南宁市基层医疗卫生机构管理的肺结核患者结核病防治核心知识知晓率分析

目的 分析南宁市基层医疗卫生机构管理的肺结核患者对结核病防治核心知识的知晓率水平,探索其影响因素,为完善结核病健康管理提供依据。方法 对311名南宁市基层医疗卫生机构服务的对象（肺结核患者）采用结构化问卷进行面对面调查,了解患者对结核病防治核心知识的知晓情况、认知态度及知识来源情况;统计学分析采用统计软件IBM SPSS Statistics23 进行。结果 311名肺结核患者对结核病核心知识总的知晓率为80.02%（1742/2177）。对结核病归口管理政策的知晓率最高（94.86%）,对结核病治疗转归的知晓率最低（46.95%）,结核病防治7条核心知识的知晓率差异有统计学意义（χ2 = 379.459,P＜0.01）。不同民族和职业分类患者的知晓率差异有统计学意义（χ2值分别为36.613、18.178;P值分别为＜0.001、0.003）。多因素分析显示,年龄和职业是结核病防治核心知识知晓率的影响因素。311名患者中,70%以上患者对结核病的认知态度比较正面,欢迎基层医疗卫生机构人员为其提供健康管理服务。患者获取结核病防治核心知识的途径比较分散,从医生处获得最高（28.63%）,从学校教育中获得最低（1.83%）。结论 南宁市基层医疗卫生机构管理的肺结核患者对结核病防治核心知识的总的知晓率仍未达到结核病防治规划提出的85%的指标要求,今后需要在继续发挥基层医疗卫生机构人员在结核病防治健康促进工作中的作用、联合卫生健康部门和教育部门将结核病健康教育列入学校教学计划中去及探索针对不同人群特点的健康促进方式,最终提高总人群的结核病防治核心知识知晓率。     

江苏省医务人员肺结核知识知晓率及影响因素分析

目的了解江苏省医务人员的肺结核相关知识,为提高医务人员的发现和正确有效治疗肺结核病的能力提供依据。方法采用多阶段随机抽样的方法抽取江苏省医务人员2156人,使用统一设计的调查问卷进行现场调查。结果江苏省医务人员基本知识知晓率为82.93%,政策知识知晓率为72.41%,总知晓率为77.95%。不同特征的医务人员其结核病知识总知晓率存在差异,从医时间长(OR=1.123,95%CI:1.053～1.197)、接受培训的医务人员(R=1.865,95%CI:1.490～2.335),其肺结核知识的知晓率较高,防保所、防疫科、疾控中心工作的医务人员肺结核知识的知晓率高于呼吸科工作的医务人员。结论江苏省基层医务人员对肺结核相关知识的知晓率较高,但尚未达到国家相关规定的要求,低于《全国结核病防治规划(2001—2010年)》中的要求的总知晓率达80%的指标,对肺结核的政策知晓率较低,应加强健康教育。     

基层疾控中心对流动人口肺结核的健康教育及护理体会

目的探讨基层疾控中心对流动人口肺结核的健康教育及护理作用,为结核病的防治提供帮助。方法收集我县自2007年至2008年（健康教育前）与2009年至2010年（健康教育后）的流动人口肺结核的就诊及治疗情况,对两阶段流动人口结核病人登记涂阳率,对结核知识的知晓率、治疗依从性及并发症等方面进行系统比较。结果通过将健康教育及护理工作放在首位及加强督导管理,病人治疗依从性明显提高,流动人口肺结核的涂阳登记率及初诊病人的就诊率,对结核知识的知晓率,治疗依从性都有明显提高,并发症逐年下降,差异具有统计意义（p〈0.05）。结论健康教育及护理工作在针对流动人口肺结核病患者的防治中起着积极的作用,提高了结核病的治疗效果及管理效果。     

The knowledge of the obligatory reporting of diseases among health professionals]

In order to assess what different health care workers (mainly physicians and nursing staff) know about the reporting of communicable diseases, with special emphasis on diseases that must be urgently reported, four groups were interviewed about this health information system (91 persons, who took part in different Public Health Seminars during the periods 1989-90 and 1990-91). The total mean score was 16.6 +/- 5.2, in a quantitative scale ranging from 0 to 27 points. Cholera was the communicable disease with the highest percentage of correct answers concerning the knowledge of its reporting (100% in two groups), while typhus was the disease with the lowest percentage (23%). The diversity of the results within the study groups suggests that it is necessary to insist on a continuous training on epidemiological surveillance and communicable diseases within Public Health activities in Catalonia.     

