發(fā)布時(shí)間：2018-03-08 18:02

  本文選題：結(jié)核病　切入點(diǎn)：中學(xué)　出處：《天津醫(yī)科大學(xué)》2014年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的：了解天津市藏族中學(xué)校師生對(duì)結(jié)核病的認(rèn)知情況,確定健康教育的方式,評(píng)價(jià)健康教育的效果,為有針對(duì)性的在藏族中學(xué)開(kāi)展結(jié)核病防控工作提供有效的方法和途徑奠定基礎(chǔ)。 方法：以天津市藏族中學(xué)的師生研究對(duì)象,其中學(xué)生819人,教師96人,通過(guò)問(wèn)卷調(diào)查的方式收集人口學(xué)特征、結(jié)核病防治相關(guān)知識(shí)、結(jié)核病相關(guān)態(tài)度、結(jié)核病相關(guān)行為和結(jié)核病知識(shí)來(lái)源等方面的信息。在調(diào)查人員統(tǒng)一的指導(dǎo)語(yǔ)下獨(dú)立完成,要求學(xué)生獨(dú)立完成問(wèn)卷。問(wèn)卷作答時(shí)間為二十分鐘,問(wèn)卷完成后,由調(diào)查員統(tǒng)一收回。并開(kāi)展一系列的與結(jié)核病防治相關(guān)的干預(yù)活動(dòng)作為健康教育措施。通過(guò)比較基線(xiàn)調(diào)查和健康教育后結(jié)核病防治相關(guān)信息的變化,探討研究所采取的健康教育對(duì)天津市藏族中學(xué)師生有關(guān)結(jié)核病防治知識(shí)、信念以及行為的影響 結(jié)果：健康教育前學(xué)生和教師的總體知曉率分別為45.2%(1851/4095)和43.4%(206/475),差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=2.439,P=0.1183)；學(xué)生和教師的全部知曉率分別為3.79%(31/819)和4.21%(4/95),差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.042,P=0.838)。五條核心信息中,學(xué)生和教師對(duì)肺結(jié)核癥狀(P0.01)及結(jié)核病是否有免費(fèi)政策(P=0.031)的認(rèn)知存在統(tǒng)計(jì)學(xué)差異,對(duì)其它三條核心信息的認(rèn)知均無(wú)統(tǒng)計(jì)學(xué)差異；學(xué)生核心知識(shí)知曉率的影響因素方面男生總體知曉率52.27%,高于女生的48.17%,差異有統(tǒng)計(jì)學(xué)意義(P=0.010)。男女生差異主要體現(xiàn)在對(duì)肺結(jié)核傳播方式以及肺結(jié)核癥狀這兩個(gè)方面,男生高于女生(P0.05)。不同年級(jí)的學(xué)生比較,雖然在肺結(jié)核傳播方式、肺結(jié)核癥狀、肺結(jié)核預(yù)防方式和總體知曉率上,有統(tǒng)計(jì)學(xué)差異(P=0.003),但并沒(méi)有觀(guān)察到隨年級(jí)增高知曉率增高的趨勢(shì),并且在控制西藏班和本地班分布不均的混雜因素后(高中僅有西藏班,初中僅初一和初三有西藏班),西藏班學(xué)生總體知曉率仍高于本地班的學(xué)生,主要體現(xiàn)在肺結(jié)核防治方面的認(rèn)知(P=0.018)。在對(duì)結(jié)核病的態(tài)度方面對(duì)自己是否可能得肺結(jié)核,68%(522/762)的學(xué)生和49.45%(45/95)的教師認(rèn)為自己不可能得結(jié)核病,差異有統(tǒng)計(jì)學(xué)意義(χ2=13.242,P0.001)；但對(duì)核心知識(shí)知曉的高低與持有這種態(tài)度沒(méi)有統(tǒng)計(jì)學(xué)關(guān)聯(lián)(χ2=0.030,P=0.862)。對(duì)“如果得了結(jié)核病,您的反應(yīng)是什么?”,71.69%的學(xué)生和68.89的教師回答一種或以上的負(fù)面反應(yīng),兩者無(wú)統(tǒng)計(jì)學(xué)差異(χ2=0.3118,P=0.5766)；75.56%的西藏班學(xué)生,64.13%的本地班學(xué)生有負(fù)面反應(yīng),兩者差異有統(tǒng)計(jì)學(xué)意義(χ2=11.748,P0.001)。主要負(fù)面心理有害怕、吃驚等。多數(shù)學(xué)生和教師對(duì)結(jié)核病患者持同情的態(tài)度。 對(duì)結(jié)核知識(shí)的需求,獲得更多關(guān)于結(jié)核方面的知識(shí)、得了結(jié)核癥狀選擇去醫(yī)療機(jī)構(gòu)就診、何時(shí)就診、病情告知均無(wú)統(tǒng)計(jì)學(xué)意義。只有對(duì)結(jié)核知識(shí)了解的主動(dòng)性方面,26.32%(210/798)的學(xué)生和58.89%(53/90)的教師有過(guò)主動(dòng)了解結(jié)核方面的知識(shí),差異有統(tǒng)計(jì)學(xué)意義(χ2=41.166,P0.001)。關(guān)于結(jié)核病防治知識(shí)學(xué)校、電視、網(wǎng)絡(luò)、黑板報(bào)、報(bào)刊雜志是學(xué)生和教師的主要來(lái)源。獲得結(jié)核知識(shí)的方式,電視、小禮品、醫(yī)務(wù)人員宣傳、主題班會(huì)和張貼畫(huà)是最受歡迎的途徑。 相比健康教育前,學(xué)生的總體知曉率由45.2%升高至59.6%(P0.05)；教師的總體知曉率由43.4%升高至69.8%(P0.05)。在健康教育前知曉率較低的“肺結(jié)核傳播方式”、“肺結(jié)核主要癥狀”和“肺結(jié)核治療減免政策”方面,教師和學(xué)生都有顯著提高(P0.05),但仍存在較多錯(cuò)誤認(rèn)識(shí)。對(duì)于結(jié)核病的態(tài)度。認(rèn)為自己可能得結(jié)核的學(xué)生在健康教育前后的比例分別為31.5%和26.5%,差異有統(tǒng)計(jì)學(xué)意義(χ2=4.893,P=0.027),教師在健康教育前后為50.6%和61.1%,差異無(wú)統(tǒng)計(jì)學(xué)差異(χ2=2.265,P=0.132)。在對(duì)結(jié)核病人的態(tài)度上,多數(shù)學(xué)生和教師持同情并希望幫助他們的態(tài)度。