天津市2019—2023年学校卫生工作开展状况

蒋家诺; 刘忠慧; 张献伟; 宋欣俐; 张依航; 董子奇; 袁雯; 董彦会; 陈璐; 宋逸; 马军

doi:10.16835/j.cnki.1000-9817.2024163

天津市2019—2023年学校卫生工作开展状况

doi: 10.16835/j.cnki.1000-9817.2024163

1.
北京大学公共卫生学院/北京大学儿童青少年卫生研究所，100191
2.
天津市疾病预防控制中心环境健康与公共卫生所

基金项目:

北京市教育科学规划课题项目 AHCA23107

详细信息

作者简介:
蒋家诺(1999-)，女，陕西西安人，在读硕士，主要研究方向为儿童青少年慢性病

通讯作者:
袁雯，E-mail：yuanwen@bjmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 G627.8 G478.2
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- 被引次数: 0
出版历程
- 收稿日期: 2024-04-17
- 修回日期: 2024-04-29
- 网络出版日期: 2024-05-30
- 刊出日期: 2024-05-25

Current status of regional school health work in Tianjin during 2019-2023

1.
School of Public Health/Institute of Child and Adolescent Health, Peking University, Beijing (100191), China

摘要

摘要: 目的探究天津市2019—2023年学校卫生工作现况，为进一步完善学校卫生工作提供政策参考。方法利用2019，2021和2023年天津市学校卫生工作调查资料，分析卫生行政部门、疾病预防控制中心和教育部门的学校卫生工作人员配备和经费，以及中小学校健康教育、常见病和传染病防控、体育活动、食品营养等工作开展情况及年份间的变化。采用Kruskal-Wallis秩和检验、χ²检验、Fisher精确检验进行统计学分析。结果 2019，2021和2023年天津市各区卫生健康委和教育部门的学校卫生工作人员数较稳定，其中卫生健康委以兼职人员为主，教育部门以专职人员为主；疾病预防控制中心的学校卫生工作人员数量逐渐增加，差异有统计学意义(H=12.65，P < 0.01)。与2019年相比，2021年和2023年区卫生健康委和中小学校的学校卫生工作经费均增加，差异均有统计学意义(H值分别为22.28，23.75，P值均 < 0.05)。2019，2021和2023年均有95.00%，97.25%和99.07%的学校设立了卫生室或保健室，97.00%，97.25%和96.30%的学校有学校卫生技术人员或保健教师。2019，2021和2023年分别有超过90%的学校健康教育课可以达到每学期4课时，心理健康教育的开设率逐年上升(86.87%，89.91%，96.30%，Z=2.40，P < 0.05)，安全应急与避险、生长发育和青春期保健教育相对开设较少，学校心理咨询服务的开设率(89.00%，97.25%，100.00%)和心理问题防控的开展率(56.12%，71.56%，81.48%)均逐年上升(Z值分别为3.83，3.96，P值均 < 0.01)；视力不良、龋齿与口腔疾病和超重肥胖防控的开展率均高于80%，脊柱弯曲异常防控的开展率呈上升趋势(38.78%，77.06%，72.22%，Z=4.87，P < 0.01)。2019，2021和2023年分别有90.91%，97.22%和93.46%的学校体育课时达标，大课间体育活动达标的学校比例逐年上升(65.00%，80.73%，85.98%，Z=3.59，P < 0.01)。所有学校均不设小卖部。结论天津市学校卫生工作整体上开展较好。需继续增加学校卫生人力资源和经费投入，探索学生常见病多病共防机制，完善校园运动和营养环境。
- 公共卫生 /
- 卫生保健提供 /
- 组织和管理 /
- 学生保健服务
Abstract: Objective To explore the current status and progress of regional school health work to provide policy reference for school health improvement. Methods Survey data on school health work in Tianjin from 2019, 2021 and 2023 was used. School health staff allocation and expenditure of the health administrative department, CDC and education department, as well as the annual implementation of health education, prevention and control of common diseases and infectious diseases, sports activities and food nutrition in primary and secondary schools were analyzed. Statistical analysis was conducted using Kruskal-Wallis test, Chi-square test, and Fisher's exact test. Results The number of school health staff in the health commissions and education departments from 2019, 2021 and 2023 was relatively stable. Part-time staffs were often employed by health commissions while full-time staffs were mainly employed by education departments. The number of school health staff at CDCs increased gradually (H=12.65, P < 0.01). School health expenditure of administrative departments and schools in 2021 and 2023 increased significantly compared with that in 2019 (H=22.28, 23.75, P < 0.05). More than 95% of schools set up clinics or health care rooms, and about 97% of schools had school health technicians or health teachers. More than 90% of schools had health education courses over 4 hours per semester. The rate of mental health education increased by year (86.87%, 89.91%, 96.30%, Z=2.40, P < 0.05). Lack of courses regarded safety emergency and risk avoidance, growth and development, and adolescent health education. The provision rate of psychological counseling services (89.00%, 97.25%, 100.00%) and psychological problem prevention and control (56.12%, 71.56%, 81.48%) also increased by year (Z=3.83, 3.96, P < 0.01). The implementation rates of prevention and control of poor vision, dental caries, overweight and obesity were all higher than 80%, and the prevention and control rate of abnormal spinal curvature showed an increasing trend (38.78%, 77.06%, 72.22%, Z=4.87, P < 0.01). More than 90% of schools met the standard for physical education class hours, and the proportion of schools conducting at least 30 minutes of recess physical activities every day increased year by year (65.00%, 80.73%, 85.98%, Z=3.59, P < 0.01). All schools did not have shops. Conclusions School health work in Tianjin is effective and constantly developing. It is necessary to continue to increase the investment of human resources and expenditure in school health, explore the approaches of co-occurrence and prevention of common diseases, and improve the school sports and nutrition environment.
- Public health /
- Delivery of health care /
- Organization and administration /
- Student health services
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表 1 天津市不同年份各区管理部门学校卫生工作人员配备情况比较[M(P₂₅，P₇₅)]

