深圳幼儿园儿童手部卫生依从性及影响因素分析

Status and influence factors of hand hygiene compliance among kindergarten children in Shenzhen city

目的了解深圳市幼儿园儿童手部卫生依从性现状,探讨幼儿园儿童手部卫生行为影响因素。方法采用分层整群随机抽样方法,于2015年4月抽取深圳市南山区和宝安区共18家幼儿园72个班级2 461名儿童的4 449个洗手时刻,观察儿童手部卫生依从性,调查相关环境因素。结果观察4 449个儿童洗手时刻,儿童总体手部卫生依从性为29%;私立幼儿园依从性(48.7%)明显高于公立(30.4%)和流动人口幼儿园(12.9%);市级幼儿园(51.1%)明显高于省级(32.9%)、区级(17.7%)及无级别幼儿园(0.0);小班儿童依从性(38.7%)高于中班(31.8%)和大班(17.0%)。在不同手部卫生时刻中,儿童依从性最高的是吃饭前(52.9%),其次是户外活动(47.4%)、手明显脏时(21.8%)、上厕所后(19.8%),在准备食物前几乎无儿童规范洗手。多因素分析显示,洗手液分配器的数量(OR=1.176,95%CI=1.092~1.268)、教师对儿童的提醒(OR=13.616,95%CI=9.431~19.660)、儿童年龄(OR=5.064,95%CI=3.796~6.575)对儿童手部卫生依从性有显著影响。结论深圳市幼儿园儿童手部卫生依从性普遍不高,有必要针对影响显著的环境因素采取相应的干预措施,改善儿童手部卫生依从性。

Objective To investigate the status and influence factors of hand hygiene compliance （HHC） among kindergarten children in Shenzhen city.Methods Totally 2 461 children were selected from 18 kindergartens in Nanshan and Baoan districts of Shenzhen city with stratified random cluster sampling and 4 449 hand-washing situations of the children were observed and environmental factors associated HHC of the children were also analyzed.Results The overall rate of HHC was 29% among the children.The children in private kindergartens showed an obvious higher rate of HHC （48.7%） than those in the public kindergartens （30.4%） and the kindergartens for migrant population （12.9%）;the children in kindergartens at municipality level demonstrated an apparent higher rate of HHC （51.1%） than those in kindergatens at province level （32.9%）,district level （17.7%）,and the kindergartens not being assigned an administrative level （0.0%）;the children in a lower glass had a higher HHC rate （38.7%） than those in a middle （31.8%）or an upper glass （17.0%）.Among the children,the highest HHC rate was observed before they having a meal,followed by that after playing outside （47.7%）,when having an obvious dirty hand（21.8%）,after toilet use（19.8%）,and before preparing food （0.0%）.Multivariate analyses revealed that the number of soap dispenser distributed in a kindergarten （odds ratio[OR]=1.176,95% confidence interval[95%CI]：1.092-1.268）,reminders for washing hand from teachers （OR=13.616,95%CI=：9.431-19.660）,and the age of a child （OR=5.064,95%CI=3.796-6.575） were significantly associated with HHC among the children.Conclusion The hand hygiene compliance is generally low among kindergarten children in Shenzhen city and effective intervention measures should be developed to improve hand hygiene compliance in the children.