大庆市城市居民社区健康教育和健康促进效果评价
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摘要
社区卫生服务是卫生服务系统的枢纽和中心环节,是社区建设的重要组成部分,而健康教育是社区卫生服务六位一体功能中的一项重要功能,也是初级卫生保健的首要内容,健康教育是所有卫生问题、预防方法及控制措施中最为重要的教育。大庆市社区卫生服务工作自1997年起步,2000年功能设置趋于完善,至今已建立社区卫生服务中心46个、社区卫生服务站129个,社区覆盖面积达全市社区的96%以上,其中医保定点覆盖率90%,已经初步形成社区卫生服务网络体系,健康教育和健康促进工作开展的越来越丰富多彩,在一定程度上满足了辖区居民的健康需求。但自2002年进行过统计评估后,制定并实施健康教育和健康促进计划,六年来一直未进行过健康教育的效果评价,针对此问题,本研究运用问卷调查法对大庆市的5个居住区居民的患病率、健康相关行为养成和健康知识知晓率情况进行调查分析,了解社区健康教育的开展对居民的健康状况的影响以及2008年社区居民的健康现状,这一系列问题成为本文研究的初衷和切入点。
结果表明,大庆市城市居民通过几年的健康教育和健康促进开展,无论是健康知识知晓率、健康知识获得途径、健康习惯的养成同2002年相比都有明显改善和提高,而慢性非传染性疾病的患病率没有增加,总结出大庆市通过开展社区健康教育和健康促进对城市居民健康影响的效果良好,但是通过对2008年社区居民健康状况和健康相关行为养成等的分析发现也存在着对社区居民健康教育效果不均衡的一面,不同年龄段人群对吸烟、饮酒、血压、饮食和锻炼等方面知识掌握不均衡,不同年龄、不同文化程度、不同职业人群的慢性非传染性疾病的患病率差异较大。
综上所述,明确今后社区健康教育和健康促进的重点是针对重点人群开展专项社区健康教育,重视高年龄组和患病率高的职业,并提出建立有效的健康教育和健康促进机制,开展科学的健康教育与促进方法,通过实施综合的高质量的健教服务,保证健康教育和健康促进的科学高效实施,为确保居民的健康,为国家城市社区卫生服务健康教育和促进提出合理化的建议。
Community health education and health promotion work of community health services " Six aspects take a whole" feature an important component part of the government-led, health administrative departments provide guidance, community health service organizations and the entire population to participate in, and to human health as the center, the family as a unit, the scope of community demand-driven, essential health care services to meet the needs of the residents for the purpose of effective, economical, convenient and continuous community health education and health promotion services. Daqing community health service work started from 1997, in 2002 the community health education and the health promotion function tended to the consummation, has established the community health service center in the whole city 46, community health service station 129, the community covers the area to reach the whole city community above 96%, its Chinese medicine Baoding coverage fraction 90%, already initially formed the community health education and the health promotion service network system, has solved the inhabitant healthy knowledge to a certain extent deficient and the healthy misdeed universal existence reality. In recent years, was following reform and open policy thorough, the people living standard enhancement, health consciousness strengthens, the healthy demand growth, Daqing community health education and health promotion activity development dramatically, but for 6 year concrete effects unknown, pending appraisal. Through appraises the Daqing city people community health education and the health effect, discovers this work existence the question, creates this kind of condition reason, which aspects as well as is this kind of condition concrete manifestation in, the deep level reason any, next step must take any measure to be possible further to improve the work, promotes the inhabitant to the community health service confidence level and the degree of satisfaction, guarantees the community health education the effect and the quality, this a series of questions become the original intention and the breakthrough point which this article studies.
The author utilizes the literature analytic method, in view of the existence question, deepens the concept, the content and the ways and means understanding from the theory stratification plane which promotes to the community health education and the health, grasps characteristic which the domestic and foreign community health education and the health promote, seeks to this research theory instruction. At the same time, carries on the investigation using the questionnaire survey procedure to Daqing's 5 community inhabitant's health basic situation, the attention geographical position, the environment, the inhabitant is different after the Jishui equality, according to the chronic non-communicable disease succeeding in the imperial civil service examinations age, determined the investigation object is above 35 years old, has the official registered permanent address resident (5 years and above), uses extracts 1067 community inhabitants according to the proportion lamination random sampling method for the investigation object. Knows rate the situation, the healthy behavior formation rate situation and several kind of common chronic illness prevalence rate situation three aspects through the questionnaire from the inhabitant healthy knowledge carries on the written investigation, the questionnaire survey result material uses EXCEL2007 to construct the storehouse, uses the SPSS13.0 software to carry on the statistical analysis.Main statistical method for general descriptive statistics and card side examination. Main statistical method for general descriptive statistics and card side examination. At the same time, also carries on the summary, the induction and the analysis directly to some materials.In the investigation process, uses the investigator to unify training, the scene direct questionnaire, the multi-people inputs ways and so on data to conduct the investigation and study separately the quality control.
