【作者】 郑鑫；

【导师】 李芝兰；

【作者基本信息】 兰州大学 ， 儿少卫生与妇幼保健学， 2013， 硕士

【摘要】 目的通过定量与定性研究,了解甘肃省5县/区社区健康教育工作人员健康教育相关知识的认知以及培训需求现状,为甘肃省健康教育事业的进一步发展和社区健康教育人员能力建设提供科学依据。方法选取兰州市城关区、七里河区、西固区、榆中县和白银区(为同期对照)目前从事社区健康教育的所有工作人员为研究对象,通过调查问卷的形式进行普查；比较分析5县/区社区健康教育工作人员健康教育专业理论知识和健康常识的正确应答率、及格率及对健康教育相关培训的需求；对5县/区社区健教人员构成、健康教育基本知识正确应答率、及格率采用卡方检验,对兰州、白银社区健教人员健康教育相关知识得分采用t检验；对健康教育专业理论知识及格率和健康常识及格率采用TOPSIS综合评价法进行综合评价；同时对社区健康教育管理人员和业务人员进行定性访谈。结果(1)兰州、白银两地社区健康教育工作人员年龄、最高学历专业背景、职称系列、从事健康教育工作年限间的差异有统计学意义(P<0.05)。在健康教育认知及培训方面,兰州与白银现况基本一致(P>0.05)。(2)调查的5县区总体情况：①兰州调查397人,白银113人,共510人。社区健教人员女性居多(占58.82%),年龄集中分布在45岁以下,本科及以上文化程度占26.47%,最高学历专业背景以临床医学为主(占64.12%),从事健康教育工作超过10年者占22.74%,专职人员占52.16%。②能正确认识健康教育、健康促进涵义的仅有18(3.53%)人,全面了解健康教育内容的有304(59.61%)人,知道健康教育常用人际传播方式的有31(6.08%)人；能正确认识危害健康行为的有229(44.90%)人,全面了解糖尿病预防措施的有192(37.65%)人,全面了解心脑血管疾病危险因素的有187(36.67%)人。③健康教育专业理论知识及格人数为4(0.78%)人,40分以下352(69.02%)人；健康常识及格人数为422(82.75%)人,75分以上93(18.24%)人,最高分88.89分,最低分40.74分。不同特征人员健康教育专业理论知识平均得分均较低,各组人员及格率及平均分数的差异均无统计学意义(P>0.05)；不同特征人员健康常识平均分最高为70.14分,最低为63.21分,各组人员及格率及平均分数的差异均无统计学意义(P>0.05)。④440(86.27%)名社区健教人员认为社区健康教育很重要,大多数人都愿意从事健康教育工作。⑤近3年来,358(70.20%)人曾参加过健康教育方面的培训,培训以市级及以下组织的为主,国家级及以上、省级、市级及以下培训的平均培训人次数分别为1.39人次、1.91人次、3.69人次；希望的培训内容主要为健康教育基本知识及技能和疾病相关知识；希望采取的培训形式总体排在前三位的依次为课堂讲授(70.20%)、授课与练习结合(63.53%)、现场实习(56.27%)；希望培训时间为一周左右的有203(39.80%)人,3天及以下的有208(40.78%)人；92.35%的社区健教人员认为有必要对健康教育专业知识或技能进修学习。⑥TOPSIS综合评价结果：城关区社区健康教育工作人员知识水平排序第一,其次依次为西固区、榆中县、白银区、七里河区。⑦由定性访谈可以看出健康教育工作的进一步发展仍面临着诸多困难：如工作经费有限,工作人员数量少、流动性大,兼职人员较多,工作人员的业务素质不高,部分群众健康意识薄弱,社会支持度低等。结论5县/区社区健康教育工作人员对健康教育工作的态度比较积极,但文化程度、最高学历专业背景、职称等结构不合理,专业认知水平较低,不能满足群众日益增长的服务需要,需引起政府和社会各界的高度重视,从多方面加大投入,提高健教人员综合素质。更多还原

