健康教育对天津市藏族中学师生结核病防治知识、信念、行为的影响

发布时间：2018-03-08 18:02

本文选题：结核病　切入点：中学　出处：《天津医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：了解天津市藏族中学校师生对结核病的认知情况,确定健康教育的方式,评价健康教育的效果,为有针对性的在藏族中学开展结核病防控工作提供有效的方法和途径奠定基础。方法：以天津市藏族中学的师生研究对象,其中学生819人,教师96人,通过问卷调查的方式收集人口学特征、结核病防治相关知识、结核病相关态度、结核病相关行为和结核病知识来源等方面的信息。在调查人员统一的指导语下独立完成,要求学生独立完成问卷。问卷作答时间为二十分钟,问卷完成后,由调查员统一收回。并开展一系列的与结核病防治相关的干预活动作为健康教育措施。通过比较基线调查和健康教育后结核病防治相关信息的变化,探讨研究所采取的健康教育对天津市藏族中学师生有关结核病防治知识、信念以及行为的影响结果：健康教育前学生和教师的总体知晓率分别为45.2%(1851/4095)和43.4%(206/475),差异无统计学意义(χ2=2.439,P=0.1183)；学生和教师的全部知晓率分别为3.79%(31/819)和4.21%(4/95),差异无统计学意义(χ2=0.042,P=0.838)。五条核心信息中,学生和教师对肺结核症状(P0.01)及结核病是否有免费政策(P=0.031)的认知存在统计学差异,对其它三条核心信息的认知均无统计学差异；学生核心知识知晓率的影响因素方面男生总体知晓率52.27%,高于女生的48.17%,差异有统计学意义(P=0.010)。男女生差异主要体现在对肺结核传播方式以及肺结核症状这两个方面,男生高于女生(P0.05)。不同年级的学生比较,虽然在肺结核传播方式、肺结核症状、肺结核预防方式和总体知晓率上,有统计学差异(P=0.003),但并没有观察到随年级增高知晓率增高的趋势,并且在控制西藏班和本地班分布不均的混杂因素后(高中仅有西藏班,初中仅初一和初三有西藏班),西藏班学生总体知晓率仍高于本地班的学生,主要体现在肺结核防治方面的认知(P=0.018)。在对结核病的态度方面对自己是否可能得肺结核,68%(522/762)的学生和49.45%(45/95)的教师认为自己不可能得结核病,差异有统计学意义(χ2=13.242,P0.001)；但对核心知识知晓的高低与持有这种态度没有统计学关联(χ2=0.030,P=0.862)。对“如果得了结核病,您的反应是什么?”,71.69%的学生和68.89的教师回答一种或以上的负面反应,两者无统计学差异(χ2=0.3118,P=0.5766)；75.56%的西藏班学生,64.13%的本地班学生有负面反应,两者差异有统计学意义(χ2=11.748,P0.001)。主要负面心理有害怕、吃惊等。多数学生和教师对结核病患者持同情的态度。对结核知识的需求,获得更多关于结核方面的知识、得了结核症状选择去医疗机构就诊、何时就诊、病情告知均无统计学意义。只有对结核知识了解的主动性方面,26.32%(210/798)的学生和58.89%(53/90)的教师有过主动了解结核方面的知识,差异有统计学意义(χ2=41.166,P0.001)。关于结核病防治知识学校、电视、网络、黑板报、报刊杂志是学生和教师的主要来源。获得结核知识的方式,电视、小礼品、医务人员宣传、主题班会和张贴画是最受欢迎的途径。相比健康教育前,学生的总体知晓率由45.2%升高至59.6%(P0.05)；教师的总体知晓率由43.4%升高至69.8%(P0.05)。在健康教育前知晓率较低的“肺结核传播方式”、“肺结核主要症状”和“肺结核治疗减免政策”方面,教师和学生都有显著提高(P0.05),但仍存在较多错误认识。对于结核病的态度。认为自己可能得结核的学生在健康教育前后的比例分别为31.5%和26.5%,差异有统计学意义(χ2=4.893,P=0.027),教师在健康教育前后为50.6%和61.1%,差异无统计学差异(χ2=2.265,P=0.132)。在对结核病人的态度上,多数学生和教师持同情并希望帮助他们的态度。在健康教育后,选择“同情但远离他们”“害怕被传染”的学生比例降低；而教师也更倾向于同情病人,而远离或害怕传染的比例降低。在结核病相关行为方面,在出现了可疑结核症状后,选择去卫生机构看病、就医的及时性上,差异有统计学意义。健康教育前,26.4%(209/792)的学生及教师向别人宣传结核病,差异有统计学意义。对宣传活动的评价,学生最乐于接受的方式为主题班会,教师则是宣传展板。在志愿者宣传、黑板报和结核防治征文上,学生的响应度也不如教师。结论：健康教育前藏族中学学生和教师对结核病的相关知识缺乏了解,尤其对结核病的肺结核传播方式、肺结核症状、治疗方法、减免政策方面的等知晓率较低,这种现象与学校对结核病知识的教育开展不够有关。从调查中我们可以看出主题班会是学生比较容易接受的宣传活动,而教师们则比较容易接受宣传展板的形式。健康教育后学生的结核病防治知识核心信息知晓率有了明显提高。学生是联系学校、社会和家庭的重要媒介,也是结核病知识传播的重要载体,尤其对于藏族学生更应作为结核病重点监测和管理对象,因此选择在藏族中学学校中进行结核病知识的健康教育。在学校内宣传结核病防治知识能够有效提高师生们的结核病防病意识,从而保障藏族中学生这个特殊的群体身新健康,并创造和谐健康的学习环境。结核病健康教育不仅是普及结核病防治知识的手段,也是结核病控制策略之一。尤其在天津市藏族中学中开展类似健康教育措施是有效、也是简易可行的控制结核病方法之一。
[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.

【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R52

【引证文献】