衢州市4~8岁留守儿童水痘疫苗接种现状及影响因素

郑灿杰; 徐文杰; 龚晓英; 方泉均; 尹志英

doi:10.16835/j.cnki.1000-9817.2023.07.024

衢州市4~8岁留守儿童水痘疫苗接种现状及影响因素

doi: 10.16835/j.cnki.1000-9817.2023.07.024

浙江省衢州市疾病预防控制中心免疫规划科, 324000

基金项目:

长三角免疫规划领军人才研究项目 CSJP022

衢州市科技局指导性项目 2022068

详细信息

作者简介:
郑灿杰(1981-), 男, 浙江衢州人, 硕士, 副主任医师, 主要从事疫苗针对性疾病监测与处置方面工作

通讯作者:
尹志英, E-mail: 26284678@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R186 R193
计量
- 文章访问数: 234
- HTML全文浏览量: 100
- PDF下载量: 18
- 被引次数: 0
出版历程
- 收稿日期: 2023-05-08
- 修回日期: 2023-05-22
- 网络出版日期: 2023-07-25
- 刊出日期: 2023-07-25

Current situation and influencing factors of varicella vaccination among left-behind children aged 4-8 years old in Quzhou

Immune Planning Department, Quzhou Center for Disease Prevention and Control, Quzhou(324000), Zhejiang Province, China

摘要

摘要: 目的了解衢州市留守儿童水痘疫苗(varicella zoster virus, VarV)接种现状并应用保护动机理论探索其影响因素, 为下一步巩固水痘疫苗接种提出参考。方法于2022年9-12月, 通过简单随机抽样方式选取衢州市下辖的6个县区共628名留守儿童, 对其看护人进行问卷调查, 收集社会学特征和保护动机理论因素, 采用Logistic回归分析衢州市留守儿童接种行为的影响因素。结果 628名留守儿童中已接种水痘疫苗的占69.59%, 其中已完成2剂次的占74.83%;尚未接种的占30.41%, 其中未来有接种意向的占10.99%。多因素Logistic回归分析显示, 亲属关系、家庭年收入、家庭孩子数、外部奖励和自我效能对留守儿童水痘接种率有影响(OR=0.43~3.40, P值均 < 0.05);其中外部奖励因子与接种概率呈正相关(OR=1.14);自我效能因子与接种概率呈负相关(OR=0.95)。结论在健康教育和学校宣传中, 通过提高留守儿童看护人的外部奖励和自我效能的保护动机因素水平, 能促进看护人产生保护动机, 提高水痘疫苗接种率。
- 水痘疫苗 /
- 接种 /
- 回归分析 /
- 儿童
Abstract: Objective To understand vaccination coverage and the influencing factors of varicella vaccine (VarV) among left-behind children in Quzhou, which based on protective motivation theory (PMT), so as to provide reference to consolidate VarV vaccination in the next step. Methods From September to December in 2022, simple random sampling was used to select 628 left-behind children in six counties of Quzhou City.A questionnaire survey on their caregivers was conducted to collect data relating to sociological characteristics and PMT factors, and the influencing factors of VarV were tested by Logistic regression. Results A total of 628 left-behind children participated in the study.The VarV rate was 69.59%, and 74.83% had received a second dose of VarV.The unvaccinated rate was 30.41%, and caregivers willingness to vaccinate children with VarV was only 10.99%.Logistic regression analysis showed that family relationships, annual household income, number of children in the family, extrinsic rewards and self-efficacy were the influencing factors of VarV among left-behind children (OR=0.43-3.40, P < 0.05).The external reward factor was positively correlated with the vaccination probability (OR=1.14), and the self-efficacy factor was negatively correlated with the vaccination probability (OR=0.95). Conclusion In the context of health education and school promotion, attention should be paid to factors relating to extrinsic rewards and self-efficacy as a means of increasing motivation to seek vaccine protection and improve the use of VarV.
- Chickenpox vaccine /
- Vaccination /
- Regression analysis /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 有无接种行为留守儿童保护动机因素各维度得分比较(x±s)

