健康教育对农村0～4岁儿童意外窒息与溺水干预效果的评价

目的 评价健康教育对意外窒息和溺水干预效果。方法 通过比较干预前后家长对意外窒息和溺水的认知和行为改变及其死亡率的变化。在江苏省苏北农村6个县,每个县抽取2个乡,分成干预组和对照组。于2000年对干预组进行健康教育干预1年。每个干预乡在健康教育前后随机抽取婴儿和1～4岁儿童家长各20～30名作为调查对象,进行问卷调查。调查两组儿童意外窒息和溺水死亡率的变化。结果 健康教育后家长认为意外伤害无法避免的为1．8％～2．9％,知道现场抢救知识为41．1％～56．80%,与健康教育前的18．8％～20．5％和11．1％～13．5％相比有显著差异。知道不给婴儿打“蜡烛包”的比例增加了212．7％,没有打“蜡烛包”及不与母亲同床同被的比例增加了75．7％和61．50%,知道设防护及设防护的比例增加了194．3％和61．2％。干预组婴儿意外窒息死亡率从487．8／10万降到71．2／10万,下降了85．4％,对照组从344．1／10万降到276．4／10万,下降了19．7％,干预组婴儿意外窒息干预后有明显下降;干预组1～4岁儿童溺水死亡率从60．0／10万降到36．2／10万,下降了39．7％,而对照组从51．7／10万上升到65．3／10万,上升了26．3％。结论 对家长开展健康教育是预防儿童意外窒息和溺水的有效干预措施。不给孩子打“蜡烛包”和让孩子单独睡小床或与父母同床不同被,在房屋周围的沟、小河边用鱼网、树枝等搭起防护栏防止意外窒息和小儿溺水是切实可行的。

Evaluation on intervening efficacy of health education on accidental suffocation and drowning of children aged 0 - 4 in countryside

OBJECTIVE: The main causes of death in children aged 0 - 4 were accidental suffocation and drowning which had a significant relation with parents' lack of prevention knowledge and effective measures. By comparing parents' acknowledge and behavior in preventing accidental suffocation and drowning and the mortality rate of accidental suffocation and drowning after intervening with those before the intervening, evaluation was made on intervening efficacy of health education. METHODS: Six counties in north Jiangsu were involved in the survey. Two townships drawn from each county were divided into the intervened group and the controlled group. Health education was carried out in the intervened group for one year in 2000. Twenty to 30 parents of infants and children aged 1 - 4 drawn randomly from every township in the intervened group were taken as investigation subjects before and after intervening, and a questionnaire was made for them to answer. Meanwhile, the mortality rates of accidental suffocation and drowning were measured. RESULTS: Followed by health education for a year, the parents' opinion about whether unintentional injury can be avoided or not has changed from 18.8% to 20.5% to 1.8% - 2.9%, and parents' knowledge about how to give first aid in spot has increased from 11.1% - 13.5% to 41.1% - 56.8%. The parents' behavior that not sleeping with their infants in the same beds and not tying infants in a candle with blanket, and setting up fence beside pools and rivers has increased by 75.7%, 61.5% and 61.2%, respectively, while their relative knowledge has increased by 212.7% and 194.3%. In the intervened group, the mortality rates of infants' accidental suffocation per 100,000 has fallen from 487.8 to 71.2, dropped by 85.4%; and the mortality rates of drowning in children aged 1 - 4 per 100,000 has fallen from 60.0 to 36.2, dropped by 39.7%. In comparison, in the controlled group, the mortality rates of infants' accidental suffocation per 100,000 has fallen from 344.1 to 276.4, dropped by 19.7%; and the mortality rates of drowning in children aged 1 - 4 per 100,000 has increased by 26.3%, from 51.7 to 65.3. CONCLUSION: Health education to parents is an effective intervening measure for prevention of accidental suffocation and drowning. The goal of health education should be to change inadequate behavior and dangerous environment in which unintentional injury is easily happened. The intervening measures that not sleeping with their infants in the same beds and not tying infants in a candle with blanket, and putting up fence beside pools and rivers are feasible and practicable.