柳州市医务人员艾滋病病毒职业暴露知识认知现状调查

发布时间：2018-10-24 10:09

【摘要】：目的：通过对柳州市十所医疗机构医务人员进行的问卷调查，了解医务人员艾滋病病毒（HIV）职业暴露知识认知情况及个人职业防护意识现状，并对调查过程中发现的预防控制职业暴露所存在的问题提出相应的解决措施、建议，并为今后医疗机构开展HIV职业暴露相关培训提供背景资料和理论依据。方法：采用横断面研究，分层随机抽取柳州市10所医疗机构（包括三级、二级、一级医院）的270名医务人员，以内科、外科、儿科、妇产科、五官科、口腔科、感染病科、手术室、检验科，以及部分行政科室和医技科室作为项目科室，按照日常工作中诊疗方式较为类似，将科室分为4类。使用自行设计的自填式问卷对上述医务人员开展HIV职业暴露知识认知情况的调查。将问卷结果录入Excel工作表建立数据库，使用Excel和SPSS19.0统计分析软件对数据进行描述性分析，对各因素对医务人员HIV职业暴露知识认知情况的影响进行多因素logistic回归分析。结果：本研究对10所医疗机构的270名医务人员进行调查，发放问卷270份，回收264份，回收率97.78%；有效问卷260份，有效率98.48%。医务人员接受过HIV职业暴露相关培训的有84.62%；知道医院有预防职业暴露规章制度及操作规程的有85.77%；没有接受过培训，或不知道预防职业暴露规章制度和操作规程的医务人员大多来自一、二级医院；认为很有必要进行HIV职业暴露培训的有98.46%。医务人员有40.77%曾直接接触过病人的血液、体液；59.23%曾发生过锐器损伤事件，，其中致伤器械主要为空心针头（63.64%）。 HIV职业暴露知识总体认知情况较好的有68.08%，中等为29.23%。AIDS/HIV基本知识、HIV职业暴露基本知识、职业暴露个人防护意识、职业暴露后处置方法等四方面内容中，均有部分医务人员对一些细节认知程度不高，如HIV灭活方式、HIV职业暴露源、向使用过的一次性注射器针头上盖针头套、发生锐器损伤后伤口处理方法和报告医院感染管理部门的意识等。将调查对象按性别、年龄、工作年限、医院级别、职业、科室、文化程度、职称不同进行分组，对各种特征对知识认知情况的影响进行单因素分析，使用2检验。结果显示职业、职称两个特征与知识认知情况的相关性有统计学意义（P＜0.05）。研究职业、职称对医务人员知识认知情况的影响，使用多因素logistic回归进行统计分析。结果显示logistic模型有统计学意义（P＜0.05），模型拟合较好（P均＞0.05）；与其他人员相比，医生、护理人员、检验人员的知识认知水平均更高（P均＜0.05，OR=3.8、3.04、9.51），其中检验人员的优势更为明显；职称为初级及以下的人员与中级及以上者相比，前者知识认知情况较差（P＜0.05，OR=0.47）。结论：医务人员对HIV职业暴露知识认知情况较好。同时，医务人员需要接受更全面、深入的职业暴露知识培训。特别对于基层医院的医务人员，以及工作资历较浅、不在临床一线工作的医务人员，应该加强对他们的管理和培训，督促医务人员工作中严格遵守普遍性预防原则，提高发生接触事件后主动报告的意识，提高职业防护能力，降低HIV职业暴露水平。
[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
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R192;R512.91

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