Table 1. Comparison of scores of various dimensions among left-behind children for PMT factors with or without vaccination behaviors(x±s)

接种行为	人数	感知严重性	感知易感性	内部奖励	外部奖励	反应效能	反应代价	自我效能
有	437	9.78±3.32	7.85±2.00	6.68±1.73	13.93±3.20	7.52±1.88	20.14±4.54	11.18±4.53
无	191	9.29±3.35	7.76±2.24	6.20±1.97	12.38±3.62	7.87±2.16	18.37±5.09	12.39±4.91
t值		1.66	0.52	3.05	5.36	-2.08	4.32	-3.00
P值		0.10	0.61	< 0.01	< 0.01	0.04	< 0.01	< 0.01

下载: 导出CSV

表 2 儿童水痘疫苗接种行为单因素分析

Table 2. Single factor analysis of VarV vaccination behaviors among children

因素	选项	人数	已接种人数	χ²值	P值	因素	选项	人数	已接种人数	χ²值	P值
亲属关系	父亲	118	92(77.97)	32.82	< 0.01	家庭年收入/万元^*	< 5	154	76(49.35)	40.73	< 0.01
	母亲	182	149(81.87)				5~10	256	200(78.13)
	祖父母	328	196(59.76)				11~20	202	150(74.26)
看护人年龄/岁	25~34	95	80(84.21)	31.49	< 0.01		>20	14	11(78.57)
	35~44	189	149(78.84)			看护人文化程度	初中及以下	485	316(65.15)	19.64	< 0.01
	≥45	344	208(60.47)				高中/中专	112	94(83.93)
看护人婚姻	已婚	578	405(70.07)	0.84	0.36		大专及以上	31	27(87.10)
状况	离异或丧偶、再婚	50	32(64.00)			水痘感染史	是	101	76(75.25)	1.76	0.19
看护人职业	公务员/企事业单位	19	16(84.21)	28.45	< 0.01		否	527	361(68.50)
	个体户/自由职业	124	106(85.48)			家庭孩子数	1	302	220(72.85)	5.15	0.08
	职员	31	25(80.65)				2	290	197(67.93)
	工人/农民	422	265(62.80)				≥3	36	20(55.56)
	其他	32	25(78.13)
注： ()内数字为接种率/%，*有缺失值。

下载: 导出CSV

表 3 留守儿童接种行为影响因素的多因素Logistic回归分析(n=628)

Table 3. Multivariate Logistic regression analysis on influential factors of VarV behavior among left-behind children(n=628)

自变量	模型1					模型2
自变量	β值	标准误	Wald χ²值	P值	OR值(95%CI)	β值	标准误	Wald χ²值	P值	OR值(95%CI)
家庭年收入/万元
5~10	1.16	0.23	25.92	< 0.05	3.18(2.04~4.96)	1.22	0.24	26.55	< 0.05	3.40(2.13~5.41)
11~20	0.93	0.24	15.11	< 0.05	2.54(1.59~4.06)	0.92	0.25	13.82	< 0.05	2.52(1.55~4.10)
>20	1.05	0.69	2.35	>0.05	2.86(0.75~11.00)	1.13	0.71	2.56	>0.05	3.11(0.78~12.43)
亲属关系
父亲	0.60	0.26	5.28	< 0.05	1.82(1.09~3.04)	0.45	0.27	2.79	>0.05	1.57(0.93~2.66)
母亲	1.04	0.23	20.19	< 0.05	2.82(1.79~4.43)	0.86	0.24	12.52	< 0.05	2.36(1.47~3.81)
家庭孩子数
2	-0.35	0.19	3.33	>0.05	1.43(0.97~2.09)	-0.44	0.20	4.77	< 0.05	0.65(0.44~0.96)
3	-0.77	0.39	3.99	< 0.05	2.16(1.02~4.81)	-0.85	0.40	4.48	< 0.05	0.43(0.20~0.94)
PMT变量
外部奖励						0.13	0.03	19.14	< 0.05	1.14(1.07~1.20)
自我效能						-0.06	0.02	7.25	< 0.05	0.95(0.91~0.99)
注：家庭年收入以 < 5万元为参照，亲属关系以祖父母为参照，家庭孩子数以1个为参照，PMT变量为连续性变量。

