运用健康信念模式分析流动人口结核病预防行为和就医意向的影响因素

摘要

Objective This study aims to explore the TB preventive behavior and intention of medical treatment among floating population and to analyze the influencing factors based on health belief model,and so as to provide the recommendations to improve the TB health behavior of floating population.Methods 1154 migrants were selected between the ages of 18-50 in six cities/areas of 3 provinces,using convenient sampling method.The survey was conducted by one-onone inquiry with unified questionnaire,and analyzed by x2 test and logistic regression.Results 59.4％ of the subjects chose "cover your nose and mouth when coughing or sneezing",and 57.8％ chose "evade or cover your nose and mouth when others cough or sneeze in front of you".While people selected "seek medical treatment when continuous cough and expectoration more than two weeks "accounted for 90.8％.Using health beliefs mode analysis showed that,tuberculosis knowledge have positive effects to behavior of covering own nose and mouth when coughing or sneezing (OR =1.129,P ＜0.01,95％ CI:1.040-1.224),and the perception of the seriousness of this disease have positive impact to evade behavior when others cough or sneeze (OR =1.075,P ＜ 0.01,95％ CI:0.999-1.156).Perceived health behaviors benefits have a positive role in TB preventive behavior (OR =1.390,1.252,P ＜0.01).Tuberculosis knowledge,perceived behavioral benefits,and awareness of the policy has a positive effect on intention of medical treatment (OR =1.168,1.388,1.233,P ＜ 0.01).Conclusion The health belief model could analysis and interpretation the factors influenced TB preventive behavior and medical intention of floating population in some way.%目的 了解流动人口有关结核病预防行为和就医意向的情况,探讨健康信念模式在分析预防行为和就医意向影响因素中的作用,为提高流动人口结核病相关健康行为提供建议.方法 采用方便抽样的方法,在3省6市18 ～50岁的1154名流动人口中进行一对一询问式调查.采用x2检验和Logistic回归进行数据分析.结果 流动人口中,59.4％自己咳嗽、打喷嚏时会捂住口鼻,57.8％在他人咳嗽、打喷嚏会回避或遮掩口鼻,90.8％会在连续咳嗽、咳痰2周以上主动就医.运用健康信念模式分析显示,肺结核知识对自己咳嗽时遮掩口鼻的行为具有正向作用(OR=1.129,P＜0.01,95％CI:1.040 ～ 1.224),而感知到疾病的严重性对他人咳嗽时遮掩口鼻的行为有正向作用(OR=1.075,P＜0.01,95％CI:0.999～1.156),感知到健康行为的益处对以上两种行为均有正向作用(OR值分别为1.390和1.252,P＜0.01).具有肺结核知识,感知到行为的益处,对政策的认知都对主动就医行为意向有正向作用(OR值分别为1.168、1.388和1.233,P＜O.01).结论 通过健康信念模式可以在一定程度上分析和解释影响流动人口结核病预防行为和就医意向的因素.