Table 1. Comparison of school health staffing situations among different district administrative departments in different years in Tianjin[M(P₂₅, P₇₅)]

年份	区卫生健康委			区疾病预防控制中心			区教育部门
年份	工作人员人数	专职人员占比/%	兼职人员占比/%	工作人员人数	专职人员占比/%	兼职人员占比/%	工作人员人数	专职人员占比/%	兼职人员占比/%
2019	2.00(1.00, 2.00)	0.00(0.00, 6.25)	100.00(93.75, 100.00)	2.00(2.00, 2.25)	50.00(0.00, 100.00)	50.00(0.00, 100.00)	3.50(3.00, 7.25)	83.33(39.91, 100.00)	16.67(0.00, 60.09)
2021	1.00(1.00, 2.00)	0.00(0.00, 0.00)	100.00(100.00, 100.00)	2.50(2.00, 3.00)	50.00(0.00, 100.00)	50.00(0.00, 100.00)	5.00(3.00, 6.50)	100.00(30.00, 100.00)	0.00(0.00, 70.00)
2023	1.50(1.00, 2.00)	0.00(0.00, 12.50)	100.00(87.50, 100.00)	3.00(3.00, 4.00)	50.00(33.33, 100.00)	50.00(0.00, 66.67)	6.00(4.75, 7.25)	90.00(47.50, 100.00)	10.00(0.00, 52.50)
H值	3.42	0.83	0.83	12.65	0.21	0.21	2.18	0.11	0.11
P值	0.18	0.66	0.66	< 0.01	0.90	0.90	0.34	0.95	0.95

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表 2 中小学校开展学校卫生工作内容不同年份间比较

Table 2. Comparison of distribution situations in the implementation of different school health works among primary and secondary schools in different years

学校卫生工作内容	2019年(n=100)	2021年(n=109)	2023年(n=108)	χ²值	P值
开设健康教育课/讲座	99(99.00)	109(100.00)	108(100.00)		0.32^b
健康教育课/讲座内容
健康行为习惯/生活方式^a	91(91.92)	106(97.25)	101(93.52)		0.21^b
常见疾病预防^a	97(97.98)	104(95.41)	108(100.00)		0.05^b
安全应急与避险^a	79(79.80)	95(87.16)	96(88.89)	3.82	0.15
心理健康^a	86(86.87)	98(89.91)	104(96.30)		0.04^b
生长发育和青春期保健^a	73(73.74)	93(85.32)	86(79.63)	4.31	0.12
健康教育课时达标^a	89(91.75)	99(94.29)	104(96.30)		0.40^b
有心理咨询服务	89(89.00)	106(97.25)	108(100.00)		< 0.01^b
每学年组织全校体检	100(100.00)	109(100.00)	108(100.00)
开展常见疾病防控	100(100.00)	109(100.00)	108(100.00)
疾病防控工作内容
视力不良	100(100.00)	106(97.25)	107(99.07)		0.33^b
龋齿与口腔疾病^a	90(91.84)	104(95.41)	100(92.59)	1.21	0.55
营养不良^a	79(80.61)	97(88.99)	85(78.70)	4.55	0.10
超重肥胖^a	80(81.63)	96(88.07)	100(92.59)	5.72	0.06
心理问题^a	55(56.12)	78(71.56)	88(81.48)	15.94	< 0.01
脊柱弯曲异常^a	38(38.78)	84(77.06)	78(72.22)	38.04	< 0.01
有近视防控方案	94(94.00)	104(95.41)	108(100.00)		0.02^b
明确近视防控职责	93(93.00)	104(95.41)	105(97.22)		0.38^b
眼保健操次数达标	93(93.00)	106(97.25)	100(92.59)		0.25^b
建立传染病防控小组	99(99.00)	109(100.00)	108(100.00)		0.32^b
明确传染病疫情报告人	100(100.00)	109(100.00)	108(100.00)
体育课时达标^a	90(90.91)	105(97.22)	100(93.46)		0.15^b
大课间体育活动达标	65(65.00)	88(80.73)	92(85.98)	14.04	< 0.01
每周制定带量食谱^a	64(90.14)	83(97.65)	87(100.00)		< 0.01^b
学校无小卖部	100(100.00)	109(100.00)	108(100.00)
注： ()内数字为百分率/%；a问卷调查应答有缺失值，b采用Fisher精确检验。

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