基于结构方程模型的基层医务人员标准预防行为影响因素

Influencing factors for standard precautions behaviors of primary health care workers based on structural equation model

  • 摘要:
    目的 了解基层医务人员标准预防知识、行为现状及其影响因素, 为提高基层医务人员标准预防行为提供参考依据。
    方法 选取洛阳市某区1 320名基层医务人员为研究对象,于2024年12月采用自行设计标准预防知识问卷、行为量表、健康信念模型量表进行横断面调查,对调查数据进行统计描述、信效度检验以及结构方程模型拟合。
    结果 共回收有效问卷1 205份(1 205/1 320, 91.29%)。基层医务人员中45.64%掌握标准预防知识,62.99%能够落实标准预防行为。不同性别、年龄者标准预防知识得分不同(P < 0.05);不同性别、职称、工作地区和单位性质标准预防行为得分不同(P < 0.05)。将知信行理论及健康信念模型结合后,医务人员在标准预防实施过程中,知识、感知严重性、行为益处、行为障碍、行动线索和自我效能对标准预防行为可产生直接影响,直接效应值为:0.054、0.112、0.276、-0.062、0.223和0.213。
    结论 基层医务人员标准预防知晓率及行为落实程度较低,通过设计合理的培训方案, 提升医务人员知识、感知严重性、行为益处、行动线索及自我效能,降低行为障碍,可以有效提高医务人员标准预防行为。

     

    Abstract:
    OBJECTIVE To understand the current status of standard precautions knowledge, behaviors of the primary health care workers and analyze the influencing factors so as to provide bases for improving the standard precaution behaviors of the primary health care workers.
    METHODS A total of 1320 primary health care workers from a district of Luoyang were recruited as the research subjects. In Dec. 2024, a cross-sectional survey was conducted by using self-designed questionnaires on standard precautions knowledge, behavior scales, and Health Belief Model (HBM) scales. The survey data were treated with statistical description, reliability and validity tests and structural equation model (SEM) fitting.
    RESULTS A total of 1205 valid questionnaires were recovered, with an effective recovery rate 91.29% (1205/1320). Among the primary health care workers, 45.64% mastered standard precautions knowledge, and 62.99% could implement standard precautions behaviors. There was significant difference in the score of standard precautions knowledge among the health care workers of different genders and age (P < 0.05); the significant differences in standard precautions behavior scores were observed among the health care workers of different genders, professional titles, work regions, and unit natures (P < 0.05). After the Knowledge-Attitude-Behavior (KAB) theory was integrated with the Health Belief Model, the knowledge, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy had direct impacts on standard precautions behaviors during the implementation process of standard precautions, with direct effect values 0.054, 0.112, 0.276, -0.062, 0.223 and 0.213, respectively.
    CONCLUSIONS The awareness rate of standard precautions and the implementation level of related behaviors are relatively low among the primary health care workers. The standard precautions behaviors can be remarkable improved by designing reasonable training programs to improve medical staff′s knowledge, perceived severity, perceived benefits, cues to action and self-efficacy, while by reducing perceived barriers.

     

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