【Abstract】 ObjectiveIn this study, we used both quantitative survey and qualitative interview to understand the present situation of expertise and training needs of community health educators in five county/districts of Gansu province, in order to provide a scientific basis for health education’s further development and community health educators’ capacity building.MethodsA general investigation was conducted on all the staffs by questionnaires, who were currently working on community health education in Chengguan District, Qilihe District, Xigu District and Yuzhong County of Lanzhou City, besides Baiyin district of Baiyin City as concurrent control. Compare the correct response rate, the pass rate and training needs. Analyze the personnel composition, correct response rate and pass rate by chi-square test and the score by t-test of health education basic knowledge between Lanzhou and Baiyin. Evaluate the pass rate of professional theoretical knowledge of health education and health common sense by TOPSIS Comprehensive Evaluation. A qualitative interview was conducted among managerial personnel and operating personnel of community health education.Results(1)The differences of ages, the highest educational background, title series, years of working in health education between community health educators in Lanzhou and Baiyin were statistically significant (P＜0.05), the difference of community health educators’ attitude to community health education work between Lanzhou and Baiyin were statistically significant (P＜0.05). It was basically similar in cognition and training needs of health education between Lanzhou and Baiyin (P>0.05).(2)The general results of the survey in five county/districts contained①In this study, the number of respondents was510, contained397of Lanzhou and113of Baiyin. The respondents were mainly women (58.82%) and aged30～45(50.00%), the stuffs whose degree of education were bachelor degree or above accounted for26.47%. The highest educational background was mainly clinical medicine (64.12%). Community health educators working more than10years accounted for22.75%and full-time staffs accounted for52.16%.②18(3.53%) knew the meaning of health education and health promotion exactly,304(59.61%) knew the content of health education comprehensively,31(6.08%) knew the common interpersonal communication way of health education,229(44.90%) knew the risk behaviors to health exactly,192(37.65%) understood the preventive measures to diabetes comprehensively,187(36.67%) understood the risk factors of cardiovascular and cerebrovascular diseases comprehensively.③The number of passes was4(0.78%) in professional theoretical knowledge of health education,352(69.02%) were below40points. The number of passes was422(82.75%) in health common sense,93(18.24%) were above75points, the highest score was88.89and the lowest was40.74. The average score in different characteristics of the personnel about professional theoretical knowledge of health education were low, the differences of average score and pass rate were not statistically significant (P>0.05). The highest average score in different characteristics of the personnel about health common sense was70.14and the lowest was63.21, the differences of average score and pass rate were not statistically significant (P>0.05).④440(86.27%) thought community health education was very important and most of them were willing to working in health education.⑤In nearly3years,358(70.20%) had took part in health education train and the train were mainly organized at municipal level or lower. The average number of training people was1.39at national level or higher,1.91at provincial level and3.69at municipal level or lower. The training contents they wanted were mainly basic knowledge and skills about health education and knowledge about diseases. The total top three training forms they wanted were lecture (70.20%), combination of lecture and practice (63.53%) and field practice (56.27%).203(39.80%) hoped the training time being a week or so and208(40.78%) being less than4days.92.35%considered it was necessary to have advanced study of knowledge and skills on health education.⑥The result of TOPSIS Comprehensive Evaluation showed community health educators’knowledge level of Chengguan District ranked first, followed by Xigu District, Yuzhong County, Baiyin District and Qilihe District.⑦The qualitative interview showed it was still faced with many difficulties in further development of health education, such as a limited budget to health education work, a low number and a large flow of health educators. In addition, many workers were part-timers and their professional quality was low, part of the masses had bad health consciousness and it still lacked adequate social support.ConclusionThe attitude of community health educators to health education was positive. However, the structure of educational level, the highest educational background and titles were unreasonable, the level of expertise was low, and the overall quality of community health educators can’t meet the growing needs for services of the masses. The government and all sectors of society should pay more attention to increase investment in many ways so as to improve the overall quality of community health educators.更多还原