在健康教育后,選擇“同情但遠(yuǎn)離他們”“害怕被傳染”的學(xué)生比例降低；而教師也更傾向于同情病人,而遠(yuǎn)離或害怕傳染的比例降低。在結(jié)核病相關(guān)行為方面,在出現(xiàn)了可疑結(jié)核癥狀后,選擇去衛(wèi)生機(jī)構(gòu)看病、就醫(yī)的及時(shí)性上,差異有統(tǒng)計(jì)學(xué)意義。健康教育前,26.4%(209/792)的學(xué)生及教師向別人宣傳結(jié)核病,差異有統(tǒng)計(jì)學(xué)意義。對(duì)宣傳活動(dòng)的評(píng)價(jià),學(xué)生最樂(lè)于接受的方式為主題班會(huì),教師則是宣傳展板。在志愿者宣傳、黑板報(bào)和結(jié)核防治征文上,學(xué)生的響應(yīng)度也不如教師。 結(jié)論：健康教育前藏族中學(xué)學(xué)生和教師對(duì)結(jié)核病的相關(guān)知識(shí)缺乏了解,尤其對(duì)結(jié)核病的肺結(jié)核傳播方式、肺結(jié)核癥狀、治療方法、減免政策方面的等知曉率較低,這種現(xiàn)象與學(xué)校對(duì)結(jié)核病知識(shí)的教育開(kāi)展不夠有關(guān)。從調(diào)查中我們可以看出主題班會(huì)是學(xué)生比較容易接受的宣傳活動(dòng),而教師們則比較容易接受宣傳展板的形式。健康教育后學(xué)生的結(jié)核病防治知識(shí)核心信息知曉率有了明顯提高。學(xué)生是聯(lián)系學(xué)校、社會(huì)和家庭的重要媒介,也是結(jié)核病知識(shí)傳播的重要載體,尤其對(duì)于藏族學(xué)生更應(yīng)作為結(jié)核病重點(diǎn)監(jiān)測(cè)和管理對(duì)象,因此選擇在藏族中學(xué)學(xué)校中進(jìn)行結(jié)核病知識(shí)的健康教育。在學(xué)校內(nèi)宣傳結(jié)核病防治知識(shí)能夠有效提高師生們的結(jié)核病防病意識(shí),從而保障藏族中學(xué)生這個(gè)特殊的群體身新健康,并創(chuàng)造和諧健康的學(xué)習(xí)環(huán)境。結(jié)核病健康教育不僅是普及結(jié)核病防治知識(shí)的手段,也是結(jié)核病控制策略之一。 尤其在天津市藏族中學(xué)中開(kāi)展類(lèi)似健康教育措施是有效、也是簡(jiǎn)易可行的控制結(jié)核病方法之一。
[Abstract]:Objective: to understand the cognition of tuberculosis among teachers and students in Tibetan Middle Schools in Tianjin, identify the way of health education, evaluate the effect of health education, and lay a solid foundation for effective targeted prevention and control of tuberculosis in Tibetan middle schools.
Methods: To study the teachers and students in Tianjin Tibetan middle school, including 819 students, 96 teachers, collect demographic characteristics through the questionnaire survey, TB related knowledge, TB related attitude, tuberculosis and tuberculosis related behavior knowledge sources of the information. Independent investigators in a unified instruction, students are required to independently complete the questionnaire. A questionnaire for twenty minutes, after completing the questionnaire, unified recovery by the investigators. And carry out a series of related tuberculosis prevention and intervention activities as measures of health education. Through the change of TB prevention and control related information comparison baseline survey and health education, to explore the Health Education Institute of Tianjin city take the Tibetan middle school teachers and students about the tuberculosis prevention and cure knowledge, belief and behavior influence
Results: the general health education before the students' and teachers' awareness rate were 45.2% (1851/4095) and 43.4% (206/475), the difference was not statistically significant (2=2.439, P=0.1183); the awareness of students and teachers were 3.79% (31/819) and 4.21% (4/95), no significant difference (x2 2=0.042 P=0.838). The five core information, students and teachers on the symptoms of tuberculosis and tuberculosis (P0.01) whether the policy of free (P=0.031) there was significant difference in the cognition, there was no significant difference in the other three core information cognition; knowledge