The effects of a training program on knowledge, attitude and practice of the staff of primary health care centers towards growth monitoring: an intervention study

This study was carried out aiming at assessing the effects of a training program on the knowledge, attitude and practices (KAP) of health care workers (HCWs) in primary health care centers (PHCCs) regarding growth monitoring (GM). It included 148 health care workers (30 General Practitioners (GPs) and 118 nurses), from 17 PHCCs in Jeddah city, Kingdom of Saudi Arabia (KSA). Tests on KAP were held before and six months following a training program on GM conducted by the investigators. Results showed significant improvements in the KAP of the trained health care workers after training, the 44 trained HCWs obtained higher mean comprehension score (7.9 +/- 1.2), higher mean practice score (11.6 +/- 3.0), and higher mean general scores (32.3 +/- 4.6) compared to the mean scores they obtained in the pre-test (5.7 +/- 1.5; 7.4 +/- 2.2 and 25.7 +/- 4.4, respectively). These differences were statistically significant (P < 0.001). However; the difference in the mean knowledge scores, before and after the GM training program was not significant. The training has also led to the disappearance of the significant knowledge gap between GPs and nurses. And also, the 44 trained HCWs had higher mean comprehension score (7.9 +/- 1.2), mean practice score (11.6 +/- 3.0), and mean general scores (32.3 +/- 4.6) compared to those among untrained group (controls) (6.3 +/- 2.1; 8.5 +/- 3.7, and 27 +/- 6.1, respectively). These differences were statistically significant (P < 0.0005). Nevertheless, the difference in the mean knowledge scores, between the two groups, was not statistically significant. It also has led to some changes in the attitude of the trained HCWs towards GM compared to the untrained group. In conclusion, We credit the significant improvements in KAP of HCWs to the training program and recommend its adoption by the national MCH program in KSA. We also recommend new methods of teaching and training based on sound educational concept of active participation and practical work as well as supportive supervision and evaluation.     

Tuberculosis infection control in rural South Africa: survey of knowledge, attitude and practice in hospital staff

A baseline assessment of tuberculosis infection control (TB IC) knowledge, attitude and practice (KAP) was conducted among staff in a resource-limited rural South African hospital where nosocomially transmitted multi- and extensively drug-resistant (M/XDR) TB had been reported. Assessment consisted of anonymous questionnaires and direct observation during July-September 2007, soon after the report of M/XDR-TB. Data were obtained from 57 questionnaires and 10h of direct observation. While knowledge and attitudes were generally supportive of TB IC implementation, 49.1% of staff felt that the hospital did not care about them and/or was not working to prevent staff TB infections, and 42.9% were less willing to continue as a healthcare worker because of staff TB/MDR-TB/XDR-TB deaths. Practices were variable. The recent appointment of an IC officer and implementation of natural ventilation were strengths, but the facility lacked a TB IC policy, the patient TB screening process was inadequate, and 41.5% of respondents were unaware of their personal human immunodeficiency virus (HIV) status. Respondents reported a number of barriers to TB IC implementation such as concerns about the confidentiality of staff health information, the stigma of TB and HIV, inadequate resources, and patient non-compliance. Assessment of staff KAP provided useful data regarding deficits and barriers to TB IC, and helped to focus subsequent IC strategies. Given the critical importance of reducing nosocomial TB transmission, it is recommended that facilities should conduct simplified TB IC assessment, ensure the confidentiality of staff health information, address the stigma of TB/HIV, and implement multi-faceted TB IC facility and behavioural change interventions. Behavioural science methods have the potential to improve TB IC research and implementation.     

Public health and correctional collaboration in tuberculosis control

OBJECTIVE: To assess the extent that 20 large jail systems and their respective public health departments collaborate to prevent and control tuberculosis (TB). METHODS: Data were collected through questionnaires sent to jail medical directors and TB control directors, interviews, and on-site observation in each of the jails. RESULTS: Only 35% of jail systems and health departments reported having effective collaboration in TB prevention and control activities. Four barriers were reported by a majority of the jail systems: funding (65%), staffing (60%), staff training (55%), and communication (55%). Lack of advance notice of a patient's release was rated as the greatest barrier to discharge planning. Fifty percent of the jail systems reported that they scheduled appointments for soon-to-be released patients with TB, and 10% did so for patients being treated for latent TB infection (LTBI). Fewer patients actually received appointments: seven (39%) of 33 released patients with TB had documentation in their medical record of appointments, and one of 46 released patients on treatment for LTBI had them. Characteristics associated with increased collaboration include having designated liaisons between jail systems and health departments and holding periodic meetings of staff. CONCLUSIONS: Health departments and jail systems in the same jurisdiction have implemented recommendations regarding collaboration to a limited extent. Such collaborations need strengthening, especially discharge planning and evaluation of TB control activities.     

