Current situation of primary and secondary school students' health services in community health service organizations in Shenzhen
-
摘要:
目的 了解和评估深圳市社区健康服务机构中小学生健康服务现况，为提升健康服务能力提供依据。 方法 2022年6月，以深圳市684家社区健康服务机构和587名兼职卫生健康副校长为研究对象，采用深圳市社区健康服务机构中小学生健康服务能力专项调研问卷和社区健康服务机构兼职卫生健康副校长履职能力专项调研问卷进行问卷调查。使用SPSS 26.0软件进行描述性分析。 结果 深圳市社区健康服务机构全科或临床医师配备率为99.9%；67.1%的社区健康服务机构与学校建立对口协作关系；50.8%为学生提供诊疗服务；24.8%为学生提供健康体检服务；85.2%为学校提供健康指导；94.3%的社区健康服务机构负责人兼职卫生副校长，自评履职能力为(7.63±1.59)分；场地限制和医护人手不足是推进学生体检进社康的主要问题。 结论 深圳市社区健康服务机构医疗服务资源和专业人员培训不足，为中小学生提供健康体检和健康管理的服务能力不高。需进一步推进教卫融合，持续提升服务能力，促进学生健康工作有效开展。 -
关键词:
- 社区卫生服务 /
- 组织和管理 /
- 健康促进 /
- 中小学生卫生保健服务
Abstract:Objective To understand and assess the current situation of primary and secondary school students' health services in community health service organizations in Shenzhen, so as to provide a basis for upgrading the capacity of health services. Methods A total of 684 community health service organizations and 587 part-time health vice-principals in the Shenzhen City were selected for the study in June 2022, and the special questionnaire surveys regarding primary and secondary school students' health service capacity and the community health service organizations and part-time health vice-principals performance ability were administered in Shenzhen. SPSS 26.0 software was used for a descriptive analysis. Results The staffing rate of general practitioners or clinical physicians in Shenzhen's community health service organizations was 99.9%, 67.1% of community health service organizations established counterpart collaborative relationships with schools, 50.8% of community health service organizations provided diagnostic and treatment services for students, 24.8% of community health service organizations provided health check-up services for students, 85.2% of community health service organizations provided health guidance to schools, and 94.3% of community health service organizations had a part-time vice-principal of health with a score of (7.63±1.59) in the self-assessment of their ability to carry out their duties, and space constraints and shortage of nursing were the main problems in promoting student medical check-ups in the community health service organizations. Conclusions The community health service organizations in Shenzhen suffer from inadequate medical service resources and inadequate training for professional staff, resulting in low service capacity for providing physical examinations and health management for primary and secondary school students. There is a need to further promote the integrated development of education and health, and continuously enhance service capabilities, to promote the orderly development of student health work. 1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 深圳市社区健康服务机构提供学生健康体检服务情况