was 52.27% boys overall awareness influence factors of students core knowledge, higher than the 48.17% girls, the difference was statistically significant (P=0.010). The difference between male and female students are mainly embodied in the way of spread of tuberculosis and tuberculosis symptoms of these two aspects, the boys than girls (P0.05). Compared with students of different grades, although in tuberculosis Kernel mode of transmission, the symptoms of tuberculosis, TB prevention and the overall awareness rate, there were significant differences (P=0.003), but was not observed with the grade increased awareness rate increased, and in the control class and the class of Tibet local distribution of confounding factors are not only in Tibet (after high school class, junior grade one and only Tibet, Tibet third class) students overall awareness rate is still higher than that of the local students, mainly reflected in the aspects of prevention and control of tuberculosis (P=0.018). In the cognitive attitude of TB in terms of their possible tuberculosis, 68% (522/ 762) 49.45% (45/95) students and teachers thought they could not TB, the difference was statistically significant (2=13.242, P0.001); but the core knowledge level and the attitude is no statistical association (x 2=0.030, P=0.862). "If all nuclear attack, what is your response?", 71.69% Students and 68.89 teachers to answer one or more negative reaction, no difference between them (2=0.3118, P=0.5766); 75.56% of the students in Tibet, 64.13% local students have a negative reaction, the difference was statistically significant (2=11.748, P0.001). The main negative psychological fear, surprise most. The students and teachers a sympathetic attitude to TB patients.
The tuberculosis knowledge needs to get more knowledge about tuberculosis, had symptoms of tuberculosis to medical institutions, when treatment, inform had no statistical significance. Only the initiative to understand the knowledge of tuberculosis, 26.32% (210/798) 58.89% (53/90) students and teachers have the initiative to understand the knowledge of tuberculosis, the difference was statistically significant (2=41.166, P0.001). On the knowledge of TB prevention and control school, TV, network, blackboard, newspapers and magazines are the main source of students and teachers. To obtain TB knowledge, TV, small gifts, medical staff propaganda theme class meeting and posters is the most popular way.
Compared to before the health education, students' overall awareness rate increased from 45.2% to 59.6% (P0.05); teachers' overall awareness rate increased from 43.4% to 69.8% (P0.05). The awareness in health education before the low rate of "tuberculosis", "the main symptoms of pulmonary tuberculosis and tuberculosis treatment relief policy" hand, teachers and students have improved significantly (P0.05), but there are still many misconceptions. For TB attitude. Think you may have tuberculosis students before and after health education were 