下载: 导出CSV

参考文献(16)

[1]	贾成梅, 王勇, 许燕, 等. 2014—2018江苏省水痘突发公共卫生事件流行病学特征[J]. 中国公共卫生, 2020, 36(4): 601-604. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW202004030.htm JIA C M, WANG Y, XU Y, et al. Epidemiological characteristics of varicella epidemic-related public health emergencies in Jiangsu Province, 2014-2018[J]. Chin J Public Health, 2020, 36(4): 601-604. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW202004030.htm
[2]	潘锋. 疫苗接种是预防传染病的最有效措施: 访中国疾病预防控制中心曾光教授[J]. 中国当代医药, 2019, 26(5): 1-3. doi: 10.3969/j.issn.1674-4721.2019.05.002 PAN F. Vaccination is the most effective measure to prevent infectious diseases: interview with professor Zeng Guang of Chinese Center for Disease Control and Prevention[J]. Chin Mod Med, 2019, 26(5): 1-3. (in Chinese) doi: 10.3969/j.issn.1674-4721.2019.05.002
[3]	张成富, 薛士银. 涟水县1951—2016年6种免疫规划主要针对传染病预防控制效果分析[J]. 江苏预防医学, 2018, 29(2): 193-195. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYF201802027.htm ZHANG C F, XUE S Y. Analysis of the effectiveness of prevention and control against 6 vaccine preventable infectious disease from 1951 to 2016[J]. Jiangsu J Prev Med, 2018, 29(2): 193-195. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JSYF201802027.htm
[4]	郝鹏飞, 秦利利, 徐浩, 等. 河南省留守儿童预防接种现状及影响因素[J]. 江苏预防医学, 2020, 31(3): 308-311. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYF202003024.htm HAO P F, QIN L L, XU H, et al. Current situation and influencing factors of vaccination for left-behind children in Henan Province[J]. Jiangsu J Prev Med, 2020, 31(3): 308-311. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JSYF202003024.htm
[5]	芮小勤, 李婷婷, 聂蓉. 成年女性HPV疫苗接种意愿及行为问卷的编制及信效度检验[J]. 护理管理杂志, 2022, 22(5): 347-350. doi: 10.3969/j.issn.1671-315x.2022.05.009 RUI X Q, LI T T, NIE R. Development, reliability and validity of HPV vaccination willingness and behaviors questionnaire for adult women[J]. J Nurs Administr, 2022, 22(5): 347-350. (in Chinese) doi: 10.3969/j.issn.1671-315x.2022.05.009
[6]	刘彩. 基于保护动机理论的农村居民乙肝疫苗接种意愿和接种行为研究[D]. 济南: 山东大学, 2012. LIU C. An application of protection motivation theory to Hepatitis B vaccination willingness and behavior in rural China[D]. Jinan: Shandong University, 2012. (in Chinese)
[7]	张作记. 行为医学量表手册[M]. 北京: 中华医学电子音像出版社, 2005: 187-188. ZHANG Z J. Handbook of behavioral medicine scales[M]. Beijing: Chinese Medical Multimedia Press, 2005: 187-188. (in Chinese)
[8]	WHO. Varicella and herpes zoster vaccines: WHO position paper, June 2014[J]. Wkly Epidemiol Rec, 2014, 89(25): 265-287.
[9]	应杰, 汪松波, 傅琼瑶, 等. 金华市金东区2011—2019年水痘疫情与防控分析[J]. 海峡预防医学杂志, 2021, 27(2): 36-38. https://www.cnki.com.cn/Article/CJFDTOTAL-HXYF202102014.htm YING J, WANG S B, FU Q Y, et al. Analysis of the the epidemic situation from 2011 to 2019 in Jindong District in Jinhua City[J]. Strait J Prev Med, 2021, 27(2): 36-38. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HXYF202102014.htm
