阜阳市8所卫生室健康素养现状及提升建议

辛蒙雨; 童莺歌; 李浩岚; 张静; 王苗玲; 程雯倩; 潘祥; 韩秀美; 朱琳

doi:10.16766/j.cnki.issn.1674-4152.004257

阜阳市8所卫生室健康素养现状及提升建议

doi: 10.16766/j.cnki.issn.1674-4152.004257

1.
杭州师范大学公共卫生与护理学院, 浙江杭州 311121
2.
台州市椒江区海门街道社区卫生服务中心, 浙江台州 318099
3.
蚌埠医科大学第一附属医院肿瘤放疗科, 安徽蚌埠 233004
4.
安徽中医药大学附属太和县中医院风湿科, 安徽阜阳 236600

基金项目:

教育部规划基金项目 23YJAZH136

详细信息

通讯作者:
童莺歌，E-mail: 1352597965@qq.com

中图分类号: R193 R197.6
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- 被引次数: 0
出版历程
- 收稿日期: 2025-02-18
- 网络出版日期: 2026-01-07

Health literacy status and improvement strategies of eight health clinics in Fuyang city

1.
School of Public Health and Nursing, Hangzhou Normal University, Hangzhou, Zhejiang 311121, China

摘要

摘要: 目的了解阜阳市的卫生室健康素养现状并探讨其影响因素，提出提升卫生室健康素养的建议，为基层卫生室开展健康促进与健康教育工作提供参考依据。方法本研究采取便利抽样方法，于2024年5—7月选择阜阳市的8所卫生室作为调查对象，并从这些卫生室中分别选取医务人员和就诊患者，运用基层医疗卫生机构健康素养(PHOHL)测量工具进行问卷调查。采用极差标准化法对PHOHL测量工具一、二级维度进行标准化处理，对各维度得分进行横向比较。结果 8所卫生室的PHOHL总分为144.25~231.41(200.31±35.50)分。PHOHL测量工具分4个维度，其中“健康促进型物质环境”维度得分最高(0.757)，其次是“机构外部合作”维度(0.718)，“员工支持健康促进”(0.631)与“健康促进型管理系统”(0.630)维度得分均较低。社区卫生室PHOHL得分高于村卫生室[(225.04±6.53)分vs. (159.08±15.73)分, t=8.576, P < 0.001]。结论被调查卫生室的健康素养总体水平处于中等，社区及村卫生室的健康素养仍需提高。政府相关部门应注意平衡城乡医疗卫生资源，加强对村卫生室的资源配置，并通过改进管理及提升员工健康素养技能以优化其健康促进职能。
- 健康素养 /
- 健康促进 /
- 现状调查 /
- 卫生室
Abstract: Objective To investigate the current status of health literacy in health clinics in Fuyang city and explore its influencing factors, so as to propose suggestions for improving health literacy and provide a reference for health promotion and education in primary health care settings. Methods A convenience sampling method was adopted to select eight primary health clinics in Fuyang city from May to July 2024. Medical staff and patients from these clinics were surveyed using the primary health care organization health literacy (PHOHL) measurement tool. The range standardization method was applied to normalize the primary and secondary dimensions of the PHOHL tool, allowing horizontal comparisons across dimensions. Results The total PHOHL scores of the eight health clinics ranged from 144.25 to 231.41, with an average score of (200.31±35.50) points. Among the four dimensions of the PHOHL tool, "Health-Promoting Physical Environment" had the highest average score (0.757), followed by "External Collaboration" (0.718), "Staff Support for Health Promotion" (0.631), and "Health-Promoting Management Systems" (0.630). The PHOHL score of community clinics was higher than that of village clinics [(225.04±6.53) points vs. (159.08±15.73) points, t=8.576, P < 0.001]. Conclusion The overall health literacy level of the surveyed clinics is moderate. Health literacy in both community and village clinics needs to be improved. Relevant government departments should strive to balance the allocation of health resources between urban and rural areas, strengthen support for village clinics, and enhance their health promotion capacity through improved management and staff competencies.
- Health literacy /
- Health promotion /
- Cross-sectional survey /
- Health clinics

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表 1 8所卫生室PHOHL总分及各维度得分(分)

Table 1. Total and dimensional scores of PHOHL in eight primary health clinics (points)

