發(fā)布時間：2018-03-09 16:46

  本文選題：被動吸煙　切入點(diǎn)：孕婦　出處：《復(fù)旦大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的了解上海市某區(qū)孕婦二手煙暴露情況及主要影響因素、關(guān)于二手煙與健康關(guān)系的知識、對被動吸煙的態(tài)度,評價基于技能培養(yǎng)的被動吸煙干預(yù)活動對降低孕婦被動吸煙暴露水平的效果。研究方法橫斷面調(diào)查法分析孕婦被動吸煙現(xiàn)況,隨機(jī)對照試驗評價干預(yù)效果,采用問卷調(diào)查方法。具體包括：1.采用整群抽樣的方法,選擇上海市某區(qū)人口構(gòu)成基本接近、社區(qū)衛(wèi)生服務(wù)提供較均衡的6個社區(qū),對從2011年3月至2012年2月建冊的孕婦在基線與終末調(diào)查時分別進(jìn)行一對一問卷調(diào)查,內(nèi)容包括孕婦人口學(xué)特征,孕婦及丈夫吸煙狀況,二手煙吸入情況,吸二手煙與健康關(guān)系的知識等。2.將其中4個社區(qū)分配到干預(yù)組,2個社區(qū)分配到對照組。在干預(yù)社區(qū)進(jìn)行兩次面對面指導(dǎo)、兩次孕婦學(xué)校視頻課程(孕婦及丈夫一同參加)、一次入戶訪視、一次電話隨訪,提供二手煙危害知識和主動拒絕被動吸煙的技能；對對照社區(qū)不另外施加特殊干預(yù)措施。研究結(jié)果共3700名孕婦完成基線調(diào)查,剔除自報吸煙者25名,最后共3675人納入分析,其中干預(yù)組2301人,對照組1374人。3240名產(chǎn)婦完成終末調(diào)查,其中干預(yù)組2151人,對照組1089人。1.二手煙暴露情況本次調(diào)查在基線調(diào)查的3675名非吸煙孕婦中,發(fā)現(xiàn)1486名孕婦在近30天內(nèi)遭受到被動吸煙,總被動吸煙率為40.4%。孕婦在家中的近30天內(nèi)被動吸煙率分別為18.4%,在室內(nèi)工作場所為12.4%,公共場所為26.1%。2.二手煙暴露率的影響因素調(diào)查發(fā)現(xiàn),在控制其他因素前提下,孕婦二手煙暴露率與其年齡、家庭人均月收入、教育程度、職業(yè)和生育史有關(guān)。與年齡較低者相比,年齡高一歲者被動吸煙率是降低7%(OR=0.93,95%CI=0.9～0.96)；與人均月收入為10000元以上者相比,人均月收入為3000元以下的被動吸煙率是其1.32倍(OR=1.32,95%CI=1.02～1.72)；與教育程度為大學(xué)及以上者相比,教育程度為高中/中專的是其0.78倍(OR=0.78,95%CI=0.65～0.94)；與職業(yè)為無業(yè)/失業(yè)的相比,職業(yè)為工人或服務(wù)人員、專業(yè)技術(shù)人員或管理人員、個體戶或臨時工、其他的被動吸煙率分別是前者的1.16倍、1.29倍、1.34倍與2.02倍(OR=1.16,95%CI=0.89～1.53;OR=1.29,95%CI=1.04～1.62：OR=1.34,95%CI=0.97～1.86與OR=2.02,95%CI=1.55～2.62)；與初產(chǎn)婦相比,經(jīng)產(chǎn)婦被動吸煙率是其0.73倍(OR=0.73,95%CI=0.59～0.92)。3.對二手煙與健康關(guān)系認(rèn)識的知識得分及對被動吸煙的態(tài)度本次調(diào)查發(fā)現(xiàn),被調(diào)查的孕婦對二手煙與健康關(guān)系認(rèn)識的知識得分為58.4分。99%的被調(diào)查孕婦表示不希望被動吸煙。4.干預(yù)效果基線時干預(yù)組知識得分58.6分,終末調(diào)查知識得分增加至86.1分,差異有統(tǒng)計學(xué)意義(p0.001)：基線時對照組知識得分為57.6分,終末調(diào)查知識得分增加至87.0分,差異也具有統(tǒng)計學(xué)意義(p0.001)。基線時干預(yù)組在家中被動吸煙率為21.9%,終末調(diào)查時干預(yù)組在家中被動吸煙率為3.2%,差異有統(tǒng)計學(xué)意義(p0.001)；基線時對照組在家中被動吸煙率為12.0%,終末調(diào)查時對照組在家中被動吸煙率為2.8%,差異也具有統(tǒng)計學(xué)意義(p0.001)。終末調(diào)查時干預(yù)組與對照組在家中近30天內(nèi)被動吸煙時間均減少,差異均有統(tǒng)計學(xué)意義。基線時干預(yù)組在室內(nèi)工作場所被動吸煙率為12.6%,終末調(diào)查時干預(yù)組在室內(nèi)工作場所被動吸煙率為1.2%,差異有統(tǒng)計學(xué)意義(p0.001)；基線時對照組在家中被動吸煙率為13.1%,終末調(diào)查時對照組在家中被動吸煙率為1.1%,差異也具有統(tǒng)計學(xué)意義。終末調(diào)查時干預(yù)組與對照組在室內(nèi)工作場所近30天內(nèi)被動吸煙時間均減少,差異均有統(tǒng)計學(xué)意義。基線時干預(yù)組在公共場所被動吸煙率為29.1%,終末調(diào)查時干預(yù)組在家中被動吸煙率為5.0%,差異有統(tǒng)計學(xué)意義(p0.001)；干預(yù)前對照組在家中被動吸煙率為18.0%,終末調(diào)查時對照組在家中被動吸煙率為2.3%,差異具有統(tǒng)計學(xué)意義。終末調(diào)查時干預(yù)組與對照組在公共場所近30天內(nèi)被動吸煙時間均減少,差異均有統(tǒng)計學(xué)意義。結(jié)果顯示,終末調(diào)查時干預(yù)組對二手煙與健康關(guān)系認(rèn)識的知識得分增值與對照組差異無統(tǒng)計學(xué)意義(F=1.67,p=0.196)。排除了基線的差異后,終末調(diào)查時,干預(yù)組在家中的被動吸煙率是對照組的0.50倍(t=-2.75,p=0.006),在家中被動吸煙時間低于對照組,差異有統(tǒng)計學(xué)意義(F=11.41,p=0.0007)；排除了基線的差異后,終末調(diào)查時干預(yù)組在室內(nèi)工作場所的被動吸煙率、被動吸煙時間與對照組差異無統(tǒng)計學(xué)意義(t=0.12,p=0.907與F=0.45,p=0.5022);排除了基線的差異后,終末調(diào)查時,干預(yù)組在公共場所的被動吸煙率、被動吸煙時間與對照組差異無統(tǒng)計學(xué)意義(t=-1.23,p=0.218與F=0.02,p=0.8866)。選擇年齡低于30歲,職業(yè)為專業(yè)技術(shù)人員或行政管理人員的孕婦進(jìn)行分析。結(jié)果顯示,終末調(diào)查時干預(yù)組在家中的被動吸煙率與對照組差異無統(tǒng)計學(xué)意義(χ2=2.089,p=0.148),但被動吸煙時間減少值的總體中位數(shù)大于對照組,差異有統(tǒng)計學(xué)意義(z=2.122,p=0.034)；終末調(diào)查時,干預(yù)組在室內(nèi)工作場所的被動吸煙率、被動吸煙時間減少值的總體中位數(shù)與對照組差異無統(tǒng)計學(xué)意義(χ2=1.745,p=0.186與z=1.45,p=0.147)；干預(yù)組在公共場所被動吸煙時間減少值的總體中位數(shù)大于對照組,差異有統(tǒng)計學(xué)意義(z=-2.521,p=0.012)。研究結(jié)論干預(yù)對降低孕婦在家庭內(nèi)被動吸煙暴露水平有效,對降低在工作場所和公共場所的被動吸煙暴露水平無效。技能與知識綜合干預(yù)有一定效果。應(yīng)改變傳統(tǒng)干預(yù)模式,注重培養(yǎng)研究對象的技能。應(yīng)加大工作場所和公共場所禁煙,加大控?zé)焾?zhí)法監(jiān)督力度,營造無煙環(huán)境。
