上海市部分社区卫生服务机构健康教育现况调查

Health education in community health-care service in Shanghai

目的了解上海社区卫生服务机构健康教育现况，探讨我国城市社区的健康教育模式。方法对5个社区卫生服务中心的200名卫生服务人员进行健康教育知识问卷调查。结果96.5％（193／200）受调查者认同健康教育的重要意义，98.0％（196／200）能进行健康宣教；仅60.5％（121／200）接受过正规的培训课程，85.5％（171／200）认为仍需接受定期培训；对问卷中健康教育认知情况、健康生活方式及常见慢性病健康教育知识3项内容的回答正确率，分别为94.0％（752／800）、47.0％（1046／2200）和33.6％（806／2400）；不同年龄、社区正确率差异有统计学意义（X^2=17.663和82.376，P〈0.001和0.000）；不同性别、职称差异无统计学意义（X^2=0.015和2.406，均P〉0.05）；开展健康教育的主要影响因素为诊病时间不足（48.5％）、患者依从性差（33.0％）和缺乏相关知识（15.0％）。结论社区医务人员已认识健康教育的重要性，但对理论知识和技能掌握不够。应建立社区卫生服务人员健康教育干预指南，健全行政督导、考核和奖惩机制，促进健康教育工作的开展。

Objective To study current status of health education and explore its pattern in community health-care service （CHS） in Shanghai. Methods A total of 200 health-care workers （HCWs） from five CHS centers in Shanghai were investigated by questionnaire of health education knowledge. Results Among 200 HCWs investigated, 96.5% （193/200） of them have recognized importance of health education, 98.0% （196/200） could undertake health education in their clinical work, only 60.5% （121/ 200） had received regular training on it, and 85. 5% （171/200） thought they should be further trained regularly. Correct awareness of knowledge was 94.0% , 47.0% and 33.6% for health education perception, healthy life-style and health education knowledge for chronic disease, respectively in them. There was very significant difference in correct awareness of knowledge between HCWs with varied ages and districts（X^2=17.663 and 82.376, P=0.001 and 0.000, respectively）, but no significant difference was found between men and women and those with varied professional titles （X^2 = 0. 015 and 2. 406, P = 0. 903 and 0. 300, respectively）. Short of time （48.5%）, lack of relevant knowledge （15.0%） in HCWs and poor compliance of patients （ 33.0% ） were main factors influencing their implementation of health education. Conclusions HCWs in CHS have already recognized importance of health education, but have not known enough its theoretical knowledge and skills. It is necessary to set guidelines of health education intervention for HCWs in CHS, and perfect monitoring and evaluation, as well as mechanism for rewards and penalties to promote development of health education in CHS.