上海市闵行区中小学生近视防控综合干预措施探索

Exploring Comprehensive Intervention Measures for Prevention and Control of Myopia among Primary and Middle School Students in Minhang District,Shanghai

目的通过对上海市闵行区136所中小学校147名保健老师、370名三四年级学生家长和13名社区卫生服务中心眼防工作者进行调查,了解近视防控(简称防近)现状,为政策制定提供理论依据。方法采样自制问卷调查和定性访谈,具体内容涉及学校防近工作开展情况、家长对防近工作满意度和健康教育需求、社区卫生服务中心对防近的支持和落实情况。结果闵行区中小学校的防近奖惩机制不完善,桌椅合适度偏低,保健老师防近知识缺乏,48.50%的学校对读写姿势有检查和要求;学生在家使用手机、ipad的频率较高,家长对近视高危因素的知识比较匮乏,专家讲座、活动咨询和屈光发育档案复诊干预未能满足需求;社区卫生服务中心购买仪器设备审批流程长、数据录入工作量大、拨款少和医院复诊没有优惠政策等使得防近工作完成的真实性和准确性难以保证。结论卫生部门提供技术支持和指导,学校提供场地和具体实施工作,简化工作流程,让家长配合做好近视防治工作,三方共同协作是开展防近工作切实可行的措施。

OBJECTIVE Through the investigation of 147 health care teachers, 370 third - and fourth-grade students and 13 communityhealth service center eye-protection workers in Minhang District, it could understand the current situation of myopia prevention and providea theoretical basis for myopia prevention. METHODS Self-made questionnaires and qualitative interviews. The content involved the treatmentof myopia in schools, the satisfaction of parents in prevention and treatment of myopia, the need for health education, and the supportand implementation of prevention and treatment of myopia by community health service centers. RESULTS The reward and punishmentmechanism for prevention and treatment of myopia in primary and secondary schools in Minhang District were imperfect, the suitability oftables and chairs is low, and the health teachers lack knowledge of prevention and treatment of myopia. 48.50% schools had the examinationand requirements for reading and writing postures. The frequency of students’using ipad and mobile phones at home is high. There is a lackof knowledge about the prevention and treatment of high-risk factors in myopia. Expert lectures, activity consultations, and refractive developmentfiles review interventions did not meet the needs.The community health service center had long process for purchasing instrumentsand equipment. The data entry and return work had a large amount of work and there was no preferential policy for hospital review, so theauthenticity and accuracy of the work are difficult to guarantee. CONCLUSION The health department provides technical support and guidance.The school provides venues and specific implementation work. Simplify the work flow so that parents could cooperate in the preventionand control of myopia. The three parties needed work together to implement practical measures for prevention and treatment of myopia.