乡村医生健康管理认知及需求意愿与行为研究分析

Analysis of village doctors＇knowledge rate,demand and behavior of health management

目的：了解乡医健康管理相关知识及需求意愿与行为，为开展乡村社区健康自我管理提供科学依据。方法采用自行设计调查问卷，在广州辖区两个县级市随机抽取8个乡镇的106个村卫生室的106名乡医进行调查。结果乡医平均年龄（50．91±7．84）岁，最高学历为医学中专占36．79％。健康管理知晓率平均为30．09％，三个年龄段比较，差异有统计学意义（χ^2＝137．185，P ＝0．000），以35～44岁知晓率最高为52．61％；不同文化程度中中专学历知晓率最高为47．44％，差异有统计学意义（χ^2＝112．900，P ＝0．000）。健康管理知识需求：仅2．83％和3．77％认为具备的健康管理技能“完全能”和“能”满足目前工作需要，18．87％和25．47％认为培训对社区健康管理工作“很有”和“有”意义；尽管有63．21％希望获得培训，但主要原因是基于上级的要求，有16．98％近1年内未接受相关培训，其主要原因是认为没有必要和没有时间，有11．32％表示愿意为培训支付费用，但97．17％从未自费参加过相关的培训，平时经常自学健康管理知识的有27．36％。结论乡医群体年龄明显偏大、学历较低，应具备的健康管理等方面的专业知识明显不足，主观积极性不高，客观缺乏激励和约束。建议政府加强和重视山区农村卫生室健康管理工作，改善人员结构、工作待遇和发展前途，以保障乡医为基层提供有效的健康管理服务。

Objective To survey village doctors＇knowledge,demand and behavior of health management,to provide scientific evidence for village people＇s health self-management.Methods Prepared a self-designed question-naire and make it completed by 106 village doctors chosen at random from 106 different villages in the eight towns in Guangzhou＇s two mountainous districts.Results The average age of the village doctors was（50.9 1 ±7.84）years,36.79% of them had the ultimate diploma of a health technical school,and the average knowledge rate of health man-agement was 30.09%.There was remarkable difference among the 3 age groups which disclosed statistic value（χ^2 =112.900,P =0.000）.The 35-44 age group was the highest in the knowledge rate of health management （52.61%）. The doctors with a ultimate technical diploma vary in the knowledge rate （the highest was 47.44%）,which also had statistic value（χ^2 =112.900,P =0.000）.Only 2.83% of the village doctors believed that their health management skill can ＂completely meet＂the current demand and 3.77% ＂can＂.18.87% believed that training about health management was ＂very meaningful＂and 25.47% ＂meaningful＂.63.21% （most required by the health bureau） expected to receive training.16.98% didn＇t receive such training in the recent year because they thought it was un-necessary or not available.11.32% of the village doctors were willing to pay for the health management training,while 97.17% had never taken such training on their own expenses.Conclusion Village doctors are mostly elderly,low-educated,and insufficient in the professional knowledge of health management.Without the corresponding motivations and regulations,they are not enthusiastic about the training.It is suggested that the local authorities pay more attention to the buildup of the village health stations and improve the structure,knowledge,and earning of the village doctor group so as to ensure the effective health management service for the masses in villages.