中小学校传染病流行风险评价指标体系构建

孙力菁; 翟娅妮; 周月芳; 张喆; 陆殷昊; 罗春燕

doi:10.16835/j.cnki.1000-9817.2022.08.031

中小学校传染病流行风险评价指标体系构建

doi: 10.16835/j.cnki.1000-9817.2022.08.031

上海市疾病预防控制中心儿童青少年健康所，200336

基金项目:

上海市公共卫生体系建设三年行动计划 2020—2022年

优秀人才培养计划 GWV-10.2-YQ15

详细信息

作者简介:
孙力菁(1988-)，女，上海市人，博士，副主任医师，主要研究方向为儿童青少年行为发育

通讯作者:
罗春燕，E-mail: luochunyan@scdc.sh.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R181.3 R183 G478
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- 被引次数: 0
出版历程
- 收稿日期: 2022-02-21
- 修回日期: 2022-04-28
- 网络出版日期: 2022-08-24
- 刊出日期: 2022-08-25

Construction of risk assessment index system of epidemic infectious diseases in primary and middle schools

Institute of Child and Adolescent Health, Shanghai Municipal Center for Disease Control and Prevention, Shanghai(200336), China

摘要

摘要: 目的建立中小学校传染病流行风险评价指标体系，做好学校传染病预警工作，将学校传染病防控的关口前移。方法通过文献查阅，业内相关专家咨询以及结合实际工作经验等方法，形成指标条目池。采用德尔菲法进行两轮专家咨询(第1轮13名，第2轮20名)，统计分析每轮咨询时专家意见的集中程度(平均分、满分比)和协调程度(变异系数、协调系数W)，其中协调系数W采用多个样本的非参数Kendall's W检验得到。根据专家反馈意见对指标进行必要的增、减、修，最终确定评价的指标体系，并采用层次分析法计算各指标权重。结果两轮咨询的专家权威系数分别为0.89和0.88，表格回收率均为100%；各三级指标变异系数范围分别为0.07~0.31和0.06~0.19，协调系数W分别为0.25和0.47，说明专家意见的一致性和可信度均较好。最终建立由5个一级指标、23个二级指标、86个三级指标组成的中小学校传染病流行风险评价指标体系。采用层次分析法计算指标的级别内权重，学校卫生管理与保障制度、学校卫生人员设施、健康监测与认知水平、严重性和应对措施5个一级指标的变异系数分别为0.09，0.06，0.08，0.12和0.06，权重系数分别为20.42%，21.19%，19.87%，17.45%和21.08%。结论研究构建了适用于中小学校的学校传染病流行风险评价指标体系，专家积极性、协调性和权威程度均较好，对于落实中小学校传染病预警工作具有实际指导意义。
- 传染病控制 /
- 组织和管理 /
- 质量指标，卫生保健 /
- 中小学生卫生保健服务
Abstract: Objective To establish a risk assessment index system for epidemic infectious diseases in primary and secondary schools, for early warning and prevention of school infectious diseases accurately and timely. Methods Through literature review, the indicators pool was established by consulting relevant experts and referring to practical experience. Then two rounds of expert consultation using the Delphi method were conducted(13 experts of round 1, and 20 experts of round 2). The concentration of expert opinions (the average, the percentage of full marks) and the coordination of expert opinions (the coefficient of variation, the coordination coefficient W) were calculated and analyzed. The coordination coefficient W was obtained by nonparametric Kendall's W test of multiple samples. According to the experts' feedback, necessary addition, reduction and modification of the indicators were carried out to determine the evaluation index system, and the analytic hierarchy process (AHP) was used to calculate the weight of each indicator. Results The expert authority coefficients of the two rounds of consultation were 0.89 and 0.88, respectively, and the form recovery rate was 100%. The range of the variation coefficient of each three-level indicator was 0.07-0.31 and 0.06-0.19, and the coordination coefficient W was 0.25 and 0.47, respectively, indicating that the consistency and credibility of expert opinions were good. Finally, the risk assessment index system of infectious diseases in primary and secondary schools was established, which was composed of 5 first-level indexes, 23 second-level indexes and 86 third-level indexes. The AHP was used to calculate the intra-level weight of the index. The variation coefficient of five first-level indicators of school health management and security system, school health personnel facilities, health monitoring and cognition level, severity and coping measures were 0.09, 0.06, 0.08, 0.12 and 0.06, respectively, and the weight coefficients were 20.42%, 21.19%, 19.87%, 17.45% and 21.08%, respectively. Conclusion The risk assessment index system of school infectious diseases is applicable to primary and secondary schools. The initiative, coordination and authority of experts in this system are all high. It is of practical guiding significance for the early warning of infectious diseases in primary and secondary schools.
- Communicable diseases control /
- Organization and administration /
- Quality indicators, health care /
- School health services
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 第二轮德尔菲专家咨询各级指标的专家意见及权重系数

