Knowledge, attitudes and practices regarding tuberculosis prevention and control: analysis of influencing factors of prevention and control behavior among college students in Wuhan, China
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摘要:
目的 了解武汉市大学生结核病防控知识、态度及行为现状与结核病防控行为形成的因素，为分类开展结核病防控健康教育提供参考依据。 方法 参照中国疾病预防控制中心设计的《大学生结核病防控知信行问卷调查表》，采用判断抽样法抽取武汉市22所大专院校，通过问卷星平台对15 272名大学生进行问卷调查，采用多因素Logistic回归分析结核病防控行为形成的影响因素。 结果 大学生结核病防控知信行总知晓率为79.69%，其中核心知识知晓率为79.28%，及格率为92.46%；正确态度持有率为89.69%，及格率为90.56%；正确行为形成率为72.11%，及格率为96.62%。单因素分析显示，不同性别、年级、父亲学历、母亲学历、患者接触史、结核病史、核心知识知晓和态度认知情况大学生防控行为形成及格率差异均有统计学意义(χ2值分别为91.83，10.28，137.46，103.49，16.50，47.37，1 992.54，1 138.22，P值均＜0.05)；多因素Logistic回归分析显示，女性(OR=1.86), 父亲学历为小学、初中、高中、大专或本科生(OR值分别为2.94，3.05，3.17，3.24)，无结核病史(OR=3.32)，核心知识知晓及格(OR=9.91)，态度持有得分及格(OR=7.35)均与大学生结核病防控行为呈正性相关(P值均＜0.05)。 结论 大学生结核病防控知信行总知晓率尚未达标且不够全面，性别、有无结核病史、防控核心知识知晓率、态度持有情况以及父亲学历是大学生结核病防控行为的主要影响因素。 -
关键词:
- 结核 /
- 健康知识, 态度, 实践 /
- 行为 /
- 回归分析 /
- 学生
Abstract:Objective To determine the knowledge, attitudes and practices (KAP) regarding tuberculosis prevention and control among college students in Wuhan, China, while analyzing the factors affecting tuberculosis prevention behavior. Methods Referring to the National KAP Questionnaire for Tuberculosis Prevention and Control among College Students, which was designed by China Center for Disease Control and Prevention, 22 colleges and universities in Wuhan were selected using a judgment sampling method, and a questionnaire survey was carried out through the online questionnaire platform. The formation of tuberculosis prevention and control behavior among this population was analyzed by single factor and multi-factor Logistic regression. Results The total awareness rate of KAP regarding tuberculosis prevention and control among college students in Wuhan was 79.69%; the awareness rate of core knowledge was 79.28%, and the passing rate was 92.46%. The correct attitude holding rate was 89.69%, while the passing rate was 90.56%. In respect to correct behavior, the formation rate was 72.11%, with a passing rate of 96.62%. The multivariate Logistic regression analysis showed that the following factors were more likely to promote tuberculosis prevention and control behaviors that met the target: female college students (OR=1.86); college students whose father had a primary school education level, junior high school and equivalent, high school and equivalent, and junior high school students (OR=2.94, 3.05, 3.17, 3.24); no history of tuberculosis (OR=3.32); the passing knowledge of core knowledge (OR=9.91), and the passing attitude holding score (OR=7.35)(P < 0.05). Conclusion The overall awareness rate of KAP regarding tuberculosis prevention and control among college students in Wuhan is acceptable, the mainly influenced factors are gender, history of tuberculosis, awareness rate of core knowledge about prevention and control, attitudes and cognition, and parents' educational background. -
Key words:
- Tuberculosis /
- Health knowledge, attitudes, practice /
- Behavior /
- Regression analysis /
- Students
1) 利益冲突声明 所有作者声明无利益冲突。2) 张正斌与杨云为并列第一作者 -
表 1 大学生结核病防治知识态度行为正确回答率(n=15 272)
Table 1. Positive responses to tuberculosis prevention knowledge, attitude and behavior among college students(n=15 272)
