【作者】 钱国宏；

【导师】 王玉；

【作者基本信息】 兰州大学 ， 社会医学与卫生事业管理， 2013， 硕士

【摘要】 目的通过对甘肃农村健康教育现况的系统调查,探讨农村健康教育现状和工作中存在的问题,提出甘肃农村地区开展健康教育工作的思路和对策,探索适合甘肃农村开展健康教育工作的模式。方法采用分层抽样、整群抽样方法对甘肃农村居民和灾区居民健康素养、健康行为进行调查。通过统计报表,对甘肃健康教育机构分布情况、健康教育机构人员构成情况、经费投入情况、网络建设情况和健康教育工作开展情况进行全面分析。通过个人深入访谈的形式了解卫生行政人员和健康教育工作者态度、农村健康教育二工作存在的问题、农村开展健康教育的有效策略。结果1.甘肃省农村居民健康素养水平为5.30%。其中健康理念和基本知识具备率17.84%,健康生活方式和行为习惯具备率3.38%,健康技能具备率28.94%。2.通过舟曲泥石流灾后健康教育活动,灾区居民健康知识知晓率达到75%以上。73.8%的农村居民家庭共用毛巾,57.83%的农村居民家庭从不洗澡,47.35%的农村居民经常性饮酒。3.健康教育专业机构方面：2010年全省完全独立的健康教育专业机构20个,属于爱卫办科室的23个,属于卫生局科室的39个,属于疾病预防控制中心的8个。人员方面：2010年健康教育机构人员与2008年相比总数减少,兼职人员数量增加,而专职人员数量减少明显。4.访谈结果显示,51.11%(92/180)的受访者认为应该开展传染病预防方面健康教育;48.89%(88/180)的受访者认为开展中医养生保健知识健康教育,43.89%(79/180)的受访者认为开展慢性病(高血压、心脑血管疾病、癌症等)防控方面健康教育；36.11%(65/180)的受访者认为开展食物中毒防控方面健康教育。在健康教育干预方式方面：62.22%(112/180)的受访者认为医生面对面健康咨询是开展健康教育的最好方式；52.77%(95/180)的受访者认为电视广播宣传最好；50.55%(91/180)的受访者认为墙体标语和宣传栏最好：40.55%(73/180)的受访者认为健康讲座较好。结论1.甘肃农村居民健康素养水平较低,农村居民基本健康生活行为形成率较低。把健康素养66条、食品安全、传染病、慢性病、中医养生保健知识纳入到农村健康教育内容意义重大。2.舟曲灾后健康教育干预效果评价证明,灾后健康教育是确保“灾后无大疫”的重要保障,健康教育工作与医疗卫生救援工作同步启动并持续到卫生救援工作最后,保持常态化运行。建议各级政府要重视灾前灾后健康教育工作。3.甘肃省市州及以下健康教育机构不健全,人员不能满足新医改健康教育工作需求,建议各级政府提高对健康教育工作的认识、尽快完善机构、充实专业人员、保证工作经费并强化对基层健康教育工作的绩效考核。4.要建立开展农村健康教育机制体制,推广农村健康教育“一二三四五”模式：一个组织监督指导机构：县级健康教育机构：二个健康教育执行单位：乡镇卫生院、村委会；三个健康教育服务对象：农村学生、留守老人和农村妇女；四种健康教育干预方式：医生面对面健康咨询、广播电视宣传、刷写墙体宣传标语(更换健康教育宣传栏)、卫生工作者健康巡讲；五项健康教育传播内容：健康素养66条、食品安全、传染病、慢性病、中医养生保健知识。更多还原

【Abstract】 ObjectivesThe article aims to discuss the problems of current health education, put forward the thoughts and countermeasures, explore the opitimal working modles of rural health education based on investigation of health education status of rural areas in Gansu.MethodsThe health literacy and health behavior of residents in rural and disaster area were investigated using stratified sampling and cluster sampling method. The distribution and staff composition of health education institute, funds investment, network construction and work development situation of health education were analysed by statistical reports. The working attitude and existing problems as well as effective strategies were investigated by personal interviews.Resultsl.The health literacy level of rural residents in Gansu was5.30%, the rate of health concept and knowledge, health lifestyle and behavior habits, health skills were17.84%,3.38%and28.94%, respectively.2. Through the post-disaster health education, the health awareness rate of the residents in Zhouqu disaster area reached above75%(827/1100). The residents shared the same towel, never took a bath, drunk regularly were73.8%(446/604)57.83%(346/604).47.35%(286/604), respectively.3.There were20completely independent health education institutes.23of institution belong to the Patriotic Health Campaign Committee Office,43belong to the Health Bureau,8belong to the Disease Control and Prevention Centre in health education professional institutions. The total number of persons in health education institutions was reduced, however, the number of part-time staff was increased, while full-time staff was reduced in2010.4. Personal interview results showed,51.11%(92/180) of the surveyed suggested the health education about prevention of infectious disease should be carried out.48.89%(88/180) of the surveyed thought traditional Chinese medicine health care knowledge should be developed.43.89%(79/180) of the surveyed thought chronic disease including hypertension, cardiovascular disease, cancer and other should be educated;36.11%(65/180) thought the knowledge of food poisoning prevention and control should be spread.62.22%(112/180) thought the best methods of health education was face to face talking with doctor.52.77%(95/180) thought the best methods of health education was TV and radio propaganda.50.55%(91/180) thought wall posters and bulletin board were the best.40.55%(73/180)accepted the method of health classes.Conclusions1. The health literacy level and health behavior formation rate of the rural resident in Gansu were lower. It is very important that health literacy66items, food safety, infectious disease, chronic disease and traditional Chinese medicine health care knowledge were the contents of health education for the rural resident.2. The evaluation of intefering effect on health education after Zhouqu disaster showed that the health education after the disaster is very important for "NO Infectious Disease after Disaster ". The government should pay more attention to health education before or after disaster.3. The state of Gansu province and the following health education institutions is not perfect, personnel can’t meet the demand of new reform health education work. Governments at various levels should improve the awareness of the health education work, perfect the institutions, enrich the professional as soon as possible, ensure working funds and strengthen the health education work at the grass-roots level of performance appraisal.4. The government should establish the rural health education mechanism system, promote the "12345"health education modles for rural resident:An organizing and supervising mechanism, that is the health administrative department or health education insititute in the county; two agencies of health education implementing department, that are rural township hospitals and village committee; three groups of health education, students, the older and the women:four methods for health education, TV and radio propaganda, wall posters, bulletin board and health classroom; five contents of health education, health literacy66items, food safety, infectious disease, chronic disease and traditional Chinese medicine health care knowledge.更多还原