[10]	许玉洋, 刘艳, 张小平, 等. 杭州市2~11岁儿童水痘减毒活疫苗接种情况调查[J]. 预防医学, 2020, 32(7): 689-691, 697. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYFX202007011.htm XU Y Y, LIU Y, ZHANG X P, et al. Investigation on the vaccination status of varicella vaccine among children aged 2-11 in Hangzhou City[J]. Prev Med, 2020, 32(7): 689-691, 697. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZYFX202007011.htm
[11]	王进鑫, 刘旭. 6~9岁儿童性侵害现状调查与对策研究[J]. 少年儿童研究, 2019(9): 15, 22-36. https://www.cnki.com.cn/Article/CJFDTOTAL-SNEY201909005.htm WANG J X, LIU X. Investigation and countermeasure study on the status of sexual assault of children aged 6-9[J]. Children Stud, 2019(9): 15, 22-36. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SNEY201909005.htm
[12]	徐佳薇, 王青, 匡珊珊, 等. 重庆市农村留守儿童接种率现状及其监护人预防接种知信行研究[J]. 重庆医学, 2015, 44(35): 4988-4991. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX201535028.htm XU J W, WANG Q, KUANG S S, et al. Research of immunization coverage of left-behind children and their guardian's immunization knowledge, attitudes and practice in rural areas of Chongqing[J]. Chongqing Med, 2015, 44(35): 4988-4991. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX201535028.htm
[13]	陆沛超, 劳雪琼, 夏莲, 等. 玉林市玉州区2013年国家免疫规划疫苗接种率调查[J]. 江苏预防医学, 2015, 26(5): 65-66. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYF201505025.htm LU P C, LAO X Q, XIA L, et al. A coverage survey of national immunization program vaccines of Yuzhou District in 2013[J]. Jiangsu J Prev Med, 2015, 26(5): 65-66. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JSYF201505025.htm
[14]	颜洁, 张淑君, 赖智维, 等. 湖南省2019年2-12岁儿童6种国家免疫规划疫苗接种率调查[J]. 中国疫苗和免疫, 2021, 27(3): 289-291. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM202103013.htm YAN J, ZHANG S J, LAI Z W, et al. A coverage survey of six national immunization program vaccines among 2-12-year-old children of Hunan Province in 2019[J]. Chin J Vaccin Immun, 2021, 27(3): 289-291. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM202103013.htm
[15]	邱箫仪, 马艳玲, 蔡永年, 等. 男男性行为者采取艾滋病预防行为动机的影响因素研究[J]. 中国艾滋病性病, 2023, 29(3): 299-304. https://www.cnki.com.cn/Article/CJFDTOTAL-XBYA202303012.htm QIU X Y, MA Y L, CAI Y N, et al. Influencing factors of the motivation on protective behaviors in HIV prevention among men who have sex with men[J]. Chin J AIDS STD, 2023, 29(3): 299-304. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XBYA202303012.htm
[16]	葛金金, 刘黎, 吴奇峰, 等. 南京市3~11岁儿童父母对子女接种新冠肺炎疫苗加强针的意愿[J]. 中国学校卫生, 2022, 43(9): 1324-1328. doi: 10.16835/j.cnki.1000-9817.2022.09.011 GE J J, LIU L, WU Q F, et al. Parent's willingness to vaccinate their children aged 3-11 years with the COVID-19 booster vaccine in Nanjing[J]. Chin J Sch Health, 2022, 43(9): 1324-1328. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.09.011