Study on improving the awareness about flu and vaccination rate among patients with coronary atherosclerotic heart disease
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摘要:
目的 了解冠心病患者对流行性感冒（简称为流感）及疫苗的认知情况，并对社区健康干预措施在提高此类人群流感认知及疫苗接种率中的效果进行评价。 方法 采用随机整群抽样的方式，将徐州市鼓楼区7家社区卫生服务中心在管冠心病患者随机分为干预组与对照组，干预组给予多频次社区健康干预，对照组不作任何处理。比较干预前后对流感知晓率及干预、对照两组疫苗接种率的异同。 结果 干预组1 711例、对照组1 805例参与了此次研究；干预后，干预组对流感及其疫苗的认知程度普遍有所提升（均有P < 0.05），总知晓率由15.84%上升至53.59%（χ2=518.734，P < 0.001）；干预组与对照组流感疫苗接种率基线数据分别4.32%、4.76%，两者差异无统计学意义（χ2=0.391，P=0.532）；经干预后，干预组流感疫苗接种率为7.89%，高于本组基线数据（χ2=43.373，P < 0.001），也高于对照组在项目结束时接种率（1.88%，χ2=69.258，P < 0.001）；对照组在项目结束时流感疫苗接种率为1.88%，较本组基线（χ2=36.125，P < 0.001）与干预组基线接种率均低（χ2=17.583，P < 0.001）。 结论 徐州市鼓楼区冠心病患者流感疫苗的接种率不高，后期应针对冠心病患者进一步加大流感相关知识的宣教，社区健康干预不失为提高冠心病患者流感知晓率与疫苗接种率的有效手段。 Abstract:Objective To assess the awareness about influenza and vaccines among patients with coronary heart disease(CHD), and to evaluate the effects of community-based public health interventions in increasing the influenza vaccination rate and the awareness about flu. Methods Patients with CHD in community health service centers in Gulou District were divided into two equal groups by using random cluster sampling, which were group (IG) and the control group (CG). Multi-frequency community-based public health interventions (e.g. health education) were implemented in IG, and CG was not treated. The awareness about influenza among patients with CHD was compared before and after interventions in IG, and the vaccination rate of CG was also compared after interventions. Results A total of 1 711 and 1 805 people were included in IG and CG, respectively. After the intervention, the awareness of influenza and its vaccines increased in IG (all P < 0.05), for example, the total awareness rate increased from 15.84% to 53.59%(χ2=518.734, P < 0.001).The baseline data of influenza vaccination rate in IG and CG were 4.32% and 4.76%, respectively, and there was no significant difference between them (χ2=0.391, P>0.05). After interventions, the vaccination rate increased to 7.89% in IG, which was higher than that before interventions (χ2=43.373, P < 0.001). The vaccination rate decreased to 1.88% in CG (χ2=69.258, P < 0.001), which was lower than the baseline rate (χ2=36.125, P < 0.001), and also much lower than IG after interventions (χ2=17.583, P < 0.001). Conclusions The flu vaccination rate among patients with CHD in Guolou District of Xuzhou City is not high. The community-based public health intervention is an effective means to improve the flu awareness rate and vaccination rate among patients with CHD. -
表 1 干预组与对照组人员基本情况
[n(%)] Table 1. List of basic conditions of the intervention group and the control group
[n(%)] 类别 干预组
(n=1 711)对照组
(n=1 805)t/z/χ2值 P值 年龄[岁，(x±s)] 70.03±8.55 70.41±7.96 -1.365a 0.172 性别 0.138 0.710 男 760(44.42) 813(45.04) 女 951(55.58) 992(54.96) 文化程度 -0.602b 0.547 小学或以下 430(25.13) 423(23.43) 初中 855(59.97) 944(52.30) 高中、中专、技职校 355(20.75) 345(19.11) 大专及以上 71(4.15) 93(5.15) 目前(或退休前)职业 2.831 0.900 机关、党群组织、企事业单位负责人 138(8.05) 129(7.15) 专业技术人员 133(7.77) 147(8.14) 办事员或行政有关人员 112(6.55) 129(7.15) 商业、服务人员 178(10.40) 187(10.36) 农、林、牧、渔、水利生产人员 75(4.38) 81(4.49) 生产、运输设备操作人员及有关人员 847(49.50) 906(50.19) 军人 19(1.11) 24(1.33) 其他 209(12.22) 202(11.19) 注：a采用的两独立样本t检验；b采用的秩和检验。 
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表 2 干预组在干预前后对流感及其疫苗认知的情况
[n(%)] Table 2. Comparison of the intervention group's knowledge of influenza and its vaccines before and after the intervention
[n(%)] 类别 干预前 干预后 χ2值 P值 流感与普通感冒异同 586(34.25) 1 328(77.62) 481.650 ＜0.001 流感的流行月份 341(19.93) 1 049(61.31) 614.065 ＜0.001 流感的传播途径 389(22.74) 1 135(66.34) 468.986 ＜0.001 流感的易感人群 401(23.44) 1 293(75.57) 740.561 ＜0.001 流感的预防措施 499(29.16) 1 316(76.91) 573.519 ＜0.001 冠心病患者接种流感疫苗的必要性 263(15.37) 894(52.25) 499.245 ＜0.001 流感病毒可诱发心血管事件 311(18.18) 809(47.28) 408.955 ＜0.001 流感病毒可诱发病毒性肺炎 197(11.51) 927(54.18) 598.181 ＜0.001 流感疫苗可预防心血管事件发生 175(10.23) 693(40.50) 411.214 ＜0.001 总知晓率 271(15.84) 917(53.59) 518.734 ＜0.001
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表 3 干预组与对照组前后两次流感疫苗接种情况
[n(%)] Table 3. Comparison of the situation of twice as before and after influenza vaccination of the intervention group and the control group
[n(%)] 组别 接种例数(例) χ2值 P值 基线 项目结束 干预组 74(4.32)a 135(7.89)b 43.373 ＜0.001 对照组 86(4.76) 34(1.88) 36.125 ＜0.001 注：a表示对照组项目结束时接种率与干预组基线接种率相比，P < 0.05；b表示对照组项目结束时接种率与干预组干预后接种率相比，P < 0.05。
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