Table 1. The secondround of Delphi expert consultation on expert opinions and weight coefficients of indicators at all levels

一级指标	二级指标	三级指标	集中程度		变异系数	权重/%
一级指标	二级指标	三级指标	平均分	满分比/%	变异系数	权重/%
学校卫生管理与保障制度			4.65	50	0.09	20.42
	学校卫生管理制度		4.63	45	0.09	50.41
		突发公共卫生事件报告制度	4.53	40	0.10	11.12
		因病缺课登记追踪制度	4.85	75	0.06	11.92
		复课证明查验制度	4.68	55	0.09	11.49
		新生入学预防接种证查验制度	4.75	65	0.08	11.67
		学生健康管理制度	4.15	25	0.16	10.20
		健康教育制度	4.08	15	0.14	10.01
		预防性消毒和通风制度	4.68	50	0.09	11.49
		每日晨检和全日健康巡检制度	4.75	65	0.09	11.67
		防控物资与设备配备制度	4.25	25	0.13	10.44
	组织保障		4.55	35	0.09	49.59
		建立组织领导小组和工作网络	4.63	45	0.09	20.33
		明确责任部门及人员职责	4.68	50	0.08	20.55
		制定预案	4.40	40	0.13	19.34
		明确报告人员及流程	4.80	65	0.06	21.10
		建立辖区联防联控工作网络	4.25	20	0.12	18.68
学校卫生人员设施			4.83	70	0.06	21.19
	校内卫生保健机构		4.40	35	0.14	11.00
		面积布局	3.83	0	0.13	23.76
		保健设备配置情况	3.88	0	0.11	24.07
		服务能力	3.85	0	0.11	23.91
		隔离观察室设置	4.55	45	0.12	28.26
	校内卫生保健人员		4.78	65	0.07	11.93
		卫生保健人员与学生人数配比	4.33	30	0.12	33.59
		卫生保健人员定期培训	4.50	30	0.09	34.95
		是否有疫情处置经验	4.05	5	0.10	31.46
	食堂卫生		4.68	45	0.07	11.68
		食物进货来源	4.60	45	0.09	17.61
		保鲜设备	4.65	50	0.09	17.80
		食堂员工操作习惯	4.05	0	0.11	15.50
		食堂保洁消毒	4.45	20	0.08	17.03
		食堂监测结果	4.38	35	0.13	16.75
		食堂分级结果	4.00	10	0.12	15.31
	厕所卫生		4.60	45	0.09	11.50
		厕所数量	4.33	20	0.11	16.26
		人均蹲位数	4.43	30	0.10	16.64
		保洁人员打扫厕所的频率	4.48	30	0.10	16.82
		清洁用具的消毒	4.38	20	0.10	16.45
		厕所蹲位使用独立便器(非槽式便池)	4.28	25	0.14	16.07
		厕所通风	4.73	65	0.09	17.76
	教室卫生		4.35	15	0.10	10.87
		卫生打扫频次	3.93	5	0.10	23.79
		教室学生密度	4.55	40	0.10	27.58
		教室通风换气次数	4.20	15	0.12	25.46
		教室空气质量	3.83	0	0.14	23.18
	宿舍卫生		4.30	15	0.10	10.75
		是否有宿舍卫生管理制度	3.73	5	0.17	46.56
		宿舍人均面积	4.28	15	0.12	53.44
	饮水卫生		4.61	45	0.09	11.53
		饮用水卫生专人负责管理	4.50	45	0.11	19.91
		饮用水水质检测结果	4.65	55	0.09	20.58
		饮水设施日常管理	4.25	10	0.08	18.81
		直饮水水质监测结果	4.65	55	0.09	20.58
