某乡镇家族性高胆固醇血症患者血脂知信行及其相关因素调查

A survey of knowledge, attitudes and practices on community familial hypercholesterolemias

目的:了解乡镇居民家族性高胆固醇血症(familial hypercholesterolemia,FH)患者的血脂相关知识、态度和行为现状并分析其相关因素,为开展健康促进提供依据。方法:采用整群抽样方法,对2012年云南省玉溪市红塔区4个乡镇在公共卫生服务均等化项目中检出的血清总胆固醇≥7.8 mmol/L的FH患者为先证者,并对直系亲属进行筛查,最终共纳入151例FH患者进行血脂知信行调查。结果:该人群血脂相关知识普遍缺乏,有86.09%的人不了解血脂异常相关知识;血脂控制态度不积极,有79.47%的人不知道自己的血脂水平;调脂行为不足,有63.58%的人没有采取措施控制血脂。女性人口、农村居民、丧偶者、老年人、低文化程度和低收入群体知识、态度、行为问卷得分较低(均P <0.05)。多因素分析表明,年龄(β=-0.243,R^2=0.207,P=0.014)与文化程度(β=3.514,R^2=0.267,P <0.001)是影响知识得分的主要因素;性别(β=-1.316,R^2=0.022,P=0.014)与年龄(β=-0.121,R^2=0.146,P <0.001)是影响态度得分的主要因素;文化程度(β=1.489,R^2=0.158,P <0.001)与医疗保险(β=-1.788,R^2=0.126,P <0.001)是影响行为得分的主要因素。相关分析发现,调查人群的知识分别与态度和行为呈正相关(rs=0.255,P=0.002;rs=0.624,P <0.001)。结论:玉溪市乡镇居民家族性高胆固醇血症患者血脂相关知识较为缺乏,血脂控制态度不良、调脂行为不足。态度与行为不足与知识的缺乏有关。应针对FH人群加强高胆固醇异常的控制及健康教育和健康促进。

Objective:To explore knowledge,attitudes,practices(KAP)and related factors on township residents with familial hypercholesterolemia(FH)and to provide evidence for health education program.Methods:Subjects of hypercholesterolemias who received equal public health services with total cholesterol(TC)≥7.8 mmol/L were screened by cluster sampling from 4 townships in Hongta District of Yuxi,Yuannan in 2012.A total of 15l FH subjects who met diagnostic criteria were investigated by a standard questionnaire.The KAP status was described and multiple linear regression analysis was used to identify factors associated with KAP of hyperlipoidemia.Results:The knowledge,attitudes and practices of hyperlipoidemia in investigated residents were unsatisfactory.In our study,investigated residents who lacked hyperlipoidemia-related knowledge,ignored their cholesterol problems and took no steps to lower their lipid levels accounted for 86.09%,79.47%and 63.58%of all subjects respectively.Females,rural residents,widows and widowers,the elderly,and people with lower incomes and less education showed lower KAP scores(all P<0.05).Age(β=-0.243,R2=0.207,P=0.014)and education(β=3.514,R2=0.267,P<0.001)were two major factors that affected the score of knowledge.Gender(β=?1.316,R2=0.022,P=0.014)and age(β=?0.121,R2=0.146,P<0.001)were factors that mainly affected the score of attitudes.Education level(β=1.489,R2=0.158,P<0.001)and medical insurance(β=?1.788,R2=0.126,P<0.001)were factors that largely affected the score of practice.Our study demonstrated that investigated residents’scores for hyperlipoidemia-related knowledge were positively correlated with their attitudes(rs=0.255,P=0.002)and practices(rs=0.624,P<0.001)respectively.Conclusion:The status of knowledge,attitudes and practices of subjects with FH is poor.The unsatisfactory attitudes and practices scores are associated with the lack of health knowledge.It is necessary to step up the control of hypercholesterolemia,raise the awareness of hypercholesterolemia and promote public health.