贵州省常规免疫报告接种率偏高的影响因素分析  

Analysis on the key factors for high reported routine immunization rate in Guizhou Province

作　　者：穆秋玥 王涛[1] 张大勇[2] 朱青[2] 杨云亮[3] 张逌[4] 刘洪 

机构地区：[1]北京大学医学部公共卫生学院,北京100191 [2]贵州省疾病预防控制中心,贵州贵阳550004 [3]遵义市疾病预防控制中心,贵州遵义563000 [4]毕节市疾病预防控制中心,贵州毕节551700 [5]铜仁市松桃县疾病预防控制中心,贵州铜仁554100

出　　处：《现代预防医学》2014年第1期148-151,共4页Modern Preventive Medicine

摘　　要：目的采用德尔菲法探讨引起贵州省报告接种率偏高的关键影响因素,为制定相应的适宜管理措施提供依据。方法通过文献获得目前国内导致报告免疫接种率偏高的一些因素,设计咨询表;采用德尔菲法对选取的20名专家开展咨询,经过三轮咨询后通过统计分析计算导致偏高的各影响因素各级条目的权重,最后筛选出关键影响因素。结果三轮咨询专家的积极系数分别为100.0%、95.0%和94.7%;克朗巴赫α系数分别为0.92、0.98、0.89;专家权威系数为0.79。影响因素共筛选出7个一级条目,19个二级条目,4个三级条目,变异系数范围为0.117 5~0.247 1。一级条目中,接种对象底数不清、接种对象监护人、免疫服务人员、免疫服务可及性的问题所占权重最高,分别为0.155 4、0.150 4、0.149 0、0.143 8,其次级条目中的"流入儿童数量不清楚"、"超生儿童父母不带儿童接种"、"留守儿童由文化程度更低的祖父母和外祖父母监护"、"基层免疫服务人员人数不够"、"基层免疫服务人员收入低"和"交通不便"所占其权重较高,分别达到0.504 6、0.260 6、0.255 7、0.192 0、0.190 6、1.000 0。结论贵州省引起报告接种率偏高的关键影响因素有4个:无法掌握流入儿童底数;超生儿童和留守儿童的特性造成免疫不及时和免疫脱漏;免疫服务人员人数不够和收入低;交通不便。应采取针对性措施,切实改变现状。Objective Using the Delphi method to get the key factors of high reported immunization rate, and provide evidences for developing counterpart measures. Methods Delphi questionnaire was based on literature retrieve and review.20 experts were se- lected for consulting, the weight of all factors was calculated for screening key factors influencing the reported immunization rate for three rounds of consultation. Result Expert active coefficient were 100.0%, 95.0% and 94,7% respectively for the 3 consecutive rounds of consultation; and the Cronbach＇s a was 0.92, 0.98 and 0.89 respectively; authoritative coefficient of experts was 0.79. Seven first-level entries, 19 secondary entries, 4 third-level entries were screened after 3 rounds consultation, and the CV coeffi- cient ranged from 0.117 5 to 0.247 1. The weight of ＂base number of subjects need to be vaccinated was unclear＂ ＂issues of immu- nization subjects＂ ＂issues o^vaccination practitioners＂ and ＂inconvenience of accessibility to immunization service＂ were the highest ones among the first level entries, the weighted coefficient was 0.155 4, 0.150 4, 0.149 0, and 0.143 8, respectively. While the weight coefficients for ＂number children immigrated was unclear＂, ＂parents of children out of birth control was unwilling to take their children to the vaccination site for vaccination＂, ＂grandparents take care of the children＂, ＂no sufficient number of grassroots practitioners＂ ,＂low income of the grassroots practitioners＂ ＂inconvenience of transportation ＂ were the highest ones among the sec- ondary entries, and the values were 0.504 6, 0.260 6, 0.255 7, 0.192 O, 0.190 6 and 1.000 0, respectively. Conclusion The key factors for high reported routine immunization rate in Guizhou province are that ＂it＇s difficult in obtaining the exact number of immi- grant children need to be vaccinated＂ , ＂characteristics of children out of birth control and left-behind children are the causes of delayed vaccination and missed vaccinatio

关 键 词：报告接种率 影响因素 德尔菲法 

分 类 号：R195[医药卫生—卫生统计学]