上海郊区某镇大肠癌高危人群结肠镜检查知信行状况及影响因素研究

Knowledge,Attitude and Practice of Colonoscopy among Population at High Risk of Colorectal Cancer in a Town,a Suburb of Shanghai

目的:了解大肠癌高危人群对结肠镜检查认知、态度、行为现状,分析其影响因素,为高危人群结肠镜检查顺应性的改善提供工作依据。方法:于2019年1月~2019年3月,采用整群随机抽样的方法,从上海市闵行区华漕镇抽取300例大肠癌高危者作为调查对象,统计对象的性别、年龄、文化程度、医保状况、腺瘤性息肉及大肠癌家族史、高脂低纤饮食史、结肠镜健康教育史、结肠镜检查史、家庭医生签约史,运用自制问卷调查研究对象的结肠镜检查知信行状况,对获得数据进行Logistic回归分析。结果:调查对象的结肠镜检查知识知晓率、态度积极率、行为执行率分别为47. 00%、24. 33%、23. 33%;知、信、行得分分别为18. 94±2. 76、16. 39±3. 60、14. 89±4. 85。影响因素分析显示,调查对象的检查态度与其文化程度、高脂低纤饮食史、健康教育史、结肠镜检查史密切相关(均P <0. 05);检查行为与其高脂低纤饮食史、结肠镜检查史、家庭医生签约史、检查态度得分状况密切相关(均P <0. 05)。结论:大肠癌高危人群的结肠镜检查知信行状况仍有待改善,建议重点加强对文化程度偏低、有高脂低纤饮食史、无结肠镜检查经验者的检查行为的干预,引导其与家庭医生签约;以契约服务的形式定期开展宣教,提高其结肠镜检查知晓率;加强饮食等生活方式的干预,促进其自我检查意愿的提升,以提高结肠镜检查的顺应性。

Objective: To investigate knowledge,attitude and practice of colonoscopy in the population at high risk of colorectal cancer in a town,a suburb of Shanghai,so as to provide experience for improving the acceptance of colonoscopy among high-risk population. Methods: Cluster random sampling was adopted to enroll 300 people at high risk of colorectal cancer from Huacao town,a suburb of Shanghai from January 2019 to March 2019. All subjects’ gender,age,educational background,health insurance status,family history of adenomatous polyps and colorectal cancer,history of high-fat,low-fiber diets,history of colonoscopy-related health education,history of colonoscopy,history of contracts with family doctors were recorded. Knowledge,attitude and practice regarding colonoscopy among the subjects were assessed by using a self-made questionnaire. Data were analyzed by logistic regression. Results:47. 00%(141 cases) of the respondents have a good knowledge of colonoscopy;24. 33%(73 cases) of the respondents have a positive attitude towards colonoscopy;and 23. 33%(70 cases) of the respondents were examined by colonoscopy.The scores in knowledge,attitude and practice were 18. 94 ± 2. 76,16. 39 ± 3. 60 and 14. 89 ± 4. 85,respectively. The attitude of respondents was closely related to education background,history of high-fat,low-fiber diets,history of colonoscopyrelated health education and history of colonoscopy(P < 0. 05);while the behavior of respondents was closely related to history of high-fat,low-fiber diets,history of colonoscopy,history of contracts with family doctors and attitude towards colonoscopy(P < 0. 05). Conclusion: Knowledge,attitude and practice of colonoscopy in the population at high risk of colorectal cancer remain to be improved. We should improve the acceptance of colonoscopy among those with lower education level,a high-fat,low-fiber diet and no experience of colonoscopy,and encourage them to sign contracts with family doctors to receive regular education and other contractual services in order to increase their knowledge of colonoscopy. It is also effective to improve the intervention in lifestyle such as diet,so as to improve the acceptance of colonoscopy.