兒童放射診斷檢查輻射風險認知研究
發(fā)布時間：2018-09-06 14:00
【摘要】：研究背景隨著放射診療技術的迅猛發(fā)展及廣泛應用,在促進診療技術進步、提高診療水平,造福廣大患者和受檢者的同時,如果防護不當將可能會對人體造成不必要的危害。兒童作為電離輻射致健康效應的敏感人群,對電離輻射致癌更為敏感,其放射診療的合理應用和防護顯得尤為重要,也一直受到國際組織的關注。放射診斷檢查實踐的正當化和防護最優(yōu)化是降低患者劑量的主要手段,而放射診斷檢查中涉及的主要利益相關者的輻射風險認知是提高防護正當化和最優(yōu)化的重要影響因素之一。國內關于兒童放射診斷檢查輻射風險認知的研究很少,需要在這些方面給予更多的關注,加強兒童放射診斷檢查輻射風險認知的健康宣教及健康教育極其重要。本研究選擇北京大型綜合和�？漆t(yī)院,開展兒童放射診斷檢查輻射風險認知的研究,旨在了解相關人群的輻射風險及放射防護的認知程度,為今后制定兒童放射診斷檢查相關政策和策略提供參考依據。研究目的調查放射診斷檢查中涉及的主要利益相關者,包括醫(yī)院兒科醫(yī)生、放射科工作人員及就診患兒家長對兒童放射診斷檢查輻射風險及防護的認知狀況和影響因素,為放射診斷檢查技術應用的正當化及采取必要的防護措施和健康宣教提供科學依據。研究方法1.研究設計本研究采用橫斷面研究、方便抽樣的方法確定研究對象。選擇北京地區(qū)3家三級甲等醫(yī)院(包括首都醫(yī)科大學附屬北京兒童醫(yī)院、首都兒科研究所附屬兒童醫(yī)院、北京大學第三醫(yī)院),將調查時在崗的兒科醫(yī)生、放射科工作人員和就診的患兒家長作為調查對象,發(fā)放問卷進行現(xiàn)場調查。2.調查方法經過預調查,按照組間均數(shù)比較,確定了應該調查的樣本量。由經過培訓調查人員現(xiàn)場發(fā)放調查問卷,按照要求填寫問卷,由調查人員將問卷當場收回,當即檢查填寫有無遺漏或明顯矛盾。本次調查共發(fā)放問卷609份,回收有效問卷600份,回收率98.5%,調查過程中有5人拒訪。3.數(shù)據錄入和統(tǒng)計分析調查問卷回收后,經過審核和處理,選出600份有效問卷進行編號,用epidata3.1數(shù)據錄入,SPSS 23進行統(tǒng)計分析,統(tǒng)計學方法主要有:①描述性分析,包括頻數(shù)、均數(shù)、標準差、構成比等。②多因素分析,包括多重線性回歸和二分類Logistic回歸分析等。研究結果1.不同人群對輻射基礎知識客觀評估知曉狀況不同(1)兒科醫(yī)生輻射知曉程度客觀評估正確回答率達62.5%,大于50%,處于中上水平;女性輻射知曉程度低于男性,p=0.002,具有統(tǒng)計學意義(p0.05)。(2)放射科工作人員輻射知曉程度客觀評估正確回答率達64.5%,大于50%,處于中上水平;職業(yè)分類中放射科技師(p=0.017)、本科及以上文化程度(本科p=0.029、碩士p=0.004、博士p=0.002)均對輻射基礎知識知曉程度有影響,具有統(tǒng)計學意義(p0.05)。(3)就診患兒家長輻射知曉程度客觀評估7道有4道題正確回答小于50%,處于中下水平;就診患兒家長文化程度(本科p=0.007;碩士p=0.002)、職業(yè)(家務及待業(yè)p=0.023;醫(yī)務人員及教師p=0.018)均對輻射基礎知識的知曉程度有影響,具有統(tǒng)計學意義(p0.05)。(4)三組人群輻射風險認知女性輻射知曉程度低于男性,p=0.000;人群分類中就診患兒家長輻射基礎知識低于兒科醫(yī)生,兒科醫(yī)生低于放射科工作人員,p=0.000,具有統(tǒng)計學意義(p0.05)。2.不同人群對兒童放射診斷檢查輻射風險認知不同。(1)兒科醫(yī)生84.0%在多種檢查手段時出于診斷的需要;55.5%在確診病情時首選X線檢查;49.0%在兒童頭暈、頭痛(非外傷或者輕微外傷)首選核磁檢查。(2)放射科工作人員55.0%認為比較了解輻射;98.5%認為輻射影響的器官是性腺;98.5%回答放射檢查時給患者特殊部位屏蔽防護;70.0%在放射檢查前進行輻射風險告知。(3)就診患兒家長73.5%認為放射線對兒童健康有影響;35.0%認為放射檢查時佩戴防護用品;75.0%在醫(yī)生開具放射檢查時不會擔心對身體有影響而放棄。3.兒童放射診斷檢查輻射風險認知信息環(huán)境以及獲取健康宣教的最佳途徑。(1)兒科醫(yī)生和放射科工作人員首選健康宣教方式希望通過專業(yè)培訓(54.0%和68.5%)、現(xiàn)場講座(35.5%和53.5%)以及宣傳掛圖(37.5%和32.5%)等進行。(2)就診患兒家長首選宣教方式通過宣傳掛圖(45.0%)、互聯(lián)網和電視(35.5%)以及手機短信(28.0%)等進行。研究結論1.兒童放射診斷檢查輻射風險認知中,不同人群輻射評估知曉狀況不同,因而針對不同人群加強輻射風險認知的培訓和管理突顯重要。2.兒科醫(yī)生和放射科工作人員健康宣教的最佳途徑是專業(yè)培訓及現(xiàn)場講座;就診患兒家長最佳途徑是宣傳掛圖、互聯(lián)網和電視,同時采用多元化健康宣教途徑提高輻射相關知識的健康傳播。3.在兒科放射診斷三組利益相關者中,就輻射認知水平而言,放射科工作人員優(yōu)于兒科醫(yī)生,就診患兒家長認知水平還需整體提高,尤其要加強對兒科醫(yī)師不同放射檢查導致的輻射劑量和健康效應的培訓,以提高其輻射認知水平。建議加強兒科醫(yī)生、放射科工作人員以及就診患兒家長輻射風險認知的健康教育。兒科醫(yī)生要加大輻射相關知識的培訓力度;放射科工作人員應繼續(xù)加強專業(yè)知識及法規(guī)培訓;需要對就診患兒家長加強科普知識宣傳,提高參與主動性,從而更好的提高兒童放射診斷檢查中相關人群的輻射防護意識和認知水平。
[Abstract]:BACKGROUND With the rapid development and wide application of radiation diagnosis and treatment technology, it is possible to cause unnecessary harm to human body if the protection is improper, while promoting the progress of diagnosis and treatment technology, improving the level of diagnosis and treatment, benefiting the vast number of patients and subjects. For the sake of sensitivity, the rational application and protection of Radiology Diagnosis and treatment are particularly important, and have been concerned by international organizations. The legitimacy and optimization of radiology diagnosis practice are the main means to reduce patients'doses, and the