進農(nóng)村健康教育工作提供政策依據(jù)。方法:使用統(tǒng)一設(shè)計的調(diào)查問卷,采用普查的方法,開展村衛(wèi)生室機構(gòu)調(diào)查、村衛(wèi)生室醫(yī)務(wù)人員問卷調(diào)查,并對市(區(qū))衛(wèi)計局、市(區(qū))健康教育所、鎮(zhèn)衛(wèi)生院、村衛(wèi)生室的關(guān)鍵人員進行訪談。采用率、構(gòu)成比等指標(biāo)對村衛(wèi)生室的一般情況、健康教育設(shè)施配置情況、人力資源現(xiàn)況、健康教育服務(wù)情況、醫(yī)務(wù)人員開展健康教育的態(tài)度和健康教育知識掌握情況等內(nèi)容進行描述性分析。利用Logistic回歸分析法分析村衛(wèi)生室出版宣傳欄期次達(dá)標(biāo)情況的影響因素、村衛(wèi)生室發(fā)放資料種類達(dá)標(biāo)情況的影響因素。采用Epidata3.1進行數(shù)據(jù)錄入,SPSS21.0進行統(tǒng)計分析。結(jié)果:1.村衛(wèi)生室的一般情況:村衛(wèi)生室的經(jīng)營屬性以村集體所屬為主,占72.0%,其次是鄉(xiāng)鎮(zhèn)醫(yī)院所屬,占16.8%。廣州市的農(nóng)村地區(qū)一半實行緊密型鎮(zhèn)村衛(wèi)生服務(wù)一體化管理,一半實行基本型鎮(zhèn)村衛(wèi)生服務(wù)一體化管理。承擔(dān)基本公共衛(wèi)生服務(wù)的衛(wèi)生室比例為86.6%。2.健康教育設(shè)施配置情況:廣州市村衛(wèi)生室的健康教育宣傳欄、宣傳資料展架、電腦、視頻播放設(shè)備、農(nóng)家書屋中健康教育專區(qū)等健康教育設(shè)施配置率分別為93.0%、72.4%、75.9%、22.5%、94.8%。3.村衛(wèi)生室醫(yī)務(wù)人員構(gòu)成:男女性別比例為1:0.7;年齡在20-82歲之間,30-39歲比例最高,占32.3%,60歲以上,占29.8%;學(xué)歷以中專為主,達(dá)50.5%;專業(yè)以西醫(yī)比例最高,占37.9%,預(yù)防醫(yī)學(xué)僅約占1.3%,0.6%的醫(yī)務(wù)人員未學(xué)過醫(yī)學(xué);職稱以鄉(xiāng)村醫(yī)生資格為主,占58.8%,有職稱級別的人員占38.8%。4.村衛(wèi)生室醫(yī)務(wù)人員開展健康教育態(tài)度、知識掌握情況:89.8%的人認(rèn)為衛(wèi)生室有必要開展健康教育服務(wù)。96.6%的人表示愿意在診療過程中開展健康教育服務(wù)。19.6%的人認(rèn)為完全有能力在診療過程中開展健康教育服務(wù)。51.0%的人認(rèn)為有能力為村民開展健康教育講座。掌握健康促進步驟、健康教育形式、健康教育傳播方式、健康教育傳播效果、健康行為的醫(yī)務(wù)人員比例分別為8.4%、20.2%、0.9%、46.1%、18.3%。5.村衛(wèi)生室健康教育服務(wù)現(xiàn)狀:多數(shù)村衛(wèi)生室只是配合做些簡單的健康教育工作,比如,發(fā)放宣傳資料和開展個體化健康教育。2013年未開展過講座、咨詢、播放視頻等項目工作的村衛(wèi)生室占38.7%、37.1%、80.4%。94.2%的醫(yī)務(wù)人員曾經(jīng)針對就診病人開展過個體化健康教育服務(wù)。43.9%的醫(yī)務(wù)人員給村民開展過健康教育講座。2013年出版宣傳欄次數(shù)、開展講座次數(shù)、開展咨詢次數(shù)、播放視頻種類、發(fā)放資料種類達(dá)到《廣州市鎮(zhèn)衛(wèi)生院和村衛(wèi)生站(室)績效考核實施方案(試行)》(2011年)要求的衛(wèi)生室占83.7%、15.5%、15.3%、4.6%、27.3%。影響衛(wèi)生室出版宣傳欄期數(shù)達(dá)標(biāo)的因素有衛(wèi)生室是否承擔(dān)基本公共衛(wèi)生服務(wù)、衛(wèi)生室是否擁有宣傳欄、醫(yī)務(wù)人員是否接受過健康教育培訓(xùn)、醫(yī)務(wù)人員數(shù)量、衛(wèi)生室經(jīng)營屬性等5項,影響衛(wèi)生室發(fā)放資料種類達(dá)標(biāo)的因素有衛(wèi)生室是否承擔(dān)基本公共衛(wèi)生服務(wù)、醫(yī)務(wù)人員是否接受過健康教育培訓(xùn)、衛(wèi)生室服務(wù)人口等3項。6.村衛(wèi)生室開展健康教育的阻礙因素:從訪談了解到,阻礙村衛(wèi)生室開展健康教育的因素包括:管理制度不順暢、考核流于形式、基本公共衛(wèi)生補助不夠吸引力、管理機構(gòu)及村衛(wèi)生室相關(guān)人員存在重醫(yī)輕防的觀念、醫(yī)務(wù)人員能力及人手不足、村民健康意識薄弱。結(jié)論:1.村衛(wèi)生室開展健康教育服務(wù)的工作量不足。2.村衛(wèi)生室開展健康教育服務(wù)的影響因素包括鎮(zhèn)村衛(wèi)生服務(wù)一體化管理的模式、績效考核制度、公共衛(wèi)生服務(wù)補助制度、醫(yī)務(wù)人員數(shù)量及能力、硬件設(shè)施、村民參與度。3.村衛(wèi)生室醫(yī)務(wù)人員開展健康教育服務(wù)的意愿較高,但能力不足。4.村衛(wèi)生室健康教育服務(wù)設(shè)施配置率較低。建議:1.加快緊密型鎮(zhèn)村衛(wèi)生服務(wù)一體化管理進程,完善考核及補償機制。2.調(diào)整醫(yī)務(wù)人員結(jié)構(gòu),加強培訓(xùn),提高醫(yī)務(wù)人員開展健康教育的能力。3.加大投入,提高村衛(wèi)生室健康教育服務(wù)設(shè)施配置率。4.充分利用診療服務(wù)平臺,規(guī)范個體化健康教育服務(wù)。
[Abstract]:Objective: the purpose of this study is to analyze the status of the development of village health rooms in Guangzhou and the status of health education service, and to analyze the influencing factors of health education service in village health rooms, and put forward the countermeasures to promote health education in village health rooms in Guangzhou, in order to improve the quality of health education service in village health rooms and promote health education in rural areas. Policy basis. Methods: using the unified design questionnaire, using the census method, carry out the village health room investigation, the village health room medical staff questionnaire survey, and interview the city (District) health care Bureau, the city (District) Health Education Institute, the town health hospital, the village health room key personnel. The situation, the configuration of health education facilities, the current situation of human resources, the health education service, the attitude of health education and the knowledge of health education, and so on. Using the Logistic regression analysis method to analyze the influencing factors of the situation of the publication of the village public health room, the issue of the village health room. Epidata3.1 data entry and SPSS21.0 were used for data entry and statistical analysis. Results: the general situation of the 1. village health rooms: the village health rooms were mainly owned by the village group, accounting for 72%, followed by the township hospitals, and half of the rural areas in the Guangzhou city of Guangzhou implemented the close Township village sanitary clothes. Integration management, half of the basic Township and village health service integration management. The proportion of basic public health services is 86.6%.2. health education facilities allocation: health education propaganda column of Guangzhou village health room, publicity material display, computer, video broadcasting equipment, health education area in farm book house and other health areas. The educational facilities allocation