北京市某区级医疗机构医护人员丙型病毒性肝炎防治知识现况

Current status of hepatitis C knowledge among medical staff in a district hospital in Beijing

目的了解北京市某区级医疗机构医护人员丙型病毒性肝炎(简称丙肝)相关知识知晓情况及培训效果。方法培训前对北京市某区级医疗机构医护人员进行丙肝知识问卷调查,内容包括人口学信息,丙肝基本知识、诊断、治疗和防护措施知识,并采用单因素和多因素Logistic回归方法对培训前有关丙肝诊断标准和治疗方案这两个核心知识正确率的影响因素进行分析。培训后再次开展问卷调查,采用χ^(2)检验比较培训前后丙肝防治及诊断治疗与防护知识正确率的差异。结果培训前发出并收回有效调查问卷220份,对HCV采取100℃高温5分钟可灭活、丙肝是可以临床治愈的、治疗丙肝的抗病毒药物已经纳入国家医疗保险目录的正确回答率,分别为33.2%、66.4%、62.3%;丙肝病例的诊断标准、丙肝的治疗方案、标准预防原则和暴露HCV后可检测HCV-RNA的时间等问题的正确率分别为28.2%、23.2%、41.8%和28.6%。将培训前的“丙肝病例的诊断标准”和“丙肝的标准治疗方案”回答正确情况作为因变量,调整其他影响因素后两个核心知识答题结果显示:≥40岁(与≤30岁年龄组相比)、本科及以上(与文化程度为大专及以下相比)、副高及以上职称(与初级职称相比)、工作6~10年及≥11年(与工作年限≤5年相比)回答正确概率更高。非感染科医护人员(与感染科相比)回答正确概率更低。培训后发出及回收有效问卷181份,丙肝整体相关知识回答正确率较培训前有所提高。但丙肝病例的诊断标准、丙肝的治疗方案两个核心知识的回答正确率仅为58.6%和54.7%,虽较培训前有所提高,差异有统计学意义,但正确率均未超过60%。结论北京市某区级医疗机构医护人员对于丙肝防治相关知识的知晓水平不高,尤其是诊断治疗与防护措施知识方面认知水平整体不高,应进一步针对性地加强对医护人员的培训力度,提高丙肝诊疗与防治知识水平。

Objective To evaluate hepatitis C related knowledge awareness before training and the training effectiveness among medical staff in a district-level hospital.Methods The medical staff in a district-level hospital were investigated by a questionnaire of hepatitis C related knowledge before training.The content of the questionnaires included demographic information,basic knowledge of hepatitis C,and knowledge of diagnosis,treatment,and protective measures.Univariate and multivariate Logistic regression methods were used to analyze the factors affecting the accuracy of the knowledge awareness of diagnostic criteria and treatment plan for hepatitis C before training.After the training,a questionnaire survey was conducted,and a chi-square test was used to compare the the knowledge of prevention and treatment,diagnosis,and protection of hepatitis C before and after the training.Results A total of 220 questionnaires were received before the training.In terms of basic knowledge of hepatitis C,correct rate of"HCV can be inactivated by taking a high temperature of 100°C for 5 minutes","hepatitis C can be clinically cured,"and"antiviral drugs for hepatitis C have been included in the national medical insurance catalog"were 33.2%,66.4%,and 62.3%before training.In the knowledge of hepatitis C diagnosis,treatment,and preventive measures,correct rate of the diagnostic criteria of hepatitis C cases,the standard treatment plan of hepatitis C,the standard precautionary principle and the time when HCV-RNA can be detected after exposure to HCV were 28.2%,23.2%,41.8%and 28.6%before training.For the two items of"diagnostic criteria for hepatitis C cases"and"standard treatment plan for hepatitis C cases",aged 40 or above(compared with aged 30 or below),bachelor degree or above(compared with a college education or below),deputy senior and above titles(compared with group junior titles)and working 6-10 years and≥11 years(compared with≤5 years)had a higher probability of being right.The probability of correct answers was lower in the staffs from noninfectious departments(compared with the infectious departments).After the training,181 valid questionnaires were sent out and collected,and the correct rate of hepatitis C related knowledge was improved compared to before the training.However,the correct answers to the two core knowledge of diagnostic criteria and treatment were only 58.6%and 54.7%,which were higher than before the training(P<0.05),but still less than 60%.Conclusions The level of awareness of the knowledge of hepatitis C prevention and treatment among medical staff in this medical institution is not high,especially in terms of diagnostic standards,treatment,and protective measures.The training of clinical medical staff should be further strengthened to improve the knowledge and professional level of hepatitis C diagnosis,treatment,and prevention.