流动人口HIV感染孕产妇健康综合评价指标体系研究  

Construction of comprehensive health evaluation index system for HIVinfected pregnant and lying-in women in floating populations

作　　者：陈银炜 周洋[2] 刘珍[3] 张晓辉[1] CHEN Yinwei;ZHOU Yang;LIU Zhen;ZHANG Xiaohui(Department of Women's Health,Women's Hospital,School of Medicine,Zhejiang University,Hangzhou,Zhejiang 310006,China;Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou,Zhejiang 310051,China;Zhejiang University,Hangzhou,Zhejiang 310014,China)

机构地区：[1]浙江大学医学院附属妇产科医院妇女保健部,浙江杭州310006 [2]浙江省疾病预防控制中心,浙江杭州310051 [3]浙江大学,浙江杭州310014

出　　处：《预防医学》2023年第3期210-214,共5页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：中央高校基本科研业务费专项资金;联合国儿童基金会消除艾滋病、梅毒和乙肝母婴传播项目。

摘　　要：目的构建流动人口艾滋病病毒(HIV)感染孕产妇健康综合评价指标体系,为消除艾滋病母婴传播提供支持。方法通过文献复习和小组讨论初步确定流动人口HIV感染孕产妇健康综合评价指标框架,由妇幼保健、临床医学、公共卫生领域的专家经过两轮德尔菲咨询,对指标的重要性、优先性和可测量性进行评分并计算权重,根据评分的均值和变异系数(CV)筛选指标。采用专家积极系数、权威系数和意见协调程度评价专家咨询效果。结果26位专家参与咨询,其中女性19人;30~<41岁5人,41~<51岁14人,≥51岁7人;硕士及以上学历17人;均为副高级及以上职称。两轮咨询专家积极系数分别为96.30%和100.00%,权威系数分别为0.84和0.89。最终确定个体和家庭因素、疾病因素、社会环境、医疗卫生服务利用4个一级指标,50个二级指标,CV为0.084~0.236,协调系数W值为0.282~0.405(均P<0.001)。二级指标中,居住地领取抗病毒药物是否对流动人口有限制(0.780)、孕期HIV病毒载量(0.750)、居住地建孕产保健手册是否对流动人口有限制(0.749)、是否孕早期建卡(0.738)的权重较高。结论本研究建立的流动人口HIV感染孕产妇健康综合评价指标可为评价流动人口HIV感染孕产妇健康公平性提供参考。Objective To establish a comprehensive health evaluation index system for HIV-infected pregnant women in floating populations,so as to support the elimination of mother-to-child transmission of HIV.MethodsThe preliminary framework of the comprehensive health evaluation indicators was constructed based on literature review and focus group discussion.Experts from maternal and child healthcare,clinical medicine and public health were invited to participate in two-round Delphi consultations.The indicators were scored and weighed according to the importance,priority and measurability,and determined according to means and coefficients of variation of scores.The effectiveness of the consul-tation was evaluated by positive coefficient,authority coefficient and coordination coefficient.ResultsTwenty-six ex-perts participated in this study,including 19 women.There were 5 experts aged 30-40 years,14 experts aged 41-50years,and 7 experts aged 51 years and over.There were 17 experts with a master degree and above.All experts had vice senior professional titles and above.The positive coefficients in the two rounds of consultations were 96.30%and100.00%,the authority coefficients were 0.84 and 0.89,respectively.Finally,4 primary indicators(individuals and fami-lies,disease factors,social environment,health service utilization)and 50 secondary indicators were identified,with the coefficients of variation ranging from 0.084 to 0.236 and the coordination coefficients ranging from 0.282 to 0.405(all P<0.001).Among the secondary indicators,getting antiviral drugs at the place of residence was restricted to floating populations or not(0.780),HIV viral load during pregnancy(0.750),the registration of maternal and childbirth care man-uals at the place of residence was restricted to floating populations or not(0.749),and first-trimester registration or not(0.738)had a high weight.ConclusionThis index system can provide the reference for evaluating the health equity of HIV-infected pregnant and lying-in women in floating populations.

关 键 词：艾滋病病毒 孕产妇 流动人口 德尔菲法 健康评价 

分 类 号：R512.91[医药卫生—内科学]