【作者】 孙妍兰；

【导师】 张印红；

【作者基本信息】 兰州大学 ， 营养与食品卫生学， 2013， 硕士

【摘要】 目的：了解甘肃省四个市肺结核患者的健康现状、相关知识的掌握及行为等情况,探讨相关影响因素,为有效开展甘肃省肺结核病和相关疾病防治及健康教育预防控制策略的制订提供参考。方法：根据甘肃省肺结核病的发病情况、经济状况和地理分布,采用整群随机抽样方法选择甘肃省四个市作为本次研究现场,对4750名肺结核患者使用统一的调查问卷进行健康知识、健康行为等调查,分析不同人群健康知识掌握及健康行为的形成情况,了解相关影响因素。对其中自愿接受健康体检的患者进行指尖血空腹血糖测定、血压的测量和体格检查,比较不同年龄、性别的异常检出情况。结果：1、研究对象中共检出高血糖患者428例,检出率为9.41%；高血压患者305例,检出率为7.51%。其中男女性别间检出率均无统计学差异(P>0.05),不同年龄段检出率差别有统计学意义(P<0.05),50～岁以上年龄组检出率均高于50岁以下年龄组(P<0.05)；结核病患者体质指数(BMI)值构成比依次为：正常、消瘦、超重/肥胖；71.93%患者担心自己的健康和恢复情况。2、研究对象的健康知识总体知晓率为10.42%,平均得分21.71±10.43,与总分(62分)比为0.35。各项知识平均得分比由高到低分别是肺结核知识(0.58),营养知识(0.43),高血压、超重/肥胖知识(0.28),糖尿病知识(0.15)。影响肺结核患者知识得分的多因素分析结果显示,肺结核患者的年龄、文化程度和医疗保险形式各组间均存在着显著性差异(P<0.001)。其中,50～岁以上年龄组的知识得分明显低于50岁以下年龄组；文化程度越高,综合知识得分越高；职工医疗保险和自费患者等的知识得分高于合作医疗患者。3、研究对象的健康行为总体及格率为57.33%,平均得分9.84±2.13,与总分(16分)比为0.61。影响肺结核患者行为得分的多因素分析结果显示,肺结核患者的年龄、收入水平、是否吸烟、是否有慢性疾病史和是否知晓健康知识各组间均存在着显著性差异(P<0.001)。其中,50～岁以上年龄组的行为得分明显高于50岁以下年龄组；行为得分随收入水平的递增而呈上升水平,吸烟患者的得分低于不吸烟患者,患有高血压、糖尿病等慢性病史者得分高于不患病者,健康知识知晓患者高于不知晓患者。结论：肺结核患者健康状况不容忽视,应加强对该人群其他并发症的监测。健康知识得分总体水平较低,特别是糖尿病知识掌握现状不容乐观,健康行为水平一般。健康知识、行为的影响是多方面的,应根据结核病患者的不同人群特征,制定健康促进和健康教育工作方案,提高患者的知识水平,纠正不良健康行为,预防疾病的发生。更多还原

【Abstract】 Objective:To understand the health status of tuberculosis(TB) patients in four cities of Gansu province, health knowledge and health behavior as the related effect factors explored, to provide references for developing effective prevention and control strategies of tuberculosis and related diseases in health education.Methods:Based on the incidence of pulmonary tuberculosis, the economic situation and geographic distribution of Gansu Province, four cities were selected as the study sites. Questionnaire survey was conducted among4750tuberculosis patients by using random cluster sampling method, which including health knowledge, health behavior. By analyzing different population health knowledge and health behavior, to understand the relevant influence factors. The voluntary patients received health examination for fingertip blood glucose determination of fasting blood glucose, blood pressure measurement and physical examination, comparison of abnormal detection in different gender and age groups.Results:1、 There were428patients detected with hyperglycemia, the detection rate was9.41%,305patients had hypertension, the detection rate was7.51%. The detection rate between male and female have no significant difference(P>0.05), there were significant differences in the detection rate among different age groups(P<0.05), and the rate were significantly higher in the age group above50than the people below50(P<0.05). The composition of body mass index (BMI) in tuberculosis patients was normal, lean, overweight/obesity.71.93%patients worry about their health and recovery.2、 The health knowledge awareness rate was10.42%, the average score was21.71±10.43, and the ratio to total score (62points) was0.35. The average score from highest to lowest was TB knowledge (0.58), nutrition knowledge (0.43), knowledge of hypertension overweight/obesity (0.28) and diabetes knowledge (0.15). The multivariate analysis results showed, the differences among pulmonary tuberculosis patients’age, education and medical insurance form were statistical significance (P<0.001). Among them, the knowledge score of below50years was significantly higher as compare to the age group of above50years, health knowledge score of staff medical insurance and the patients at their own were higher than rural cooperative medical patients.3、 The health behavior passing rate was57.33%, the average score was9.84±2.13, and the average score of full marks (16points) was0.61. The multivariate analysis results showed, health behavior score among age, income, whether with a history of chronic disease and smoking of pulmonary tuberculosis patients were statistical significance (P<0.001). The behavior score of the group above50was significantly higher than below50, as income level increases, behavior score was higher, smoking patients score lower than non-smoking patients. The score of patients suffering from hypertension, diabetes and other chronic diseases were higher than healthy people, awareness of patients were significantly higher than those unaware of health knowledge of patients.Conclusion:The health status of tuberculosis patients should not be ignored, we should strengthen the monitoring of other complications among TB patients. The overall level of health knowledge score was low, especially the diabetic knowledge mastering situation is un-optimistic, a common level of health behavior. There are many factors influencing the health knowledge and behavior, we should make the working program of health education and health promotion according to the different characteristics of tuberculosis patients to increase their knowledge, correct unhealthy behavior and prevent disease from occurring.更多还原