上海市奉贤区老年护理机构护工传染病防控素养干预效果分析

Analysis of intervention effect on health literacy specific to infectious diseases prevention among nursing assistants in elderly nursing homes in Fengxian district of Shanghai

目的调查和评估奉贤区老年护理机构护工传染病防控水平干预措施效果。方法于2015-2017年连续3年对奉贤区18家老年护理机构护工进行传染病防控素养培训和精细化管理干预。干预结果与基线调查水平比较,描述传染病防控知识和理念知晓率、健康防控素养平均得分及水平等相关指标动态变化,从而评估干预效果。结果 2015-2017年奉贤区老年护理机构护工人群结构无明显变化,仍以60岁以上(2017年:占72.35%)及小学文化程度以下(2017年:占66.96%)人群为主。经过3年连续干预,奉贤区18家老年护理机构的护工传染病防控素养水平显著提升,较2015年初基线水平分别提高27.80%、76.53%和123.11%,传染病健康素养平均得分(中位数)从基线水平的55分提高到2017年的72分。老年护理机构护工不同群体传染病防控素养水平均有所提升,但60岁及以上者(2017年:24.27%～53.14%)和小学及以下文化程度者健康素养水平(2017年:21.58%～49.37%)相对较低,对以老龄及低文化程度为特点的护工群体而言,其传染病素养水平整体提升受到一定制约。结论传染病防控相关培训和院内精细化管理是提升护工传染病防控素养的有效措施。同时,严把护工招聘关也是提升护工队伍综合素质的关键。

Objective To study intervention effects on the health literacy specific to the infectious disease among nursing assistants in elderly nursing homes in Fengxian district in Shanghai. Methods Continuous interventions were carried out from 2015 to 2017 among nursing assistants in eighteen elderly nursing homes in Fengxian, and following investigations were conducted on changes of indicators like awareness rate, health literacy scores and levels as compared with the baseline, to assess the effect of the interventions. Results From early 2015 to 2017, the demographic features of the nursing assistants in Fengxian elderly nursing homes were basically similar. 72.35% of nursing assistants were 60 years old and above, and 66.96% of them were at or below elementary school education level in 2017. Through continuous interventions of three years, the nursing assistant health literacy related to infectious diseases control and prevention in eighteen elderly nursing homes in Fengxian significantly was improved. As compared with basis level of early 2015,it was increased year by year by 27.80%, 76.53% and 123.11%, respectively, and the median of the health literacy score raised from 55 points of basis up to 72 points. Basically, the health literacy of different groups of nursing assistants has been improved. However, the groups above 60 years old( 2017 : 24.27%~53.14%),or under elementary school education level(2017 : 21.58%~49.37% were still relatively low,which negatively affected the overall improvement of their health literacy.Conclusion Training, health education and delicacy management of nursing assistants are effective measures for improving their infectious disease related health literacy. And stringent recruitment of nursing assistants is also a key point.