radiation risk awareness of the major stakeholders involved in radiology diagnosis is to improve the legitimacy and protection. There are few studies on children's radiation risk perception of radiological diagnostic examination in China. More attention should be paid to these aspects. It is very important to strengthen health education and health education on children's radiation risk perception of radiological diagnostic examination. The purpose of this study is to understand the radiation risk and radiation protection awareness of the population concerned, and to provide reference for the formulation of relevant policies and strategies for children's radiation diagnosis. The knowledge and influencing factors of radiation risk and protection in children's radiological diagnosis and examination provided scientific basis for the application of radiological diagnosis and examination technology and the adoption of necessary protective measures and health education. Methods The subjects were selected from 3 first-class hospitals in Beijing area (including Beijing Children's Hospital Affiliated to Capital Medical University, Beijing Children's Hospital Affiliated to Capital Institute of Pediatrics and Peking University Third Hospital). The pediatricians, radiologists and parents of the children who were on the job were investigated and questionnaires were sent out. Field investigation. 2. Investigation methods: After pre-investigation, according to the mean comparison between groups, determine the sample size should be investigated. By trained investigators on-the-spot distribution of questionnaires, fill in the questionnaire according to the requirements, by the investigators will be returned on the spot, immediately check whether there are omissions or obvious contradictions in filling. This survey issued 609 questionnaires, recovery. After data entry and statistical analysis, 600 valid questionnaires were selected and numbered. Epita 3.1 data entry and SPSS 23 were used for statistical analysis. The main statistical methods were: (1) descriptive analysis, including frequency, mean and standard deviation. (2) Multivariate analysis, including multiple linear regression and binary logistic regression analysis. Results 1. Different groups of people have different knowledge about the objective assessment of radiation knowledge. (1) The correct answer rate of objective assessment of pediatrician's radiation awareness reached 62.5%, more than 50%, which was in the middle and upper level. Male, P = 0.002, with statistical significance (p0.05). (2) Radiological staff radiation awareness objective assessment of the correct answer rate of 64.5%, more than 50%, in the upper level; occupational classification of Radiology scientist (p = 0.017), bachelor degree and above education (undergraduate P = 0.029, master P = 0.004, doctor P = 0.002) are all aware of the level of basic radiation knowledge. (3) there were 4 questions correctly answered less than 50% in the objective assessment of the radiation awareness of the parents of the children; the parents'educational level (undergraduate P = 0.007; master P = 0.002), occupation (housework and unemployment P = 0.023; medical staff and teachers P = 0.018) were all aware of the basic radiation knowledge. (4) the awareness of radiation risk among the three groups was lower than that of men (p = 0.000); the basic radiation knowledge of the parents of the patients was lower than that of the pediatricians, and that of the pediatricians was lower than that of the radiologists (p = 0.000), which was statistically significant (p 0.05). 