基于健康信念模型的医务人员职业暴露预防行为的调查研究  

Investigation on preventive behaviors of occupational exposure in medical staff based on health belief model

作　　者：张亮[1] 周捷波[1] 吕莹 许红梅[1] 龚捷文 刘亚涛[1] 葛茂军[2] ZHANG Liang;ZHOU Jiebo;LU Ying;XU Hongmei;GONG Jiewen;LIU Yatao;GE Maojun(Department of Nosocomial Infection Management,Shuguang Hospital Afflliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,P.R.China;Department of Surgery,Shuguang Hospital Affilliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,P.R.China)

机构地区：[1]上海中医药大学附属曙光医院医院感染管理科,上海201203 [2]上海中医药大学附属曙光医院外科,上海201203

出　　处：《华西医学》2023年第3期392-397,共6页West China Medical Journal

基　　金：上海市中医药大学预算内项目(18WK108)。

摘　　要：目的运用健康信念模型,探讨医务人员职业暴露预防行为的影响因素。方法2018年7月-2019年6月采用自行设计调查表对上海中医药大学附属曙光医院医务人员的健康信念和预防相关行为进行调查,对不同职业类别和工作年限的医务人员的预防相关行为和健康信念情况进行描述性分析,采用多重线性回归分析探讨健康信念对预防行为的影响。结果发放调查问卷400份,回收384份。调查对象中,女性258人(67.19%),20~30岁者169人(44.01%),工作年限在5年以内者203人(52.86%);有锐器伤经历者158人(41.15%),有血液体液暴露经历者171人(44.53%),主动免疫注射疫苗者290人(75.52%)。384名调查对象执行标准预防行为依从性总得分为(6.94±3.12)分,易感性认知、严重性认知、行为障碍认知、行为效益认知、自我效能得分分别为(24.87±4.56)、(31.27±5.92)、(16.50±5.77)、(36.06±5.60)、(15.27±2.98)分,健康信念总分为(123.97±15.91)分。工勤人员的标准预防行为依从性和健康信念总分均低于其他人员(P<0.05);医技人员和临床医生行为障碍认知高于护理人员(P<0.05),临床医生行为效益认知和自我效能低于护理人员(P<0.05)。工作年限在6~10年的医务人员的标准预防行为依从性低于实习人员和工作年限在11~15年的医务人员(P<0.05),其健康信念总分低于工作年限≥16年的医务人员(P<0.05);工作年限≥16年的医务人员具有更有好的行为效益认知和自我效能(P<0.05),同时行为障碍认知降低(P<0.05)。多重线性回归分析结果显示,性别[非标准化偏回归系数(b)=–0.644,95%置信区间(confidence interval,CI)(–1.162,–0.125),P=0.015]、文化程度[b=1.367,95%CI(1.245,1.587),P<0.001]、行为障碍认知[b=0.044,95%CI(0.004,0.084),P=0.031]是医务人员执行标准预防行为依从性总得分的影响因素。结论行为障碍认知是医务人员不能实施标准预防措施的主要因素。在职业暴露培训�Objective To explore the influencing factors of medical staff's preventive behaviors of occupational exposure using health belief model.MethodsA questionnaire was used to investigate the health beliefs and prevention-related behaviors of medical staff in Shuguang Hospital Afflliated to Shanghai University of Traditional Chinese Medicine from July 2018 to June 2019.The preventive behaviors and health beliefs of health workers with different occupational categories and working years were analyzed descriptively,and the influence of health beliefs on preventive behaviors was analyzed with multiple linear regression.Results There were 400 copies of questionnaire dispatched and 384 recovered.Among the survey respondents,258(67.19%)were females,169(44.01%)were aged 20-30 years,and 203(52.86%)had worked for 5 or less years;158(41.15%)had sharp injury experience,171(44.53%)had experience of exposure to blood or body fluids,and 290(75.52%)were actively immunized by injecting vaccines.The total score of compliance with standard preventive behaviors of the 384 respondents was 6.94±3.12.The scores of perceived susceptibility,perceived severity,perceived barriers,perceived benefits,and perceived self-efficacy were 24.87±4.56,31.27±5.92,16.50±5.77,36.06±5.60,and 15.27±2.98,respectively.The total score of health beliefs was 123.97±15.91.The compliance with standard preventive behaviors and total score of health beliefs of logistics staff were lower than those of other respondents(P<0.05).The scores of perceived barriers of medical technicians and clinicians were significantly higher than that of nurses(P<0.05).The scores of perceived benefits and perceived self-efficacy of clinicians were lower than those of nurses(P<0.05).Respondents who had worked for 6-10 years had better compliance with standard preventive behaviors than interns and the ones who had worked for 11-15 years(P<0.05),and had a lower total score of health beliefs than the ones who had worked for over 16 years(P<0.05).Respondents who had worked for over 16

关 键 词：职业暴露 健康信念 预防行为 

分 类 号：R192[医药卫生—卫生事业管理]