		饮水设施与污染源的距离	4.55	50	0.13	20.13
	爱国卫生运动		3.68	10	0.22	9.18
		校园垃圾管理	4.43	40	0.15	50.72
		医疗废弃物管理	4.30	35	0.19	49.28
	洗手设施		4.63	60	0.12	11.56
		人均水龙头数	4.48	45	0.12	21.41
		洗手液/洗手皂的配备	4.53	40	0.10	21.65
		热水龙头的配备	3.90	15	0.19	18.66
		擦手纸的配备	3.80	0	0.14	18.18
		盥洗室水龙头数(个/人)	4.20	15	0.11	20.10
健康监测与认知水平			4.53	30	0.08	19.87
	学生每日健康监测		4.88	80	0.06	22.62
		晨检和每日健康巡检	4.73	55	0.07	100.00
	教职工每日健康监测		4.60	50	0.10	21.35
		晨检和每日健康巡检	4.32	30	0.14	100.00
	学生健康水平		4.00	5	0.15	18.56
		学生体检发生率	3.93	15	0.16	45.25
		因病缺课缺勤率	4.75	65	0.08	54.76
	个人卫生习惯		4.08	5	0.10	18.91
		学生	4.08	0	0.09	24.01
		教职工	4.08	5	0.11	24.01
		学生正确洗手率	4.43	35	0.12	26.07
		从业人员正确洗手率	4.40	30	0.12	25.92
	传染病认知程度		4.00	0	0.12	18.56
		学生对传染病的认知	4.05	5	0.11	24.96
		老师对传染病的认知	4.15	5	0.11	25.58
		家长对传染病的认知	4.00	0	0.12	24.65
		后勤等教职工对传染病的认知	4.03	0	0.11	24.81
严重性			3.98	0	0.12	17.45
	发病率		4.53	50	0.12	100.00
		与上月本校发病数相比	4.08	10	0.12	26.33
		与去年同期本校发病数相比	3.95	10	0.14	25.53
		与同期本区同学段学校发病水平相比	3.83	5	0.16	24.72
		与同期本市同学段学校发病水平相比	3.63	5	0.18	23.43
应对措施			4.80	65	0.06	21.08
	疫苗接种情况		4.75	70	0.09	17.37
		流感疫苗接种率	4.40	45	0.15	47.44
		新生接种疫苗查验证	4.88	80	0.06	52.56
	开展应急演练		4.05	10	0.11	14.81
		演练次数	4.03	5	0.10	34.62
		演练教职工参与度	3.80	0	0.10	32.69
		演练学生参与度	3.80	0	0.11	32.69
	事件/疫情报告		4.68	40	0.06	17.09
		报告及时性	4.80	65	0.06	21.31
		报告准确性	4.33	25	0.11	19.20
		报告完整性	4.05	10	0.12	17.98
		是否有续发病例	4.63	50	0.09	20.53
		关班、关园(校)落实情况	4.73	55	0.07	20.98
	事件/疫情告知宣教		4.38	15	0.08	16.00
		师生和家长告知	4.55	50	0.11	51.41
		家长学生健康宣教	4.30	20	0.11	48.59
	事件/疫情后消毒		4.70	50	0.08	17.19
		消毒剂配置方法和浓度正确	4.70	55	0.09	33.94
		终末消毒范围正确	4.65	40	0.07	33.57
		消毒方法有效	4.50	20	0.08	32.49
	隔离和返校查验		4.80	65	0.06	17.55
		隔离流程正确	4.73	55	0.07	26.07
		病愈返校查验完善	4.68	50	0.08	25.79
		是否有疫情处置经验	4.00	15	0.14	22.07
		因病休退学登记	4.73	70	0.11	26.07

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