31.5% and 26.5%, the difference was statistically significant (2= 4.893, P=0.027), before and after health education for teachers and 50.6% 61.1%, the difference was not statistically different (2=2.265, P=0.132). In the attitude of tuberculosis patients, most students and teachers hold sympathy and hope to help their attitude. After health education, choose "sympathy but they are far from" fear of the disease" The proportion of students and teachers also reduced; more sympathetic toward and away from the patient, or fear of infection. To reduce the proportion of TB related behavior, in the appearance of the suspicious symptoms of tuberculosis, choose to go to the doctor for medical treatment and health institutions, timeliness, the difference was statistically significant. Health education, 26.4% students (209/792) the teacher and the propaganda of tuberculosis to others, the difference was statistically significant. The evaluation of promotional activities, the students willing to accept the way for the topic, teachers are publicity boards. In the volunteers, blackboard and TB essay, students' response as teachers.
Conclusion: health education before the Tibetan middle school students and teachers related knowledge on TB lack of understanding, especially for tuberculosis tuberculosis, tuberculosis symptoms, treatment, relief policy, awareness rate is low, the phenomenon of TB knowledge and school education is not relevant. From the survey we can see the theme class is the students more receptive to the campaign, but the teachers are easier to accept the publicity boards form. After the health education on TB knowledge awareness rate of core information of students has been significantly improved. The student is an important medium to contact the school, family and society, but also an important carrier of tuberculosis knowledge dissemination, especially for Tibetan Students it should focus on monitoring and management of tuberculosis as the object, so the choice of health education of tuberculosis knowledge in the Tibetan middle school in the school in the school. TB prevention knowledge propaganda can effectively improve the teachers and students of TB prevention awareness, in order to protect the Tibetan students in this special group of new health, and create a harmonious and healthy environment. TB health education is not only to popularize the knowledge of TB prevention and control means, also is one of the strategies for TB control.
Especially in Tianjin Tibetan middle school, it is effective to carry out similar health education measures, and it is also one of the simple and feasible methods to control tuberculosis.

【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R52

【引證文獻(xiàn)】

相關(guān)期刊論文 前2條

1 王廷偉;李小明;;陜西省榆林市初中生結(jié)核病防治知識(shí)健康教育效果分析[J];醫(yī)學(xué)動(dòng)物防制;2017年04期

2 張金靜;賀擁軍;戎浩;袁東亞;李旭光;劉曉麗;;西藏大學(xué)生肺結(jié)核防治同伴教育近期效果評(píng)價(jià)[J];中國(guó)學(xué)校衛(wèi)生;2017年03期

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