Survey results show that the Daqing City, community health education and health promotion carried out, effectively improve the health of residents knowledge of the community awareness, reducing risk factors for health behaviors occur, common chronic non-communicable diseases, the prevalence of effective control, over the years to carry out health education and health promotion results are obvious, but there are also health education and health education to the uneven effects of undesirable phenomena, such as different gender groups of hypertension, diabetes, coronary heart disease, stroke and prevalence of hyperlipidemia case there is no difference. Hypertension, diabetes, coronary heart disease and stroke in four kinds of diseases, the prevalence increased with age, while the increased population over the age of 55 have a high prevalence of the disease. The five retirees have a higher prevalence of chronic diseases, culture and education followed by health and cadres. Primary school and below education level of people with hypertension, diabetes and a higher prevalence of stroke. High blood pressure, diabetes, stroke prevalence in the population at public expense is higher. Between the ages of 55 to 65 crowd with high salt, high-salt diet reduced with higher educational level, smoking have a higher rate, higher than 2002, China's urban population smoking rate was 22%, significantly higher than males women, culture, education health and workers in the higher smoking rates, lower secondary and below have a higher rate of smoking among people, the workers drinking was significantly higher than other occupational groups to participate in physical exercise increase with age, showed a growing tendency for leading cadres who engaged in physical activity are more,Different gender groups in smoking, drinking, high blood pressure, blood sugar, blood lipid risk factors, a reasonable diet, physical activity knowledge and scientific knowledge of the situation there was no significant difference in health knowledge awareness rate was more than 80%. 2008 55 years of age of population health knowledge awareness is relatively high. With the improvement of health information literacy awareness rate is correspondingly increased. Public health of people in blood pressure and physical activity knowledge knowledge of the situation is better, both at 93%.
Through the above analysis of the results of the next community health education and promotion of the focus is on key target groups in specific community health education, emphasis on high-age group, low-educated population and a high prevalence of occupational groups, proposed the establishment of effective health education and promotion of mechanisms for carry out health education and promotion of the scientific method, through the implementation of an integrated high-quality health education services to ensure that health education and promotion of the scientific and efficient implementation, to ensure the health of residents, to Daqing City, the state of urban community health education and health services put forward proposals to promote the rationalization.
结果表明,大庆市城市居民通过几年的健康教育和健康促进开展,无论是健康知识知晓率、健康知识获得途径、健康习惯的养成同2002年相比都有明显改善和提高,而慢性非传染性疾病的患病率没有增加,总结出大庆市通过开展社区健康教育和健康促进对城市居民健康影响的效果良好,但是通过对2008年社区居民健康状况和健康相关行为养成等的分析发现也存在着对社区居民健康教育效果不均衡的一面,不同年龄段人群对吸烟、饮酒、血压、饮食和锻炼等方面知识掌握不均衡,不同年龄、不同文化程度、不同职业人群的慢性非传染性疾病的患病率差异较大。
综上所述,明确今后社区健康教育和健康促进的重点是针对重点人群开展专项社区健康教育,重视高年龄组和患病率高的职业,并提出建立有效的健康教育和健康促进机制,开展科学的健康教育与促进方法,通过实施综合的高质量的健教服务,保证健康教育和健康促进的科学高效实施,为确保居民的健康,为国家城市社区卫生服务健康教育和促进提出合理化的建议。
Community health education and health promotion work of community health services " Six aspects take a whole" feature an important component part of the government-led, health administrative departments provide guidance, community health service organizations and the entire population to participate in, and to human health as the center, the family as a unit, the scope of community demand-driven, essential health care services to meet the needs of the residents for the purpose of effective, economical, convenient and continuous community health education and health promotion services. Daqing community health service work started from 1997, in 2002 the community health education and the health promotion function tended to the consummation, has established the community health service center in the whole city 46, community health service station 129, the community covers the area to reach the whole city community above 96%, its Chinese medicine Baoding coverage fraction 90%, already initially formed the community health education and the health promotion service network system, has solved the inhabitant healthy knowledge to a certain extent deficient and the healthy misdeed universal existence reality. In recent years, was following reform and open policy thorough, the people living standard enhancement, health consciousness strengthens, the healthy demand growth, Daqing community health education and health promotion activity development dramatically, but for 6 year concrete effects unknown, pending appraisal. Through appraises the Daqing city people community health education and the health effect, discovers this work existence the question, creates this kind of condition reason, which aspects as well as is this kind of condition concrete manifestation in, the deep level reason any, next step must take any measure to be possible further to improve the work, promotes the inhabitant to the community health service confidence level and the degree of satisfaction, guarantees the community health education the effect and the quality, this a series of questions become the original intention and the breakthrough point which this article studies.