2) the radiation risk of the children in different groups was lower than that of the pediatricians (p = 0.05). (1) 84.0% of pediatricians had different perceptions of radiation risk in various examinations; 55.5% preferred X-ray examination when they were diagnosed; 49.0% preferred magnetic resonance examination when they were dizzy and headache (non-traumatic or mild traumatic). (2) 55.0% of radiologists believed that the radiation was comprehended; 98.5% believed that radiation had an effect on them. Organs were gonads; 98.5% responded to radiation screening and protection for special parts of patients; 70.0% informed of radiation risk before radiation examination. (3) 73.5% of parents thought that radiation had an impact on children's health; 35.0% thought that they wore protective equipment during radiation examination; 75.0% did not worry about shadowing the body when doctors gave radiation examination. (1) Pediatricians and radiological staff preferred health education through professional training (54.0% and 68.5%), on-site lectures (35.5% and 53.5%) and publicity wall charts (37.5% and 32.5%). Parents preferred propaganda and education through wall charts (45.0%), Internet and television (35.5%) and mobile phone text messages (28.0%). Conclusion 1. In children's radiation risk awareness, different groups have different awareness of radiation assessment, so it is important to strengthen training and management of radiation risk awareness for different groups. The best way for doctors and radiologists to conduct health education is professional training and on-the-spot lectures; the best way for parents of children to see a doctor is to publicize wall charts, the Internet and television, and to adopt diversified health education approaches to improve the health dissemination of radiation-related knowledge. 3. Radiation awareness among three groups of pediatric radiological diagnostic stakeholders As far as radiation level is concerned, radiologists are superior to pediatricians, and parents'cognitive level should be improved as a whole. In particular, training of pediatricians on radiation dose and health effects caused by different radiation examinations should be strengthened to improve their radiation awareness. Health education on radiation risk awareness. Pediatricians should strengthen the training of radiation-related knowledge; radiological staff should continue to strengthen professional knowledge and legal training; parents of children need to strengthen the publicity of scientific knowledge, improve the initiative to participate, so as to better improve the radiation prevention of the relevant groups in children's radiological diagnosis and examination. Nursing consciousness and cognition level.