知识态度行为 条目 正确回答人数 正确回答率/% 结核病防治核心信息 结核病的疾病性质 7 838 51.32 肺结核主要传播途径 13 618 89.17 肺结核常见可疑症状 13 794 90.32 怀疑患肺结核正确做法 14 688 96.18 肺结核规则治疗是否能治好 10 597 69.39 结核病防治态度 大学生需要掌握结核病防治知识 14 810 96.97 学校应开展肺结核防治健康教育 14 377 94.14 师生出现肺结核可疑症状或被诊断为肺结核后，应该主动报告老师，不隐瞒 12 918 84.59 师生出现结核病患者，是否排斥他们 12 682 83.04 结核病防控行为 怀疑得了肺结核应该怎么办 14 688 96.18 师生出现肺结核可疑症状或被诊断为肺结核后，能否继续在校上课、生活 15 066 98.65 身边有无随地吐痰的师生 6 095 39.91 你在咳嗽、咳痰时会手/纸巾遮挡口鼻吗 9 379 61.41 主动学习肺结核防病知识 9 836 64.41 
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表 2 不同组别大学生结核病知识、态度、行为及格率比较
Table 2. Comparison of passing rates of tuberculosis knowledge, attitude and behavior among college students in different groups
组别 选项 人数 统计值 知识 态度 行为 性别 男 7 666 6 929(90.39) 6 786(88.52) 7 300(95.23) 女 7 606 7 192(94.46) 7 044(92.61) 7 456(98.03) χ2值 95.31 74.71 91.83 P值 ＜0.01 ＜0.01 ＜0.01 民族 汉族 9 440 13 233(92.46) 12 970(90.62) 13 834(96.67) 少数民族 5 832 888(92.50) 860(89.58) 922(6.25) χ2值 0.01 1.14 1.05 P值 0.97 0.29 0.31 户籍 农村 14 312 8 735(92.53) 8 590(91.00) 9 108(96.48) 城市 960 5 386(92.35) 5 240(89.85) 5 648(96.84) χ2值 0.17 5.54 1.45 P值 0.68 0.02 0.23 专业 医学 891 812(91.13) 802(90.01) 868(97.42) 非医学 14 381 13 018(90.52) 13 028(90.59) 13 797(96.55) χ2值 0.37 0.33 1.93 P值 0.55 0.57 0.17 年级 大一 6 676 6 196(92.81) 6 466(96.85) 6 466(96.85) 大二 4 825 4 449(92.21) 4 335(89.84) 4 647(96.31) 大三 2 940 2 715(92.35) 2 653(90.24) 2 853(97.04) 大四及以上 831 761(91.58) 735(88.45) 790(95.07) χ2值 2.60 14.15 10.28 P值 0.46 ＜0.01 0.02 父亲学历 文盲 288 249(86.46) 237(82.29) 252(87.50) 小学 2 649 2 458(92.79) 2 408(90.90) 2 563(96.75) 初中 5 856 5 441(92.91) 5 358(91.50) 5 688(97.13) 高中 3 433 3 196(93.10) 3 119(90.85) 3 327(96.91) 大专或本科 2 873 2 642(91.96) 2 579(89.77) 2 777(96.66) 研究生 173 135(78.03) 129(74.57) 149(86.13) χ2值 71.71 83.60 137.46 P值 ＜0.01 ＜0.01 ＜0.01 母亲学历 文盲 532 467(87.78) 462(86.84) 490(92.11) 小学 3 762 3 479(92.48) 3 412(90.70) 3 634(96.60) 初中 5 724 5 337(93.24) 5 224(91.26) 5 578(97.45) 高中 3 015 2 774(92.00) 2 741(90.91) 2 911(96.55) 大专或本科 2 120 1 975(93.16) 1 905(89.86) 2 043(96.37) 研究生 119 89(74.79) 86(72.27) 100(84.03) χ2值 77.39 60.23 103.49 P值 ＜0.01 ＜0.01 ＜0.01 结核患者接触史 有 578 550(95.16) 524(90.66) 563(97.40) 无 11 613 10 826(93.22) 10 579(91.10) 11 252(96.89) 不清楚 3 081 2 745(89.09) 2 727(88.51) 2 941(95.46) χ2值 65.81 19.05 16.50 P值 ＜0.01 ＜0.01 ＜0.01 有无结核病史 有 92 71(77.17) 74(80.43) 77(83.70) 无 15 180 14 050(92.56) 13 756(90.62) 14 679(96.70) χ2值 31.05 11.09 47.37 P值 ＜0.01 ＜0.01 ＜0.01 知识知晓情况 及格 14 121 13 010(92.13) 13 907(98.48) 不及格 1 151 820(71.24) 849(73.76) χ2值 543.15 1 992.54 P值 ＜0.01 ＜0.01 态度持有情况 及格 13 830 13 010(94.07) 13 583(98.21) 不及格 1 442 1 111(77.05) 1 173(81.35) χ2值 543.15 1 138.22 P值 ＜0.01 ＜0.01 合计 15 272 14 121(92.46) 13 830(90.56) 14 756(96.62) 注：()内数字为及格率/%。
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表 3 大学生结核病防控行为多因素Logistic回归分析(n=15 272)
Table 3. Multivariate Logistic regression analysis on the formation of tuberculosis prevention and control behavior of college students(n=15 272)
自变量与常数 选项 β值 标准误 Wald χ2值 P值 OR值 (OR值95%CI) 性别 男 1.00 女 0.62 0.11 32.62 ＜0.01 1.86(1.50~2.30) 父亲学历 文盲 1.00 小学 1.08 0.31 12.50 ＜0.01 2.94(1.62~5.33) 初中 1.11 0.30 13.92 ＜0.01 3.05(1.70~5.46) 高中 1.15 0.31 13.53 ＜0.01 3.17(1.72~5.87) 大专或本科 1.18 0.32 13.39 ＜0.01 3.24(1.73~6.09) 研究生 0.78 0.50 2.39 0.12 2.18(0.81~5.85) 结核病史 有 1.00 无 1.20 0.41 8.57 ＜0.01 3.32(1.49~7.41) 核心知识知晓情况 不及格 1.00 及格 2.29 0.10 503.08 ＜0.01 9.91(8.11~12.11) 态度持有情况 不及格 1.00 及格 2.00 0.10 375.78 ＜0.01 7.35(6.01~8.99) 常数 -2.01 0.49 16.80 ＜0.01
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