The author utilizes the literature analytic method, in view of the existence question, deepens the concept, the content and the ways and means understanding from the theory stratification plane which promotes to the community health education and the health, grasps characteristic which the domestic and foreign community health education and the health promote, seeks to this research theory instruction. At the same time, carries on the investigation using the questionnaire survey procedure to Daqing's 5 community inhabitant's health basic situation, the attention geographical position, the environment, the inhabitant is different after the Jishui equality, according to the chronic non-communicable disease succeeding in the imperial civil service examinations age, determined the investigation object is above 35 years old, has the official registered permanent address resident (5 years and above), uses extracts 1067 community inhabitants according to the proportion lamination random sampling method for the investigation object. Knows rate the situation, the healthy behavior formation rate situation and several kind of common chronic illness prevalence rate situation three aspects through the questionnaire from the inhabitant healthy knowledge carries on the written investigation, the questionnaire survey result material uses EXCEL2007 to construct the storehouse, uses the SPSS13.0 software to carry on the statistical analysis.Main statistical method for general descriptive statistics and card side examination. Main statistical method for general descriptive statistics and card side examination. At the same time, also carries on the summary, the induction and the analysis directly to some materials.In the investigation process, uses the investigator to unify training, the scene direct questionnaire, the multi-people inputs ways and so on data to conduct the investigation and study separately the quality control.
Survey results show that the Daqing City, community health education and health promotion carried out, effectively improve the health of residents knowledge of the community awareness, reducing risk factors for health behaviors occur, common chronic non-communicable diseases, the prevalence of effective control, over the years to carry out health education and health promotion results are obvious, but there are also health education and health education to the uneven effects of undesirable phenomena, such as different gender groups of hypertension, diabetes, coronary heart disease, stroke and prevalence of hyperlipidemia case there is no difference. Hypertension, diabetes, coronary heart disease and stroke in four kinds of diseases, the prevalence increased with age, while the increased population over the age of 55 have a high prevalence of the disease. The five retirees have a higher prevalence of chronic diseases, culture and education followed by health and cadres. Primary school and below education level of people with hypertension, diabetes and a higher prevalence of stroke. High blood pressure, diabetes, stroke prevalence in the population at public expense is higher. Between the ages of 55 to 65 crowd with high salt, high-salt diet reduced with higher educational level, smoking have a higher rate, higher than 2002, China's urban population smoking rate was 22%, significantly higher than males women, culture, education health and workers in the higher smoking rates, lower secondary and below have a higher rate of smoking among people, the workers drinking was significantly higher than other occupational groups to participate in physical exercise increase with age, showed a growing tendency for leading cadres who engaged in physical activity are more,Different gender groups in smoking, drinking, high blood pressure, blood sugar, blood lipid risk factors, a reasonable diet, physical activity knowledge and scientific knowledge of the situation there was no significant difference in health knowledge awareness rate was more than 80%. 2008 55 years of age of population health knowledge awareness is relatively high. With the improvement of health information literacy awareness rate is correspondingly increased. Public health of people in blood pressure and physical activity knowledge knowledge of the situation is better, both at 93%.
Through the above analysis of the results of the next community health education and promotion of the focus is on key target groups in specific community health education, emphasis on high-age group, low-educated population and a high prevalence of occupational groups, proposed the establishment of effective health education and promotion of mechanisms for carry out health education and promotion of the scientific method, through the implementation of an integrated high-quality health education services to ensure that health education and promotion of the scientific and efficient implementation, to ensure the health of residents, to Daqing City, the state of urban community health education and health services put forward proposals to promote the rationalization.
引文
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