【學位授予單位】：中國疾病預防控制中心
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R146
本文編號：2226570
[Abstract]:BACKGROUND With the rapid development and wide application of radiation diagnosis and treatment technology, it is possible to cause unnecessary harm to human body if the protection is improper, while promoting the progress of diagnosis and treatment technology, improving the level of diagnosis and treatment, benefiting the vast number of patients and subjects. For the sake of sensitivity, the rational application and protection of Radiology Diagnosis and treatment are particularly important, and have been concerned by international organizations. The legitimacy and optimization of radiology diagnosis practice are the main means to reduce patients'doses, and the radiation risk awareness of the major stakeholders involved in radiology diagnosis is to improve the legitimacy and protection. There are few studies on children's radiation risk perception of radiological diagnostic examination in China. More attention should be paid to these aspects. It is very important to strengthen health education and health education on children's radiation risk perception of radiological diagnostic examination. The purpose of this study is to understand the radiation risk and radiation protection awareness of the population concerned, and to provide reference for the formulation of relevant policies and strategies for children's radiation diagnosis. The knowledge and influencing factors of radiation risk and protection in children's radiological diagnosis and examination provided scientific basis for the application of radiological diagnosis and examination technology and the adoption of necessary protective measures and health education. Methods The subjects were selected from 3 first-class hospitals in Beijing area (including Beijing Children's Hospital Affiliated to Capital Medical University, Beijing Children's Hospital Affiliated to Capital Institute of Pediatrics and Peking University Third Hospital). The pediatricians, radiologists and parents of the children who were on the job were investigated and questionnaires were sent out. Field investigation. 2. Investigation methods: After pre-investigation, according to the mean comparison between groups, determine the sample size should be investigated. By trained investigators on-the-spot distribution of questionnaires, fill in the questionnaire according to the requirements, by the investigators will be returned on the spot, immediately check whether there are omissions or obvious contradictions in filling. This survey issued 609 questionnaires, recovery. After data entry and statistical analysis, 600 valid questionnaires were selected and numbered. Epita 3.1 data entry and SPSS 23 were used for statistical analysis. The main statistical methods were: (1) descriptive analysis, including frequency, mean and standard deviation. (2) Multivariate analysis, including multiple linear regression and binary logistic regression analysis. Results 1. Different groups of people have different knowledge about the objective assessment of radiation knowledge. (1) The correct answer rate of objective assessment of pediatrician's radiation awareness reached 62.5%, more than 50%, which was in the middle and upper level. Male, P = 0.002, with statistical significance (p0.05). (2) Radiological staff radiation awareness objective assessment of the correct answer rate of 64.5%, more than 50%, in the upper level; occupational classification of Radiology scientist (p = 0.017), bachelor degree and above education (undergraduate P = 0.029, master P = 0.004, doctor P = 0.002) are all aware of the level of basic radiation knowledge. (3) there were 4 questions correctly answered less than 50% in the objective assessment of the radiation awareness of the parents of the children; the parents'educational level (undergraduate P = 0.007; master P = 0.002), occupation (housework and unemployment P = 0.023; medical staff and teachers P = 0.018) were all aware of the basic radiation knowledge. (4) the awareness of radiation risk among the three groups was lower than that of men (p = 0.000); the basic radiation knowledge of the parents of the patients was lower than that of the pediatricians, and that of the pediatricians was lower than that of the radiologists (p = 0.000), which was statistically significant (p 0.05). 