發(fā)布時(shí)間：2018-10-24 10:09

【摘要】：目的：通過(guò)對(duì)柳州市十所醫(yī)療機(jī)構(gòu)醫(yī)務(wù)人員進(jìn)行的問(wèn)卷調(diào)查，了解醫(yī)務(wù)人員艾滋病病毒（HIV）職業(yè)暴露知識(shí)認(rèn)知情況及個(gè)人職業(yè)防護(hù)意識(shí)現(xiàn)狀，并對(duì)調(diào)查過(guò)程中發(fā)現(xiàn)的預(yù)防控制職業(yè)暴露所存在的問(wèn)題提出相應(yīng)的解決措施、建議，并為今后醫(yī)療機(jī)構(gòu)開(kāi)展HIV職業(yè)暴露相關(guān)培訓(xùn)提供背景資料和理論依據(jù)。 方法：采用橫斷面研究，分層隨機(jī)抽取柳州市10所醫(yī)療機(jī)構(gòu)（包括三級(jí)、二級(jí)、一級(jí)醫(yī)院）的270名醫(yī)務(wù)人員，以?xún)?nèi)科、外科、兒科、婦產(chǎn)科、五官科、口腔科、感染病科、手術(shù)室、檢驗(yàn)科，以及部分行政科室和醫(yī)技科室作為項(xiàng)目科室，按照日常工作中診療方式較為類(lèi)似，將科室分為4類(lèi)。使用自行設(shè)計(jì)的自填式問(wèn)卷對(duì)上述醫(yī)務(wù)人員開(kāi)展HIV職業(yè)暴露知識(shí)認(rèn)知情況的調(diào)查。 將問(wèn)卷結(jié)果錄入Excel工作表建立數(shù)據(jù)庫(kù)，使用Excel和SPSS19.0統(tǒng)計(jì)分析軟件對(duì)數(shù)據(jù)進(jìn)行描述性分析，對(duì)各因素對(duì)醫(yī)務(wù)人員HIV職業(yè)暴露知識(shí)認(rèn)知情況的影響進(jìn)行多因素logistic回歸分析。 結(jié)果：本研究對(duì)10所醫(yī)療機(jī)構(gòu)的270名醫(yī)務(wù)人員進(jìn)行調(diào)查，發(fā)放問(wèn)卷270份，回收264份，回收率97.78%；有效問(wèn)卷260份，有效率98.48%。 醫(yī)務(wù)人員接受過(guò)HIV職業(yè)暴露相關(guān)培訓(xùn)的有84.62%；知道醫(yī)院有預(yù)防職業(yè)暴露規(guī)章制度及操作規(guī)程的有85.77%；沒(méi)有接受過(guò)培訓(xùn)，或不知道預(yù)防職業(yè)暴露規(guī)章制度和操作規(guī)程的醫(yī)務(wù)人員大多來(lái)自一、二級(jí)醫(yī)院；認(rèn)為很有必要進(jìn)行HIV職業(yè)暴露培訓(xùn)的有98.46%。 醫(yī)務(wù)人員有40.77%曾直接接觸過(guò)病人的血液、體液；59.23%曾發(fā)生過(guò)銳器損傷事件，，其中致傷器械主要為空心針頭（63.64%）。 HIV職業(yè)暴露知識(shí)總體認(rèn)知情況較好的有68.08%，中等為29.23%。AIDS/HIV基本知識(shí)、HIV職業(yè)暴露基本知識(shí)、職業(yè)暴露個(gè)人防護(hù)意識(shí)、職業(yè)暴露后處置方法等四方面內(nèi)容中，均有部分醫(yī)務(wù)人員對(duì)一些細(xì)節(jié)認(rèn)知程度不高，如HIV滅活方式、HIV職業(yè)暴露源、向使用過(guò)的一次性注射器針頭上蓋針頭套、發(fā)生銳器損傷后傷口處理方法和報(bào)告醫(yī)院感染管理部門(mén)的意識(shí)等。 將調(diào)查對(duì)象按性別、年齡、工作年限、醫(yī)院級(jí)別、職業(yè)、科室、文化程度、職稱(chēng)不同進(jìn)行分組，對(duì)各種特征對(duì)知識(shí)認(rèn)知情況的影響進(jìn)行單因素分析，使用2檢驗(yàn)。結(jié)果顯示職業(yè)、職稱(chēng)兩個(gè)特征與知識(shí)認(rèn)知情況的相關(guān)性有統(tǒng)計(jì)學(xué)意義（P＜0.05）。 研究職業(yè)、職稱(chēng)對(duì)醫(yī)務(wù)人員知識(shí)認(rèn)知情況的影響，使用多因素logistic回歸進(jìn)行統(tǒng)計(jì)分析。結(jié)果顯示logistic模型有統(tǒng)計(jì)學(xué)意義（P＜0.05），模型擬合較好（P均＞0.05）；與其他人員相比，醫(yī)生、護(hù)理人員、檢驗(yàn)人員的知識(shí)認(rèn)知水平均更高（P均＜0.05，OR=3.8、3.04、9.51），其中檢驗(yàn)人員的優(yōu)勢(shì)更為明顯；職稱(chēng)為初級(jí)及以下的人員與中級(jí)及以上者相比，前者知識(shí)認(rèn)知情況較差（P＜0.05，OR=0.47）。 結(jié)論：醫(yī)務(wù)人員對(duì)HIV職業(yè)暴露知識(shí)認(rèn)知情況較好。同時(shí)，醫(yī)務(wù)人員需要接受更全面、深入的職業(yè)暴露知識(shí)培訓(xùn)。特別對(duì)于基層醫(yī)院的醫(yī)務(wù)人員，以及工作資歷較淺、不在臨床一線工作的醫(yī)務(wù)人員，應(yīng)該加強(qiáng)對(duì)他們的管理和培訓(xùn)，督促醫(yī)務(wù)人員工作中嚴(yán)格遵守普遍性預(yù)防原則，提高發(fā)生接觸事件后主動(dòng)報(bào)告的意識(shí)，提高職業(yè)防護(hù)能力，降低HIV職業(yè)暴露水平。
[Abstract]:Objective: To investigate the cognitive status of AIDS virus (HIV) occupational exposure and the status of personal occupational protection awareness through a questionnaire survey of medical staff in ten medical institutions in Liuzhou City. It also puts forward corresponding measures and suggestions for prevention and control occupational exposure found in the course of investigation, and provides background information and theoretical basis for the training of HIV occupational exposure related training in medical institutions in the future. Methods: A cross-sectional study was conducted to randomly extract 270 medical personnel from 10 medical institutions in Liuzhou (including three-grade, two-grade and one-grade hospitals), and medical, surgical, pediatrics, obstetrics and gynecology, five official families, stomatology department, infectious disease department, operating room, and inspection department were randomly selected. The inspection department, as well as some administrative departments and medical and technical departments as the project departments, is similar to the diagnosis and treatment methods in daily work, and divides the departments into 4. A self-designed self-filled questionnaire was used to investigate the knowledge of HIV occupational exposure to the medical personnel mentioned above. The results of questionnaire were entered into Excel worksheet to establish a database, and Excel and SPSS19. 