机构	机构性质	健康促进型管理系统维度得分	员工支持健康促进维度得分	健康促进型物质环境维度得分	机构外部合作维度得分	总分	排序
A	村卫生室	52.50	44.88	35.05	25.00	157.43	7
B	村卫生室	41.00	49.17	36.07	18.00	144.25	8
C	村卫生室	61.00	46.57	37.01	31.00	175.57	6
D	社区卫生室	81.50	65.82	42.87	25.00	215.19	5
E	社区卫生室	79.50	59.76	51.15	41.00	231.41	1
F	社区卫生室	66.00	69.56	50.55	39.50	225.60	3
G	社区卫生室	70.00	71.22	49.55	39.50	230.27	2
H	社区卫生室	78.00	67.63	49.11	28.00	222.75	4

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表 2 8所卫生室PHOHL测量工具一、二级维度标准化得分(分)

Table 2. Standardized scores of primary and secondary dimensions of the PHOHL tool in eight primary health clinics (points)

一、二级维度	A	B	C	D	E	F	G	H	均数
Ⅰ健康促进型管理系统	0.500	0.390	0.581	0.776	0.757	0.629	0.667	0.743	0.630
Ⅰ1机构文化及管理者职责	0.711	0.474	0.421	0.789	0.789	0.579	0.789	0.789	0.668
Ⅰ2服务流程及规章制度	0.432	0.500	0.682	0.545	0.364	0.500	0.500	0.500	0.503
Ⅰ3机构内部合作网络	0.000	0.000	0.500	1.000	0.500	0.000	0.000	0.500	0.313^a
Ⅰ4物资资源配备	1.000	0.500	1.000	0.500	1.000	1.000	1.000	1.000	0.875^b
Ⅰ5人力资源配备	0.188	0.500	0.500	1.000	1.000	0.813	0.813	0.813	0.703
Ⅰ6质量改进	0.536	0.250	0.250	1.000	1.000	0.857	0.857	0.893	0.705
Ⅱ员工支持健康促进	0.477	0.523	0.495	0.700	0.636	0.740	0.758	0.720	0.631
Ⅱ1口头沟通	0.609	0.527	0.592	0.702	0.685	0.780	0.757	0.696	0.669
Ⅱ2书面沟通	0.459	0.300	0.480	0.394	0.333	0.724	0.740	0.592	0.503
Ⅱ3高风险情景下的沟通	0.537	0.527	0.606	0.693	0.522	0.732	0.694	0.635	0.618
Ⅱ4向低健康素养患者提供帮助	0.427	0.667	0.250	0.885	1.000	0.844	1.000	1.000	0.759^b
Ⅱ5医疗费用与医疗保险告知	0.500	0.525	0.633	0.664	0.468	0.831	0.820	0.602	0.630
Ⅱ6健康咨询服务	0.279	0.388	0.543	0.600	0.414	0.427	0.352	0.540	0.443^a
Ⅲ健康促进型物质环境	0.604	0.622	0.638	0.739	0.882	0.871	0.854	0.847	0.757
Ⅲ1建筑结构	0.867	0.850	0.950	0.828	0.887	0.855	0.719	0.719	0.834
Ⅲ2导医标识	0.700	0.923	1.000	0.950	0.926	0.903	0.928	0.935	0.908^b
Ⅲ3健康教育设施	0.500	0.500	0.500	0.500	1.000	1.000	1.000	1.000	0.750
Ⅲ4健康信息材料	0.566	0.472	0.437	0.608	0.726	0.720	0.693	0.665	0.611^a
Ⅲ5医疗费用信息	0.500	0.500	0.500	1.000	1.000	1.000	1.000	1.000	0.813
Ⅳ机构外部合作	0.581	0.419	0.721	0.581	0.953	0.919	0.919	0.651	0.718
Ⅳ1与社区合作	0.500	0.500	1.000	0.500	1.000	1.000	1.000	0.500	0.750
Ⅳ2与其他医疗机构合作	1.000	0.350	0.350	0.700	1.000	1.000	1.000	1.000	0.800^b
Ⅳ3与政府部门、学校合作	0.286	0.214	0.214	0.714	0.714	0.500	0.500	0.714	0.482^a
注：^a为二级维度得分均数最低；^b为二级维度得分均数最高。

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表 3 8所卫生室的PHOHL得分比较

Table 3. Differences in PHOHL scores among eight primary health clinics

类别	数量(所)	PHOHL总分(x±s，分)	t值	P值
所属地区			0.458	0.663
a	4	206.41±33.23
b	4	194.21±41.69
机构性质			8.576	< 0.001
社区卫生室	5	225.04±6.53
村卫生室	3	159.08±15.73
机构职工数量(人)			0.480	0.648
＞4	4	206.70±33.50
≤4	4	193.92±41.35

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