Table 1. Provision of students' health screening services by community health service organizations in Shenzhen
健康体检服务 全市
(n=684)社康中心
(n=530)社康站
(n=149)身高体重测量 679(99.3) 527(99.4) 147(98.7) 腰围测量 674(98.5) 524(98.9) 145(97.3) 臀围测量 590(86.3) 466(87.9) 121(81.2) 血压测量 681(99.6) 528(99.6) 148(99.3) 耳鼻咽喉检查 214(31.3) 175(33.0) 37(24.8) 口腔健康检查 386(56.4) 317(59.8) 67(45.0) 视力筛查(视力表) 635(92.8) 500(94.3) 131(87.9) 视力筛查及屈光度检测 131(19.2) 122(23.0) 9(6.0) 脊柱侧弯筛查 63(9.2) 57(10.8) 5(3.4) 口腔诊疗服务 147(21.5) 140(26.4) 7(4.7) 肺功能(肺活量)检测 297(43.4) 254(47.9) 41(27.5) 握力检测 28(4.1) 23(4.3) 5(3.4) 坐位体前屈测试 19(2.8) 18(3.4) 1(0.7) 体成分检测 56(8.2) 51(9.6) 5(3.4) 骨密度检测 346(50.6) 307(57.9) 38(25.5) 血常规检测 640(93.6) 515(97.2) 121(81.2) 尿常规检测 640(93.6) 513(96.8) 123(82.6) 血糖检测 661(96.6) 522(98.5) 135(90.6) 血脂检测 599(87.6) 489(92.3) 106(71.1) 血尿酸检测 597(87.3) 485(91.5) 108(72.5) 肝功能检测 597(87.3) 487(91.9) 106(71.1) 肾功能检测 600(87.7) 489(92.3) 107(71.8) 心电图检测 641(93.7) 512(96.6) 125(83.9) B超检测 482(70.5) 410(77.4) 68(45.6) X线检查(胸片) 116(17.0) 106(20.0) 9(6.0) 心理问卷检测 279(40.8) 230(43.4) 47(31.5) 结核分支杆菌感染检测 57(8.3) 49(9.2) 8(5.4) 注：()内数字为报告率/%；社区医院数据过少，未列入表中。 
下载: 导出CSV
表 2 深圳市社区健康服务机构为学校提供健康指导情况
Table 2. Provision of school health guidance by community health service organizations in Shenzhen
机构 数量 营养指导 运动指导 形体矫正 窝沟封闭 视力不良矫正 心理咨询服务 戒烟服务 校园疫情防控 肺结核防控 学校饮用水和卫生环境监测 均无 全市 684 134 (19.6) 93 (13.6) 93 (13.6) 112 (16.4) 194 (28.4) 230 (33.6) 170 (24.9) 473 (69.2) 375 (54.8) 137 (20.0) 101 (14.8) 社康中心 530 110 (20.8) 77 (14.5) 85 (16.0) 101 (19.1) 164 (30.9) 195 (36.8) 145 (27.4) 388 (73.2) 309 (58.3) 121 (22.8) 59 (11.1) 社康站 149 23 (15.4) 15 (10.1) 7 (4.7) 11 (7.4) 30 (20.1) 34 (22.8) 24 (16.1) 82 (55.0) 62 (41.6) 14 (9.4) 41 (27.5) 注：()内数字为报告率/%；社区医院数据过少，未列入表中。
下载: 导出CSV
表 3 深圳市推进学生体检进社区存在问题(x ±s)
Table 3. Problems in promoting student medical checkups in the community in Shenzhen(x ±s)
存在问题 全市
(n=684)社康中心
(n=530)社康站
(n=149)学校与社区健康服务机构互动不足 4.73±2.92 4.69±2.86 4.87±3.14 设备设施不齐全 5.51±3.00 5.39±3.02 6.00±2.90 医护人员人手不足 6.34±3.08 6.20±3.14 6.89±2.77 社区健康服务机构场地限制 6.40±3.11 6.28±3.17 6.91±2.79 举办医院没有统筹安排 4.18±3.19 4.23±3.19 3.99±3.20 无激励措施或激励措施落实不到位 5.32±3.24 5.33±3.23 5.28±3.28 对工作人员的技能培训不足 4.96±3.01 4.93±2.97 5.10±3.17 可提供体检内容少 4.73±2.92 4.69±2.87 4.93±3.11 青少年健康服务宣传不足 4.99±2.76 4.95±2.68 5.17±3.05 信息系统不能满足工作需求 5.48±3.08 5.49±3.06 5.42±3.21 注：社区医院数据过少，未列入表中。
下载: 导出CSV
表 4 深圳市卫生健康副校长履职能力自评得分(x ±s)
Table 4. Self-assessment scores of health and wellness vice-principals' ability to perform their duties in Shenzhen(x ±s)
履职能力 全市
(n=587)社康中心
(n=501)社康站