[Abstract]:Objective: To study in a district of Shanghai City maternal exposure to secondhand smoke and its influencing factors, on the relationship between passive smoking and passive smoking on health knowledge, attitude, evaluation of passive smoking intervention activities based on skill training to reduce passive smoking exposure level of pregnant women. The effect of analysis of the status of passive smoking pregnant women cross-sectional survey method, effect test evaluation of randomized controlled intervention, using the method of questionnaire investigation. Including: 1. by cluster sampling method, choose a district population of Shanghai close to the community health service, providing 6 community more balanced, from March 2011 to 2012 of 2 volumes of pregnant women were built one to one survey in the baseline survey and final at the end, including the demographic characteristics of pregnant women, pregnant women and her husband smoking, secondhand smoke, smoking between passive smoking and health knowledge of the.2. In 4 communities assigned to the intervention group, 2 communities were assigned to the control group. Two face to face guidance and intervention in the community, two pregnant women (pregnant women school video course and her husband to join in a home visit), and a telephone follow-up, to provide second-hand smoke knowledge and active denial of passive smoking in addition to the control community skills; not to impose special intervention measures. The results of a total of 3700 women completed the baseline survey, excluding self-reported smokers 25, finally a total of 3675 people were included in the analysis, including 2301 in the intervention group and control group of 1374.3240 women completed at the end of the investigation, including 2151 in the intervention group and the control group of 1089.1. exposure to second-hand smoke in this survey in 3675 non pregnant women who smoke baseline survey, found that 1486 of pregnant women exposed to passive smoking in the past 30 days, the total rate of passive smoking for 40.4%. pregnant women at home in the past 30 days passive smoking rate was 18. 