0 statistical analysis software were used to analyze the data, and the influence of various factors on the cognitive status of HIV occupational exposure in medical personnel was analyzed. c Regression analysis. Results: 270 medical staff in 10 medical institutions were investigated, 270 questionnaires were issued, 264 were recovered, and the recovery rate was 97. 78%. Efficiency 98. 48%. Medical staff received 81.62% of HIV occupational exposure-related training; it is known that there are 85. 77% of the hospital's regulations for prevention of occupational exposure and operating procedures; no training has been accepted, or medical personnel who do not know the regulations and operating procedures for prevention of occupational exposure Most of the personnel are from one or two hospitals; it is considered necessary to carry out the HIV professional violence There were 98. 46% of the trained medical staff. The medical staff had 40. 77% of the blood, body fluids and 59. 23% of the patients who had been in direct contact with the patient. The total cognition of HIV occupational exposure knowledge is 68. 08%, moderate 29. 23%, AIDS/ HIV basic knowledge, basic knowledge of HIV occupational exposure, occupational exposure individual protection consciousness, post-occupation treatment method, etc. Some medical personnel have a high degree of cognition to some details, such as HIV inactivation method, HIV occupational exposure source, needle cover on disposable syringe needle used, and wound treatment after sharp instrument injury. Methods and report the consciousness of hospital infection management department and so on. According to sex, age, working age, hospital level, profession, department, level of culture and professional title, the survey subjects were grouped according to sex, age, working age, hospital level, profession, department, culture degree and professional title. The effect of cognition is analyzed by single factor, and two tests are used. The results show that there are two characteristics of profession and job title and knowledge cognition. The correlation of the situation was statistically significant (P <0.05). In response, statistical analysis was performed using multi-factor logistic regression. The results showed that the model was statistically significant (P <0.05), and the model fit was better (P> 0.05). Compared with other personnel, the knowledge cognitive level of doctors, nurses and inspectors was higher (P <0.05, OR = 3. 8, 3).. 04, 9. 51), in which inspection personnel have more obvious advantages; the former is known as junior and lower, compared with intermediate and above. The cognition was poor (P <0.05, OR = 0. 47). Conclusion: The knowledge of occupational exposure to HIV in medical personnel is better. At the same time, medical personnel need to receive more comprehensive and in-depth occupational exposure knowledge training. In particular, medical personnel in primary hospitals and medical personnel who do not work in the clinic should strengthen their management and training, and urge medical personnel to work strictly Abide by the principle of universal prevention, improve the initiative after the occurrence of the contact event
【學(xué)位授予單位】：廣西醫(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)】：R192;R512.91

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 李雁凌;張占杰;吳寧;宋曉t

本文編號(hào)：2291079