中国全科医学 ›› 2023, Vol. 26 ›› Issue (34): 4283-4289.DOI: 10.12114/j.issn.1007-9572.2022.0679

• 论著 • 上一篇    下一篇

广东省社区居民脑卒中高危筛查意向的现状及影响因素研究

秦凤银, 张绮珊, 赖锦佳, 黄奕敏, 韩郭茵, 孙兴兰, 王芬, 谭益冰*()   

  1. 510006 广东省广州市,广州中医药大学护理学院
  • 收稿日期:2022-09-20 修回日期:2023-02-20 出版日期:2023-12-05 发布日期:2023-07-13
  • 通讯作者: 谭益冰

  • 作者贡献:秦凤银、谭益冰负责文章的构思与研究的设计;秦凤银、张绮珊、孙兴兰、王芬负责文献检索及整理;秦凤银负责论文的撰写及修订;张绮珊、赖锦佳、黄奕敏、韩郭茵、孙兴兰、王芬负责数据收集;秦凤银、张绮珊负责数据整理、统计学处理;秦凤银、孙兴兰、王芬负责结果的分析与解释;谭益冰对文章整体负责,监督管理。
  • 基金资助:
    广东省医学科研基金项目(A2022289); 广东省中医药科研项目(20221127)

Current Status and Influencing Factors of the Intention to Screen for High-risk Stroke among Community Residents in Guangdong

QIN Fengyin, ZHANG Qishan, LAI Jinjia, HUANG Yimin, HAN Guoyin, SUN Xinglan, WANG Fen, TAN Yibing*()   

  1. School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
  • Received:2022-09-20 Revised:2023-02-20 Published:2023-12-05 Online:2023-07-13
  • Contact: TAN Yibing

摘要: 背景 脑卒中高危人群筛查项目是我国正大力推广的国民健康工程,但在实际工作中发现居民对其的参与率较低,严重影响了筛查效能。筛查意向是筛查行为的重要预测因素,但关于居民脑卒中高危筛查意向现状及其影响因素的研究却较少。 目的 了解社区居民脑卒中高危筛查意向现状,探索影响居民脑卒中高危筛查意向的因素。 方法 于2022年3—5月,便利抽取广东省居民648名作为调查对象,采用自设问卷(包括一般资料调查表、脑卒中高危筛查意向量表、脑卒中健康知识量表、社区医疗服务信任度量表、领悟社会支持量表)对其进行调查。比较不同特征居民脑卒中高危筛查意向量表得分,采用多元线性回归分析影响居民脑卒中高危筛查意向的因素。 结果 共回收有效问卷600份,问卷有效回收率为92.6%。居民脑卒中高危筛查意向量表平均总得分为(101.30±14.98)分,其中352名(58.7%)居民筛查意向处于较高水平,248名(41.3%)居民筛查意向处于中等或较低水平。性别、居住状态、高血压患病情况、高脂血症患病情况、吸烟情况、脑卒中高危筛查知晓情况、所在社区既往脑卒中高危筛查开展情况、既往脑卒中高危筛查接受情况、自感终身发生脑卒中风险水平、自感1年内发生脑卒中风险水平不同的居民脑卒中高危筛查意向量表得分比较,差异有统计学意义(P<0.05)。居民脑卒中高危筛查意向量表得分与其脑卒中健康知识量表得分、社区医疗服务信任度量表得分、领悟社会支持量表得分呈线性正相关(P<0.05)。多元线性回归分析结果显示,性别、高血压患病情况、高脂血症患病情况、所在社区既往脑卒中高危筛查开展情况、自感终身发生脑卒中风险水平、领悟社会支持量表得分、社区医疗服务信任度量表得分、脑卒中健康知识量表得分是居民脑卒中高危筛查意向量表得分的影响因素(P<0.05)。 结论 广东省社区居民的脑卒中高危筛查意向整体处于较高水平,但部分居民的筛查意向水平仍有待提高。社区应重点关注筛查意向较弱的男性居民,加强脑卒中健康知识尤其是危险因素的科普宣传,帮助居民科学认识自身脑卒中发生风险和高危筛查的重要性。国家层面应加大对社区卫生服务机构筛查设备和医疗设施的投入力度,重视社区医护人才队伍建设,切实提高社区卫生服务机构的脑卒中高危人群筛查能力,提升居民对社区医疗服务的信任度。同时还应重视社会支持水平对居民脑卒中高危筛查意向水平的正向影响,通过加大社会面宣传力度,营造全民参与筛查的氛围,有效提高居民参与脑卒中高危筛查的意向水平。

关键词: 脑卒中, 高危筛查, 意向, 影响因素分析, 社区卫生服务, 广东

Abstract:

Background

Stroke high-risk population screening project is a national health project being vigorously promoted in China, but it is found that the participation rate of residents in it is low, which seriously affects the screening efficiency. Screening intention is an important predictor of screening behavior, however, there are few studies on the current status and influencing factors of the intention to screen for high-risk stroke among community residents.

Objective

To understand the current status of the intention to screen for high-risk stroke among community residents and explore the influencing factors.

Methods

A total of 648 residents of Guangdong Province were selected as survey respondents by using convenient sampling method from March to May 2022. Self-designed questionnaires (including General Data Questionnaire, Stroke High-Risk Screening Intention Scale, Stroke Health Knowledge Scale, Community Medical Service Trust Scale, Perceived Social Support Scale) were used to investigate the respondents. The scores of Stroke High-Risk Screening Intention Scale among residents with different characteristics were compared, and the factors affecting intention to screen for high-risk stroke among community residents were analyzed by multiple linear regression.

Results

A total of 600 valid questionnaires were collected with the recovery rate of 92.6%. The average total score of the Stroke High-Risk Screening Intention Scale among residents was (101.30±14.98), of which 352 (58.7%) residents had a high level of intention for screening, 248 (41.3%) residents had a middle or low level of intention for screening. There were significant differences in the scores of Stroke High-Risk Screening Intention Scale among residents by gender, residential status, hypertension, hyperlipidemia, smoking status, awareness of high-risk stroke screening, implementation of previous high-risk stroke screening in the community, acceptance of previous high-risk stroke screening, self-perceived lifetime risk of stroke and self-perceived risk of stroke within 1 year (P<0.05). There was a positive correlation of the score of Stroke High-Risk Screening Intention Scale with the scores of Stroke Health Knowledge Scale, Community Medical Service Trust Scale and Perceived Social Support Scale (P<0.05). Multiple linear regression analysis showed that gender, hypertension, hyperlipidemia, community has implemented stroke high-risk screening, self-perceived lifetime risk of stroke, scores of Perceived Social Support Scale, Community Medical Service Trust Scale and Stroke Health Knowledge Scale were influencing factors of intention to screen for high-risk stroke among community residents (P<0.05) .

Conclusion

The overall intention of community residents in Guangdong Province for high-risk stroke screening is high, but the screening intention of some residents still needs to be improved. It is suggested that the community should focus on male residents with low intention of screening, strengthen education of the health knowledge of stroke, especially risk factors, to help residents understand their own risk of stroke and the importance of high-risk screening. The investment in screening equipment and medical facilities in community health service institutions should be increased, the construction of community medical and nursing personnel needs more attention at the national level, so as to enhance the trust of residents in community medical services. Meanwhile, the positive impact of social support on the level of intention to screen for high-risk stroke should also be emphasized, to effectively increase the level of intention of residents to participate in high-risk stroke screening through expanding the publicity at the social level and creating an atmosphere of universal participation in screening.

Key words: Stroke, High-risk screening, Intention, Root cause analysis, Community health services, Guangdong