(n=77)熟练掌握学校卫生工作内容 8.11±1.72 8.11±1.69 7.97±1.90 熟练掌握校园疫情防控 8.92±1.32 8.91±1.32 8.92±1.42 熟练掌握学生常见传染病防控 8.64±1.48 8.63±1.49 8.65±1.51 熟练掌握学校肺结核防控 8.16±1.94 8.15±1.95 8.09±1.90 熟练掌握学生肥胖防控 7.35±2.13 7.34±2.12 7.23±2.22 熟练掌握学生营养不良(贫血)防控 7.43±2.18 7.44±2.16 7.19±2.32 熟练掌握学生近视(眼健康)防控 7.39±2.13 7.38±2.13 7.31±2.17 熟练掌握学生龋齿(口腔健康)防控 7.23±2.24 7.24±2.24 7.00±2.28 熟练掌握学生脊柱侧弯(脊柱健康)防控 6.82±2.37 6.86±2.34 6.36±2.50 熟练掌握手卫生健康指导 9.28±1.26 9.27±1.26 9.31±1.33 熟练掌握青春期健康指导 7.62±2.13 7.63±2.10 7.40±2.36 熟练掌握学生心理健康指导 7.17±2.20 7.19±2.20 6.96±2.19 熟练掌握学校卫生环境监测和报告解读 7.19±2.34 7.18±2.35 7.08±2.32 熟练掌握饮用水质量检测和报告解读 6.81±2.46 6.86±2.45 6.25±2.53 熟练掌握灯光照明课桌椅合格率监测和报告解读 6.36±2.56 6.42±2.51 5.82±2.88 总均分 7.63±1.59 7.64±1.59 7.44±1.61 注：社区医院数据过少，未列入表中。
下载: 导出CSV
-
[1] 李创, 罗乐宣, 周海滨, 等. 健康中国战略背景下深圳市公共卫生体系改革与实践[J]. 中国卫生政策研究, 2019, 12(12): 20-24.LI C, LUO L X, ZHOU H B, et al. Reformand practice of public health system in Shenzhen under the background of Healthy China Strategy[J]. Chin J Health Policy, 2019, 12(12): 20-24. (in Chinese) [2] 中华人民共和国教育部等五部门关于全面加强和改进新时代学校卫生与健康教育工作的意见[EB/OL]. (2021-09-03)[2024-04-30]. https://www.gov.cn/zhengce/zhengceku/2021-09/03/content_5635117.htm .Opinions of the Ministry of Education of the PRC and other four departments on comprehensively strengthening and improving school health and health education in the new era[EB/OL]. (2021-09-03)[2024-04-30].https://www.gov.cn/zhengce/zhengceku/2021-09/03/content_5635117.htm . (in Chinese)[3] 中华人民共和国教育部体育卫生与艺术教育司. 第八次全国学生体质与健康调研结果发布[J]. 中国学校卫生, 2021, 42(9): 1281-1282. doi: 10.16835/j.cnki.1000-9817.2021.09.001Department of Physical Health and Arts Education, Ministry of Education of the PRC. Release report of the eighth national survey on student physical fitness and health[J]. Chin J Sch Health, 2021, 42(9): 1281-1282. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.09.001 [4] 李菊红, 张紫阳, 胡潇文, 等. 深圳市12~ 15岁中学生恒牙患龋率及影响因素分析[J]. 预防医学, 2020, 32(10): 1048-1050.LI J H, ZHANG Z Y, HU X W, et al. Analysis of caries rate and factors affecting permanent teeth of secondary school students aged 12-15 years old in Shenzhen, China[J]. China Prev Med J, 2020, 32(10): 1048-1050. (in Chinese) [5] 儿童青少年脊柱弯曲异常防控技术指南编写组. 《儿童青少年脊柱弯曲异常防控技术指南》解读[J]. 中国学校卫生, 2022, 43(2): 165-170, 175. doi: 10.16835/j.cnki.1000-9817.2022.02.002Expert Group of Editorial Committee of Technical Guide for Prevention and Control of Abnormal Spinal Curvature in Chinese Children and Adolescents. Interpretation of Technical Guide for Prevention and Control of Abnormal Spinal Curvature in Children and Adolescents[J]. Chin J Sch Health, 2022, 43(2): 165-170, 175. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.02.002 [6] 罗乐宣, 李创, 陈瑶, 等. PCIC框架下深圳市建立整合型医疗卫生服务体系的研究与实践[J]. 中国卫生政策研究, 2019, 12(12): 7-13. doi: 10.3969/j.issn.1674-2982.2019.12.002LUO L X, LI C, CHEN Y, et al. The research and practice of integrated healthcare service system in Shenzhen under the PCIC framework[J]. Chin J Health Policy, 2019, 12(12): 7-13. (in Chinese) doi: 10.3969/j.issn.1674-2982.2019.12.002 [7] 赵海, 段佳丽, 滕立新, 等. 北京市中小学校校医和保健教师队伍现状调查[J]. 