4%, in indoor workplaces, public places for 12.4%, 26.1%.2. survey found that secondhand smoke exposure factors affected the rate, in the premise of controlling other factors, maternal exposure to secondhand smoke in their age, income, family education, the occupation and reproductive history. Compared with the younger age, higher age passive smoking rate is reduced by 7% (OR=0.93,95%CI=0.9 ~ 0.96); compared with the per capita monthly income of 10000 yuan, per capita monthly income of 3000 yuan for the passive smoking rate was 1.32 times (OR=1.32,95%CI=1.02 ~ 1.72); and the level of education for college and above compared to the level of education for high school / secondary school is the 0.78 times (OR=0.78,95%CI=0.65 ~ 0.94); for the unemployed / unemployed compared with the occupation, occupation for workers and service personnel, professional and technical personnel and management personnel, the self-employed or other temporary, passive smoking rates were 1.1 of the former 6 times, 1.29 times, 1.34 times and 2.02 times (OR=1.16,95%CI=0.89 ~ 1.53; OR=1.29,95%CI=1.04 ~ 1.62:OR=1.34,95%CI=0.97 ~ 1.86 and OR=2.02,95%CI=1.55 ~ 2.62); compared with the primipara, the maternal passive smoking rate was 0.73 times (OR=0.73,95%CI=0.59 ~ 0.92).3. understanding of the relationship between passive smoking and health knowledge and attitude of passive smoking was found the investigation, investigation of pregnant women's understanding of the relationship between passive smoking and health knowledge score of 58.4.99% pregnant women surveyed said they did not want the baseline effect of passive smoking.4. intervention intervention group knowledge score of 58.6 points, the final investigation of knowledge score increased to 86.1 points, the difference was statistically significant (p0.001): baseline control group knowledge score of 57.6 points, the final investigation of knowledge score increased to 87 points, the difference was statistically significant (p0.001). Baseline intervention group at home in the passive smoking rate was 21.9%, At the end of the investigation in the intervention group home passive smoking rate was 3.2%, the difference was statistically significant (p0.001); the control group at baseline in the passive smoking rate was 12%, the final investigation, the control group in the passive smoking rate was 2.8%, the difference was statistically significant (p0.001). At the end of the investigation the intervention group and the control group of passive smoking at home time nearly 30 days were reduced, there were statistically significant differences in baseline. The intervention group in indoor workplaces, passive smoking rate was 12.6%, the final investigation, the intervention group in indoor workplaces, passive smoking rate was 1.2%, the difference was statistically significant (p0.001); baseline control group at home passive smoking rate was 13.1%, the final investigation, the control group in the passive smoking rate was 1.1%, the difference was statistically significant. The final investigation, the intervention group and the control group in indoor workplaces, nearly 30 days of passive smoking is reduced, There were statistically significant differences in baseline. The intervention group in passive smoking in public places was 29.1%, the final investigation of the intervention group at home in the passive smoking rate was 5%, the difference was statistically significant (p0.001); the control group before intervention in passive