Community health workers and tuberculosis control: knowledge and perceptions

This study analyzes the knowledge of community health workers in tuberculosis control and their self-perceived knowledge and the importance they ascribe to their role in fighting the disease, in Vitória, Espírito Santo State, Brazil. The study adopted a cross-sectional design, with a pre-tested, semi-structured questionnaire completed by 105 randomly selected health workers. The comparison of proportions between the groups formed by stratification according to time-on-the-job used the chi-squared test with 5% significance. Mean age was 34.5 (+/-9.7) years. Sixty-six community health workers (62.9%) had worked on the job for three years or less. Longer time on the job was positively associated with increased understanding of the disease and activities actually performed in TB control. Still, numerous flaws were observed in TB knowledge and control measures among community health workers. Improvements in continuing education for these workers could foster a more effective contribution to detecting new TB cases in the community and improved treatment adherence by patients.     

Community knowledge, attitudes and practices towards tuberculosis and its treatment in Mpwapwa district, central Tanzania

Tuberculosis (TB) is one of the leading causes of adult mortality with 32% of the global population infected with Mycobacterium tuberculosis. The current control of TB depends mainly on case management using the Direct-Observed Treatment, Short-course (DOTs) regimen. Despite the measures taken, the disease burden is still on increase especially in the developing countries including Tanzania. Correct knowledge and positive perception of the community towards TB and its management is a prerequisite to early treatment seeking. This study was carried out in Mpwapwa district, central Tanzania, to assess the knowledge, attitudes and practice as regards to TB and its treatment. Focus group discussions involving men and women were conducted in six villages. Results show that TB was an important public health problem. However, community knowledge on its cause was poor. Symptoms of TB as mentioned by the community included persistent cough and weight loss. TB was reported to be transmitted mainly through air. Self medication was the first most preferred option, whereas health care facility consultation was the last one. Focus group discussants knew that TB cure requires a 8-month period of treatment. Friends and relatives were the main source of TB information in the community. In conclusion, rural communities of Mpwapwa District have a low knowledge on the causes and the transmission of tuberculosis which is a likely cause of the delay in seeking treatment. An intensive appropriate community health education is required for a positive behavioural change in tuberculosis control.     

学校结核病健康教育效果评价

目的评价学校开展结核病健康教育的效果,为制定学校结核病健康教育规范提供依据。方法对12所学校进行为期6个月的健康教育综合干预,并根据卫生部关于结核病防治宣传的8条核心信息设计问卷,干预前后用同一问卷进行调查,评价干预前后学生结核病知识知晓率变化情况。结果健康教育干预后,学生结核病知识掌握均有显著提高,小学组与初中组知晓率提高了近40%;知识得分不及格比例均有显著下降,小学组、初中组下降幅度大;掌握知识较好的(80分以上)比例大幅增加。对肺结核病人歧视现象也明显减少。结论本次健康教育干预,对学生结核病知识的提高效果明显,应在学校继续加强重大传染病的健康教育。     

结核病专科医院医务人员结核感染风险研究

目的 探讨结核病专科医院医务人员职业暴露危险因素,以采取有效地预防控制措施降低结核感染风险.方法 采用整群抽样的方法,进行问卷调查,采集基本信息,对受试人群进行结核菌素试验(PPD)和T细胞斑点试验(T-SPOT.TB)检测.结果 共有符合条件的497人纳入本研究,98.59％认为自己在工作中有机会接触结核病患者,81.89％工作时佩戴口罩,82.70％接种过卡介苗;受试者中,PPD试验阳性率为66.60％,T-SPOT.TB试验阳性率较低,为10.87％,两种试验结果在医院内不同职业人群间差异无统计学意义,PPD试验阳性率与工作年限有相关性(x2=11.1936,P=0.0107),而T-SPOT.TB试验结果与工作年限无明显相关.结论 加强全体医务人员,特别是行政管理人员和新上岗医务人员的个人防护和健康教育有重要意义.     