rate is 93%, 72.4%, 75.9%, 22.5%, 94.8%.3. village health room medical personnel constitute: the sex ratio of men and women is 1:0.7; age is between 20-82 years old, 30-39 years old, 32.3%, 60 years old, accounting for 29.8%; education with secondary school, 50.5%; specialized industry with the highest proportion of Western medicine, accounting for 1.3%, 0.6%, only about 1.3%, 0.6% medicine. The staff did not learn the medicine; the title of the professional title was mainly rural doctor qualification, accounting for 58.8%. The staff of the rank of professional titles accounted for the health education attitude of the 38.8%.4. village health service staff and the knowledge mastery: 89.8% people thought that the health education service of the health care room was necessary for the people to carry out health education service in the process of diagnosis and treatment.19. The people of.6% believe that people who have the ability to carry out health education service.51.0% in the process of diagnosis and treatment have the ability to carry out health education lectures for villagers. The proportion of health promotion steps, health education forms, health education communication mode, health education communication effect and health behavior are 8.4%, 20.2%, 0.9%, 46.1%, 18.3%.5., respectively. Village health room health education service status: most village health rooms only cooperate to do some simple health education work, for example, the issue of publicity materials and the development of individual health education in.2013 has not carried out lectures, consulting, playing video and other project work of 38.7%, 37.1%, 80.4%.94.2% medical staff once targeted patients. The medical staff who had carried out the individualized health education service.43.9% gave the villagers a lecture on health education, published the number of publicity columns in.2013, carried out the number of lectures, carried out the number of consultations, played video categories, and the distribution of information reached the requirements of the implementation scheme of performance assessment (Trial) of the Guangzhou Municipal Health Institute and the village health station (Trial) > (2011). The health rooms accounted for 83.7%, 15.5%, 15.3%, 4.6%. The factors affecting the number of publishers in the public health room were the basic public health services, whether the health room had the publicity column, whether the medical staff had received health education and training, the number of medical staff, and the management attributes of the health room, which affected the distribution of data in the health room. The factors of the standard are whether the health room is responsible for the basic public health services, whether the medical staff have received health education and training, the health room service population and other 3.6. village health rooms to carry out health education impeding factors: from the interview, the factors that impede the health education in the village health room include: the management system is not smooth and the assessment is in the form, The basic public health subsidy is not attractive, the management institutions and the village health room related personnel have the concept of heavy medicine and light prevention, medical staff ability and manpower shortage, and the villagers' health consciousness is weak. Conclusion: the workload of health education service in the 1. village health rooms is insufficient. The influence factors of the health education service in the.2. village health room include the town village health service. The mode of integrated management, the performance appraisal system, the public health service subsidy system, the number and ability of medical staff, the hardware facilities, the villagers' participation in the health education service of the village health room in.3. village are higher, but the ability of the health education service facilities in the village health room of.4. is low. It is suggested that 1. be accelerated. The integrated management process of health service in the village and village, perfect the examination and compensation mechanism.2. adjust the structure of medical staff, strengthen the training, improve the health education ability of medical staff, increase the input of.3., improve the allocation rate of health education service facilities in the village health room, and make full use of the service platform of diagnosis and treatment, and standardize the individual health education service.
【學(xué)位授予單位】：廣東藥科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197.62

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本文編號：2142083