2) the radiation risk of the children in different groups was lower than that of the pediatricians (p = 0.05). (1) 84.0% of pediatricians had different perceptions of radiation risk in various examinations; 55.5% preferred X-ray examination when they were diagnosed; 49.0% preferred magnetic resonance examination when they were dizzy and headache (non-traumatic or mild traumatic). (2) 55.0% of radiologists believed that the radiation was comprehended; 98.5% believed that radiation had an effect on them. Organs were gonads; 98.5% responded to radiation screening and protection for special parts of patients; 70.0% informed of radiation risk before radiation examination. (3) 73.5% of parents thought that radiation had an impact on children's health; 35.0% thought that they wore protective equipment during radiation examination; 75.0% did not worry about shadowing the body when doctors gave radiation examination. (1) Pediatricians and radiological staff preferred health education through professional training (54.0% and 68.5%), on-site lectures (35.5% and 53.5%) and publicity wall charts (37.5% and 32.5%). Parents preferred propaganda and education through wall charts (45.0%), Internet and television (35.5%) and mobile phone text messages (28.0%). Conclusion 1. In children's radiation risk awareness, different groups have different awareness of radiation assessment, so it is important to strengthen training and management of radiation risk awareness for different groups. The best way for doctors and radiologists to conduct health education is professional training and on-the-spot lectures; the best way for parents of children to see a doctor is to publicize wall charts, the Internet and television, and to adopt diversified health education approaches to improve the health dissemination of radiation-related knowledge. 3. Radiation awareness among three groups of pediatric radiological diagnostic stakeholders As far as radiation level is concerned, radiologists are superior to pediatricians, and parents'cognitive level should be improved as a whole. In particular, training of pediatricians on radiation dose and health effects caused by different radiation examinations should be strengthened to improve their radiation awareness. Health education on radiation risk awareness. Pediatricians should strengthen the training of radiation-related knowledge; radiological staff should continue to strengthen professional knowledge and legal training; parents of children need to strengthen the publicity of scientific knowledge, improve the initiative to participate, so as to better improve the radiation prevention of the relevant groups in children's radiological diagnosis and examination. Nursing consciousness and cognition level.
【學位授予單位】：中國疾病預防控制中心
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R146
【參考文獻】
相關期刊論文 前10條
1 王瓊;許娜;師美玉;;眼科出院患者健康宣教方式與改進策略[J];當代護士(上旬刊);2017年03期
2 戴麗君;黃曉芳;戴小丫;項曉萍;陳延茹;;介入放射工作的防護現(xiàn)狀與措施[J];中醫(yī)藥管理雜志;2017年03期
3 涂雷;宋海燕;董秋;譚成普;王守林;;低劑量電離輻射對醫(yī)療職業(yè)人群甲狀腺結節(jié)患病的影響[J];現(xiàn)代醫(yī)學;2017年01期
4 周德超;;放射檢查技術應用于臨床急診中的價值分析[J];中國社區(qū)醫(yī)師;2017年01期
5 吳俊峰;;磁共振成像設備的質量管理和維護[J];中醫(yī)藥管理雜志;2016年23期
6 夏焙;于紅奎;;小兒超聲診斷的現(xiàn)狀及展望[J];中華醫(yī)學超聲雜志(電子版);2016年11期
7 蔣國祥;;數(shù)字超聲診斷儀結構原理分析與維護[J];醫(yī)療裝備;2016年07期
8 宋秋霞;王芳;宋莉;莊寧;裘潔;王亮;楊婷;呂劍楠;丁雪;姚楠;;“全面二孩”政策下兒科醫(yī)生需求與缺口測算[J];中國衛(wèi)生政策研究;2016年02期
9 郭震;丁華波;許式龍;張德斌;;CT檢查中的輻射與防護[J];醫(yī)療裝備;2016年03期
10 王秀梅;劉湘琳;;50例兒童行核磁共振檢查的綜合護理干預[J];中國現(xiàn)代醫(yī)生;2016年04期
相關博士學位論文 前1條
1 張巍;醫(yī)療機構輻射安全文化評價指標體系及綜合評價模型研究[D];山東大學;2013年
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