医务人员结核病相关知识与实施防护措施调查

目的了解综合性医疗机构医务人员结核病相关知识及职业防护的知晓情况。方法采用结核病防治知识问卷,对某综合医院临床科室医务人员进行结核病相关知识及职业防护行为的问卷调查。结果共收回有效问卷333份,医务人员对结核病相关知识的正确应答率为62.84%～93.09%;国家针对结核病政策方面的内容,医务人员正确应答率为59.52%～77.27%。医务人员中结核病相关知识知晓组与不知晓组职业防护措施实施率［（10.74%～79.34%）vs（10.38%～82.55%）］无明显差异（P＞0.05）,但知晓组每次参加医院组织的定期体检的实施率（92.56%）高于不知晓组（79.25%）,差异有统计学意义（P＜0.05）。结论 综合性医疗机构的医务人员应强化结核病相关知识培训,落实职业防护措施。     

杭州市基层医务人员卫生应急能力现状及影响因素分析

  目的  调查杭州市基层医务人员卫生应急知识水平及卫生应急能力现状，了解医务人员卫生应急能力的影响因素，为提高医务人员在突发公共卫生事件中的应急救援能力提供具有针对性的建议。
  方法  采用修订后的突发公共卫生事件应急知识和应急能力问卷，对杭州市8家社区卫生服务中心417名医务人员进行调查，并从人口学因素和卫生应急知识维度对基层医务人员卫生应急能力的影响因素进行多重线性回归分析。
  结果  杭州市基层医务人员卫生应急能力各维度评分从高到低排列依次为:急救能力（3.91±0.71）分、综合能力（3.87±0.64）分、应急知识学习能力（3.73±0.70）分。多重线性回归分析显示:和无职称人员相比，高级职称人员应急能力得分提高0.216分；相比未参加过卫生应急培训者，参加过卫生应急培训的基层医务人员的得分提高0.186分；相比未经历过应急救援活动者，经历过应急救援活动者得分增加0.177分；相比单位没有完整应急预案者，单位有完整应急预案的基层医务人员得分提高0.192分（P < 0.01）。应急知识维度中，医务人员“重大传染病的特点和应对措施”维度得分每增加1分，应急能力得分增加0.475分；“法律责任”维度得分每增加1分，应急能力得分增加0.136分（P < 0.001）。
  结论  杭州市基层医务人员卫生应急能力处于中等略偏上水平，应加强针对基层医务人员的卫生应急培训，提高基层医务人员卫生应急知识，完善基层医疗卫生机构应急预案建设，强化应急演练，从而进一步提高基层医务人员卫生应急能力水平。
     

2002～2005年肺结核病人健康教育效果评估

[目的]为了了解掌握南山区肺结核病人对结核病防治知识的知晓程度，从而更好的有针对性的开展结核病健康教育工作。[方法]对凡在南山区发现确诊的肺结核病人均进行口头和书面有关结核病的传播、症状、预防、检查、治疗及管理等方面常规健康教育宣教30min以上，并在宣教前和宣教后两个月左右分别进行结核病防治知识的问卷调查。进行效果评估。[结果]2002～2005年共对462例肺结核病人进行了问卷调查，人均知识得分数由宣教前的59．4％提高到宣教后的94．2％．总知晓率由11．0％提高到68．8％，男性与女性无明显差别，65岁以上离退休人员在宣教前人均知识得分数相对低一些．流动人口较户籍、暂住人口人均知识得分数均略低，结核病特定知识知晓率在宣教前、后均不是很理想。[结论]肺结核病人对结核病防治有关知识还是比较欠缺，通过医生的健康宣教可以大大提高知晓率,从而提高治疗的依从性，因此进行有针对性的健康教育是十分必要和极其有效的手段。     

江苏省居民结核病知识、态度和行为调查分析

目的了解江苏省居民结核病相关知识、态度和行为的情况,为针对性开展结核病健康教育提供依据。方法根据文献设计调查问卷,在江苏省防治重大传染病综合示范区随机抽取社区居民进行问卷调查,统计分析人群的结核病知识、态度、行为现况。结果社区居民对结核病知识的总知晓率为62.7%。经多因素分析显示,随着年龄增加知识及格率增加(OR=0.479,95%CI=0.419～0.54),文化程度越高知识及格率越高(OR=0.538,95%CI=0.497～0.583),教师和职员及格率较高(OR=0.94,95%CI=0.911～0.971),最近半年接受过健康教育的及格率较高(OR=0.665,95%CI=0.613～0.722);研究还发现调查对象的知识、态度和行为间存在相互影响。结论居民的结核病防治知识的提高,有利于其正确态度与行为的形成,同时应着重在新进入的流动人群中开展有针对性的健康教育。     

北京市2所中学在校教职工结核病防治核心知识知晓情况调查

目的 了解中学在校教职工学校结核病健康教育宣传知识的知晓情况,为更有效地开展学校结核病防治健康教育工作提供依据.方法 于2019年5月17-31日对北京丰台区2所中学共112名在校教职工进行结核病健康教育宣传知识调查,调查结果采用统计学方法进行分析.结果 8条结核病核心知识总知晓率为87.61％ (785/896),全...     