中国学校卫生, 2015, 36(3): 466-468. http://www.cjsh.org.cn/article/id/zgxxws201503051ZHAO H, DUAN J L, TENG L X, et al. Survey on the current situation of school nurses and health teachers in Beijing's primary and secondary schools[J]. Chin J Sch Health, 2015, 36(3): 466-468. (in Chinese) http://www.cjsh.org.cn/article/id/zgxxws201503051 [8] 侯晓静, 姜兴文, 孙亚文. 上海市中小学校卫生保健教师专业素质及其发展状况评估[J]. 中国学校卫生, 2022, 43(6): 941-945. doi: 10.16835/j.cnki.1000-9817.2022.06.034HOU X J, JIANG X W, SUN Y W. Evaluation on professional competencies and development of teachers for health in primary and secondary schools in Shanghai[J]. Chin J Sch Health, 2022, 43(6): 941-945. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.06.034 [9] 陈静仪, 张赛, 陈焕, 等. 广州市多渠道配置模式后公立中小学校医队伍建设现状[J]. 中国学校卫生, 2019, 40(2): 276-278. doi: 10.16835/j.cnki.1000-9817.2019.02.033CHEN J Y, ZHANG S, CHEN H, et al. A comparative study on the construction of medical teams in public primary and secondary schools after multi-channel distribution mode in Guangzhou[J]. Chin J Sch Health, 2019, 40(2): 276-278. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.02.033 [10] 张圣捷, 周蒙, 龚曦, 等. 中国中小学校医队伍建设现状[J]. 中国学校卫生, 2021, 42(12): 1899-1902. doi: 10.16835/j.cnki.1000-9817.2021.12.034ZHANG S J, ZHOU M, GONG X, et al. Current status of school doctor personnel in primary and secondary schools in China[J]. Chin J Sch Health, 2021, 42(12): 1899-1902. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.12.034 [11] 深圳市人民政府办公厅. 深圳市社区健康服务管理办法解读材料[EB/OL]. (2020-04-01)[2024-04-30]. http://www.sz.gov.cn/cn/xxgk/zfxxgj/zcjd/content/post_7798244.html .General Office of the Shenzhen Municipal People's Government. Interpretation materials of Shenzhen community health service management measures[EB/OL]. (2020-04-01)[2024-04-30].http://www.sz.gov.cn/cn/xxgk/zfxxgj/zcjd/content/post_7798244.html . (in Chinese)[12] 孙力菁, 罗春燕, 张喆, 等. 上海市中小学校卫生保健机构设置情况和人员能力提升需求[J]. 中国学校卫生, 2022, 43(6): 937-940. doi: 10.16835/j.cnki.1000-9817.2022.06.033SUN L J, LUO C Y, ZHANG Z, et al. Investigation on the establishment of health care institutions and the need for personnel capacity improvement in primary and secondary schools in Shanghai[J]. Chin J Sch Health, 2022, 43(6): 937-940. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.06.033 [13] 深圳市卫生健康委员会. 《深圳市社区健康服务机构设置标准》政策解读[EB/OL]. (2021-12-27)[2024-04-30]. http://www.sz.gov.cn/zfgb/zcjd/content/post_9485715.html .Public Hygiene and Health Commission of Shenzhen Municipality. Policy interpretation of the Standard for Establishment of Community Health Service Organizations in Shenzhen Municipality[EB/OL]. (2021-12-27)[2024-04-30].http://www.sz.gov.cn/zfgb/zcjd/content/post_9485715.html . (in Chinese)[14] 夏樾. 面向社区用户的健康档案信息服务系统设计与分析[D]. 南京: 南京邮电大学, 2015.XIA Y. Design and analysis for community oriented health record information service system[D]. Nanjing: Nanjing University of Posts and Telecommunications, 2015. (in Chinese) -
点击查看大图
表(4)
计量
- 文章访问数: 133
- HTML全文浏览量: 64
- PDF下载量: 20
- 被引次数: 0