smoking rate was 18%, the terminal survey of control group at home the passive smoking rate was 2.3%, the difference was statistically significant. The final investigation, the intervention group and the control group in public places in the last 30 days of passive smoking time are reduced, the differences were statistically significant. The results showed that the final investigation, the intervention group on the relationship between passive smoking and health knowledge score of knowledge increment and control group the significance of (F=1.67, p=0.196). The baseline differences excluded after the final investigation, the intervention group of passive smoking at home rate is 0.50 times higher than that of control group (t=-2.75, p=0.006), passive smoking at home time is lower than that of control group, the difference was statistically Statistically significant (F=11.41, p=0.0007); exclude baseline differences, passive smoking at the end of the intervention group in the investigation of indoor work places, passive smoking time and the control group had no significant difference (t=0.12, p=0.907 and F=0.45, p=0.5022); the difference between the baseline were excluded after the final investigation. The intervention group of passive smoking in public places, passive smoking time and the control group had no significant difference (t=-1.23, p=0.218 and F=0.02, p=0.8866). Under the age of 30, for the occupation of professional and technical personnel or administrative personnel of pregnant women were analyzed. The results show that the terminal survey intervention in passive smoking group at home the rate of the control group had no significant difference (2=2.089, p=0.148), but the time of passive smoking reduction in median overall value greater than that of the control group, the difference was statistically significant (z=2.122, p=0.034); at the end of the investigation, the intervention group in the room Passive smoking in the workplace smoking rate, reduce the time value of the median overall and the control group had no significant difference (x 2=1.745, p=0.186 and z=1.45, p=0.147); the intervention group reduced the median overall value is greater than that of the control group in passive smoking in public places, the difference was statistically significant (z=-2.521, p=0.012). The conclusion of the study of intervention to reduce maternal exposure to passive smoking in family level effectively, to reduce passive smoking in workplaces and public places, the exposure level is invalid. Skills have certain effect and knowledge of comprehensive intervention. We should change the traditional intervention mode, pay attention to the cultivation of study skills. Should increase the workplace and smoking in public places, increase tobacco control supervision of law enforcement to create a smoke-free environment.

【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R715.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 楊練;毛正中;;非吸煙孕婦被動吸煙干預(yù)措施效果評價[J];中國慢性病預(yù)防與控制;2010年03期

，

本文編號：1589385