贵州省结核病防治人员工作满意度现状及影响因素分析

目的 了解贵州省结核病防治人员工作满意度现状并分析其影响因素,为结核病防治(简称结防)人力资源发展提供参考。方法 按照分层随机抽样方法,采用自行设计问卷通过问卷星平台进行调查,分别在疾病预防控制机构、定点医疗机构和基层医疗机构中共抽取1 042名结防人员进行调查。采用(■±s)进行统计描述,t检验、方差分析、多元线性回归分析进行统计分析。结果 贵州省结防人员工作满意度包括7个维度,总体工作满意度平均得分(3.65±0.67),各维度平均得分由高到低依次为人际关系(4.02±0.56)、工作意愿(3.90±0.58)、单位管理(3.68±0.86)、工作环境(3.59±0.94)、领导行为(3.57±0.89)、晋升培训(3.54±0.91)、工作报酬(3.24±1.05)。多元线性回归分析结果显示,婚姻状况(β=3.461)、年龄(β₍(40～49岁))=-0.129)、每日工作时长(β₍(7～9h))=-0.291、β(≥11h)=-0.664)、月均收入(β₍(5 000～6 999元))=0.126、β_(...     

Occupational health policies and practices related to tuberculosis in health care workers in KwaZulu-Natal,South Africa

Setting:

Three district hospitals in KwaZulu-Natal, South Africa, with specialized drug-resistant tuberculosis (TB) wards.

Objective:

To increase understanding of the implementation of occupational health (OH) and infection control (IC) guidelines for the prevention and control of TB among health care workers (HCWs).

Design:

An operational cross-sectional study conducted between July and September 2011, consisting of interviews with OH and IC nurses and chart review of OH medical records.

Results:

Although general national and provincial OH policies are in place, no specific OH policies exist for hospital settings. Two of three hospitals had a full-time OH nurse and all had a full-time IC nurse. All hospitals offered TB symptom screening; however, only 19% of HCWs were screened in 2010. TB incidence among HCWs was 1958 per 100 000 population in 2010. All hospitals offered HIV counseling and testing; however, only 22% of staff were tested across sites. Two hospitals offered isoniazid preventive therapy to HIV-positive staff and reassigned these staff to low TB risk areas.

Conclusions:

While OH policies and procedures are in place, implementation of these policies and procedures is inconsistent. This potentially places HCWs at risk of acquiring TB. These findings support the need for strengthening OH and IC services to prevent TB.     

Organization of health services and tuberculosis care management

The scope of this study was to analyze the discourse of managers regarding the relationship between the organization of the health services and tuberculosis care management in a city in the metropolitan region of Jo?o Pessoa, State of Pernambuco. Using qualitative research in the analytical field of the French line of Discourse Analysis, 16 health workers who worked as members of the management teams took part in the study. The transcribed testimonials were organized using Atlas.ti version 6.0 software. After detailed reading of the empirical material, an attempt was made to identify the paraphrasic, polyssemic and metaphoric processes in the discourses, which enabled identification of the following discourse formation: Organization of the health services and the relation with TB care management: theory and practice. In the discourse of the managers the fragmentation of the actions of control of tuberculosis, the lack of articulation between the services and sectors, the compliance of the specific activities for TB, as well as the lack of strategic planning for management of care of the disease are clearly revealed. In this respect, for the organization of the health services to be effective, it is necessary that tuberculosis be considered a priority and acknowledged as a social problem in the management agenda.     

Preventing Tuberculosis in a Low Incidence Setting: Evaluation of a Multi-lingual,Online, Educational Video on Latent Tuberculosis

Treating latent tuberculosis infection (LTBI) in those at risk is an important yet challenging cornerstone of TB elimination. We evaluated a culturally-tailored, multi-lingual, 4.5-min, health promotional video on LTBI. Mixed methods study assessed use of the video with web-analytics, acceptability of content through interviews and survey questions, and compared knowledge scores in viewers and non-viewers using a survey. The video was viewed 6999 times in six languages over 1 year. Of 1598 survey respondents, 193 viewers had a mean knowledge score of 59%, compared to 38% in non-viewers. Eighty-four percent of viewers rated the video as helpful. When controlling for other factors, viewing the video was associated with a 1.04 (95% CI 0.85–1.26) or a 21% increase in a knowledge score. Qualitative data suggested the video was acceptable and may facilitate behavior change. This online, educational video shows promise as a tool to supplement clinical care.