社区医务人员营养培训与其干预意识及行为的关联研究

A Study on Association of Nutrition Training and Nutrition Intervention Consciousness,Intervention Behaviors among Community Medical Staff in Hangzhou City

目的了解社区医务人员的膳食营养培训情况,以及培训是否与社区诊疗过程中增进的营养干预意识及行为相关联。方法选取杭州市下城区、拱墅区、西湖区的846名社区医务人员,采用问卷调查了解医务人员膳食营养技能培训情况、营养干预意识及干预行为等。应用Logistic回归分析影响技能培训的因素,采用Cochran-Mantel-Haenszel检验探索营养培训、营养干预意识、干预行为之间的关系。结果社区医务人员以女性为主,占78.49%。接受过膳食营养技能培训的医务人员占78.95%。工作时间是影响医务人员接受营养培训的主要因素。营养培训与营养咨询准备之间存在趋势性关联,随着培训的增加,营养咨询准备的自我评价越高(P<0.05)。同时,营养培训也与增加的营养干预意识及行为相关联。随着培训种类的增加,医务人员对不健康饮食风险、接诊时常规询问患者的饮食习惯、建议患者给自己孩子树立健康饮食榜样3方面认识态度认识均有显著提高(P<0.05)。营养培训的增加也同时增进了医务人员的营养干预行为,接受营养培训较多的医务人员,会为更多的社区就诊患者进行血压、体重、血胆固醇的测量,与患者交流平衡膳食、合理营养重要性以及给予肥胖患者减重建议(P<0.05)。结论应进一步加强对社区医务人员的营养知识与干预技能培训,不断提升以社区为基础的慢性病综合干预措施效果。

Objective To know the status of nutrition education of community medical staff and analyze its association with nutrition intervention consciousness and behaviors. Methods Three representative districts including Xiacheng,Gongshu and Westlake were selected and 846 community medical staff was involved in this study. Questionnaire investigation was applied to collect the information from mainly three aspects including training,consciousness and practice. Logistic stepwise regression analysis and Cochran- Mantel- Haenszel test were used. Results Most of the community medical staff was female（ 78. 49%）. 78. 95% of the staff had received the training of nutrition knowledge and its main influencing factor was working time. The Association was observed between the nutrition training and the preparation of nutrition consultation. The more training received,the higher self- assessment would be（ P〈0. 05）. Meanwhile,as the types of training increased,the awareness and attitude of medical staff was improved remarkably,such as knowing risks of unhealthy dietary,asking the dietary habit of the patients routinely,and advising patients to establish a good dietary habit to their children（ all P〈0. 05）. Nutrition training also had a positive association with nutrition intervention behavior,such as implementing more measurement of blood pressure, weight, and blood cholesterol for community outpatients, communicating with them in the importance of balanced diet and proper nutrition,and giving weight loss suggestion to obese patients（ all P〈0. 05）. Conclusion Training on nutrition knowledge and intervention skills of community medical staff should be emphasized and reinforced in the future,in order to promote the effect on chronic diseases prevention of community- based intervention strategies.