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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

刘婧楠,  李政,  王燕玲,  常春

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文章导航 > 中华疾病控制杂志  > 2019 >  23(1): 60-64
刘婧楠, 李政, 王燕玲, 常春. 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[J]. 中华疾病控制杂志, 2019, 23(1): 60-64. doi: 10.16462/j.cnki.zhjbkz.2019.01.013
引用本文: 刘婧楠, 李政, 王燕玲, 常春. 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[J]. 中华疾病控制杂志, 2019, 23(1): 60-64. doi: 10.16462/j.cnki.zhjbkz.2019.01.013
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LIU Jing-nan, LI Zheng, WANG Yan-ling, CHANG Chun. Analysis of tuberculosis medical intention and the influencing factors among middle school students with health belief model[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2019, 23(1): 60-64. doi: 10.16462/j.cnki.zhjbkz.2019.01.013
Citation: LIU Jing-nan, LI Zheng, WANG Yan-ling, CHANG Chun. Analysis of tuberculosis medical intention and the influencing factors among middle school students with health belief model[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2019, 23(1): 60-64. doi: 10.16462/j.cnki.zhjbkz.2019.01.013
shu

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

doi: 10.16462/j.cnki.zhjbkz.2019.01.013

  • 100191 北京, 北京大学公共卫生学院社会医学与健康教育系

详细信息
    通讯作者:

    王燕玲, E-mail: wangyl2006@bjmu.edu.cn

  • 中图分类号: R521

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

  • Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China

More Information

    摘要
  • 摘要:   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。
    Abstract:   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.
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  • 表  1  不同特征调查对象有关HBM得分情况(n=2 547)

    Table  1.   The score of health belief model among subjects of different characteristics (n=2 547)

    调查内容 结核病知识 易感性 严重性 益处 障碍 提示因素
    性别
      男 2.812±0.911 4.026±1.932 9.342±2.695 17.530±3.219 9.803±4.389 0.545±0.540
      女 2.901±0.774 4.236±1.720 9.408±2.541 17.665±2.992 9.329±4.202 0.550±0.538
      t值 -2.667 -2.890 -0.633 -1.108 2.732 -0.210
      P值 0.008 0.004 0.527 0.280 0.006 0.834
    独生
      是 2.874±0.869 4.158±1.879 9.447±2.558 17.692±3.119 9.689±4.511 0.564±0.540
      否 2.851±0.823 4.098±1.797 9.310±2.681 17.535±3.089 9.468±4.112 0.534±0.548
      t值 0.641 0.818 1.298 1.254 1.252 1.388
      P值 0.522 0.413 0.194 0.210 0.211 0.165
    城乡
      城镇 2.958±0.890 4.106±1.854 9.391±2.541 17.617±3.128 9.662±4.191 0.537±0.545
      农村 2.739±0.781 4.148±1.805 9.338±2.719 17.565±3.094 9.423±4.410 0.556±0.541
      t值 6.534 -0.574 0.501 0.419 1.375 -0.906
      P值 ＜0.001 0.566 0.615 0.675 0.169 0.365
    所在地域
      东部 3.037±0.876 3.791±1.890 9.363±2.715 17.718±3.370 10.121±4.727 0.555±0.545
      中部 2.751±0.851 4.112±1.825 9.188±2.664 17.438±3.105 9.409±3.987 0.521±0.531
      西部 2.793±0.788 4.447±1.732 9.557±2.490 17.640±2.853 9.211±4.147 0.562±0.554
      F值 28.071 27.574 4.364 1.767 9.968 1.142
      P值 ＜0.001 ＜0.001 0.013 0.171 ＜0.001 0.319
    住宿
      是 2.914±0.723 4.148±1.829 9.597±9.222 17.661±2.993 9.671±4.243 0.514±0.533
      否 2.829±0.898 4.117±1.826 9.222±2.663 17.563±3.181 9.421±4.313 0.564±0.545
      t值 2.591 0.397 3.426 0.759 1.380 -2.190
      P值 0.010 0.692 0.001 0.448 0.168 0.029
    合计 2.856±0.846 4.128±1.833 9.371±2.624 17.597±3.108 9.565±4.303 2.856±0.544
    注：存在缺失值。
    下载: 导出CSV

    表  2  调查对象结核病就诊意向影响因素Logistic回归分析

    Table  2.   The influencing factors of TB medical intention by multiple Logistic regression analysis

    自变量 β sx Wald值 P值 OR(95% CI)值
    性别(男)a
      女 -0.211 0.098   4.678 0.031 0.809(00.668~0.980)
    独生子女(是)a
      不是 -0.200 0.098   4.160 0.041 0.819(00.676~0.992)
    城乡(城市)a
      农村 -0.368 0.097 14.251 <0.001 0.692(00.572~0.838)
      严重性 -0.046 0.018   6.609 0.010 0.955(00.922~0.989)
      提示因素 -0.665 0.092 51.695 <0.001 0.514(00.429~0.617)
      常数 0.832 0.299   7.739 0.005 2.297
    注：a为对照组。
    下载: 导出CSV
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  • 修回日期:  2018-10-16
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