健康教育项目对医师有关血脂异常与冠心病防治知识和行为的干预效果

Evaluation of impact of a health education project on knowledge and behavior of prevention and treatment for hyperlipidemia and coronary heart disease in health-care workers in China

目的评价健康教育项目对医师有关血脂异常与冠心病防治知识及行为的干预效果。方法为实施健康教育项目,建立了一个包括20个分中心的教育网络,对项目对象(各级医院医师)进行相关的有针对性的心血管病健康教育培训。通过比较干预人群(两次独立抽样,干预前为1502人,干预后有效调查1512人)干预前后有关血脂异常与冠心病相关知识的认知率的变化来了解干预的效果。同时对非干预人群行抽样调查,设为对照组(1164人),以便分析干预的净效应。结果干预后各级医院医师对血脂异常与冠心病相关知识的认知率均有增加,其中乡村医师增幅最明显,达8.7%～40.2%;对成人血脂正常范围的认知,各级医师增加了16.1%～48.0%;对于冠心病患者血脂控制目标水平的认知,各级医师增加了26.4%～42.4%;运用膳食治疗方法来降低血脂水平的医师增加了18.2%;对单纯高胆固醇血症的患者给予他汀类药物治疗的地市级医师增加了49.6%,乡村医师增加了47.4%;工作中对非心血管病患者测血脂的比例增幅不足15.0%。结论通过干预,各级医院医师有关血脂异常和冠心病的防治知识有了明显提高,但其医疗行为改善不理想,在今后的健康教育项目实施中应予重视。

Objective To evaluate the impact of Cardiovascular Health Education Project on knowledge, attitude and behavior (KAB) in health-care workers (HCW) of China in prevention and treatment for hyperlipidemia and coronary heart disease (CHD).Methods A training network, including 20 local centers, was established for implementation of the health education project. Health education on prevention and treatment for cardiovascular diseases was provided for all the participants of the project. Two separate study samples were drawn from the target population trained in the network before (1 502 participants) and after (1 512 participants) training, including primary-care, secondary-care and tertiary-care HCW at provincial, prefecture, county, and township hospitals and clinics.A control group outside the network without intervention (1 164 participants) was also set up for estimation of the net effect of the Projrct. Their KAB were investigated for all the three groups.Results Awareness of knowledge in prevention and treatment for hyperlipidemia and CHD increased significantly in HCW at all levels by ~8.7%~40.2%, particularly in HCW at village level. In terms of diagnostic criteria for hyperlipidemia in adults, awareness increased by 16.1%~48.0% in HCW at all levels, as compared with that before intervention. With respect to the control level of blood lipid in patients with CHD, awareness also increased by 26.4%~42.4% in HCW at all levels.With respect to behavior of HCW, number of HCW who could use dietary modification to lower their blood lipid for patients with CHD increased by 18.2%.And, number of HCW who could prescribe statin for the patients with isolated hypercholesterolemia increased by 49.6% at prefecture and county levels and by 47.4% at village level.But, number of HCW who could measure blood lipid level for non-cardiovascular patients increased by less than 15.0%. Conclusions Level of knowledge in prevention and treatment for hyperlipidemia and CHD in HCW at varied levels could be obviously improved by health education based on the Project, especially in tertiary-care HCW, but little was achieved in their behavioral changes. So, it is necessary to pay more attention to them in the implementation of health education project.