运用健康信念模式分析中学生结核病就诊意向的影响因素

目的  了解我国部分地区中学生结核病出现可疑症状时就诊意向及其影响因素，探讨健康信念模式在分析结核病就诊意向影响因素中的作用。 方法  采用概率比例规模抽样方法（probability proportionate to size sampling，PPS），对我国六个省共计2 547名中学生进行问卷调查。基于健康信念模式，采用Logistic回归分析结核病就诊意向。 结果  女生、城镇学生、东部地区学生、住宿学生核心知识得分高于同组其他调查对象，差异具有统计学意义（均有P<0.05）。西部地区中学生感知疾病威胁程度大，男生、东部地区中学生感知疾病严重性程度高，非住宿生更容易受到家人、朋友的提醒和就诊陪伴。调查对象出现咳嗽，咳痰等症状时就诊意向延迟率为25.4%。多因素Logistic回归分析结果显示，性别（OR=0.809，95%CI：0.668~0.980）、城乡（OR=0.692，95%CI：0.572~0.838）、是否是独生子女（OR=0.819，95%CI：0.676~0.992）、感知疾病的严重性（OR=0.955，95%CI：0.922~0.989）和提示因素（OR=0.514，95%CI：0.429~0.617）是结核病就诊意向的影响因素。 结论  通过健康信念模式可以在一定程度上分析和解释影响中学生结核病就诊意向的影响因素，应针对不同人群特点，加强健康教育，倡导健康行为。

Analysis of tuberculosis medical intention and the influencing factors among middle school students with health belief model

  Objective  To understand the medical intention and influencing factors of middle school students with suspected tuberculosis symptoms in some areas of China and to analyze the influencing factors based on health belief model.  Methods  A total of 2 547 middle school students in six provinces of China were chosen by PPS sampling method. Logistic regression was used to analyze tuberculosis medical intention.based on health belief model.  Results  Female students, urban students, eastern students and residential students had higher degree on knowledge than other respondents in the same group, which had statistically significant difference(all P<0.05). Middle school students in the western region had a higher degree of perceived disease threat, boys and middle school students in the eastern region were more likely to be reminded and accompanied by family members and friends. The delay rate was 25.4% when students have continuous cough and expectoration more than two weeks. In terms of logistic regression analysis, gender (OR=0.809, 95% CI: 0.668-0.980), urban and rural (OR=0.692, 95% CI: 0.572-0.838), only-child (OR=0.819, 95% CI: 0.676-0.992), perceive the severity of the disease(OR=0.955, 95% CI: 0.922-0.989) and prompt factors(OR=0.514, 95% CI: 0.429-0.617) were the influencing factors of the tuberculosis medicial intention.  Conclusions  The health belief model could analyze and explain the influencing factors that affect the tuberculosis medical intention of middle school students in some way. Health education should be strengthened and health behaviors should be advocated according to the characteristics of different groups.