医护人员对未分化疾病健康科普的知信行现状及其影响因素分析

夏晴; 李鑫; 蔡梦阳; 蒋元英; 马方晖; 任菁菁

doi:10.16766/j.cnki.issn.1674-4152.004339

医护人员对未分化疾病健康科普的知信行现状及其影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.004339

夏晴¹,
李鑫^{1, 2},
蔡梦阳¹,
蒋元英¹,
马方晖²,
任菁菁^2, ,

1.
杭州市临平区第一人民医院全科医学科, 浙江杭州 311100
2.
浙江大学医学院附属第一医院全科医学科, 浙江杭州 310003

基金项目:

国家自然科学基金项目 72274169

浙江省中医药科技计划项目 2024ZL140

杭州市医药卫生科技项目 B20240578

详细信息

通讯作者:
任菁菁，E-mail：3204092@zju.edu.cn

中图分类号: R192 R499
计量
- 文章访问数: 7
- HTML全文浏览量: 2
- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2025-03-26
- 网络出版日期: 2026-04-01

Current status of knowledge, attitude and practice of medically unspecified disease health education in medical staff

1.
General Practice Department, the First People' s Hospital of Hangzhou Linping District, Hangzhou, Zhejiang 311100, China

摘要

摘要: 目的调查医护人员对未分化疾病健康科普的知信行现状及其影响因素，为有效开展未分化疾病健康科普提供依据。方法于2024年6—7月，采用整群抽样法对杭甬地区1 313名医护人员以自制调查问卷进行现状调查。进一步采用Pearson分析探索医护人员健康效用值与未分化疾病健康科普的知、信、行得分的相关性。结果医护人员的健康效用值为0.87±0.15，未分化疾病健康科普的知识、信念、行为及问卷总分的百分制得分分别为(74.33±12.28)分、(84.47±13.32)分、(79.55±13.45)分、(78.54±9.91)分；知、信、行得分两两之间均呈正相关关系(r值分别为0.293、0.200、0.757，均P＜0.05)；健康效用值与知、信、行得分之间呈正相关关系(r=0.060、0.214、0.228，均P＜0.05)；性别、职业、婚姻、运动习惯、熬夜习惯、是否经常参与健康科普是健康效用值的影响因素(P＜0.05)；学历、BMI、职业、熬夜习惯、运动习惯、是否经常参与健康科普是知信行得分的影响因素(P＜0.05)。结论医护人员对未分化疾病的健康科普知识和行为干预处于中等水平，态度较积极，且健康状况较差。为提升医护人员健康状况，提高其健康科普水平，改善未分化疾病诊疗现状，未来需加强对医护人员未分化疾病健康科普方面的培训和实践指导。
- 医护人员 /
- 未分化疾病 /
- 健康科普 /
- 知信行 /
- 现状调查
Abstract: Objective To analyze the current status of knowledge, attitude and practice (KAP) on health education for medically unspecified disease (MUD) among medical staff, as well as the factors influencing the practices, and to provide a basis for effective health education on MUD. Methods A total of 1 313 medical staff in the Cities of Hangzhou and Ningbo were sampled using a cluster sampling method from June 2024 to July 2024. Data was collected through a self-designed survey questionnaire. Further Pearson correlation analysis was performed to examine the pairwise correlations between health utility value and the scores of knowledge, attitude and practice of MUD health education. Results The mean health state utility value was (0.87±0.15) for medical staff, and the average scores of MUD health education knowledge, attitude practice, and total score were (74.33±12.28) points, (84.47±13.32) points, (79.55±13.45) points and (78.54±9.91) points, respectively. The scores of knowledge, attitude and practice of MUD health education were positively correlated to each other (r=0.293, 0.200, 0.757, all P < 0.05). The health state utility value was positively correlated with the scores for knowledge (r=0.060), attitude (r=0.214), and practice (r=0.228) of MUD health education (all P < 0.05). Gender, occupation, marital status, frequency of staying up late, exercise habits, and prior participation in health education were the influencing factors of the health utility value (P < 0.05). Education level, body mass index, occupation, staying up late, exercising, and whether they had participated in health education frequently or not were the influencing factors for KAP of MUD health education (P < 0.05). Conclusion The medical staff have a moderate level of knowledge and practice toward MUD health education, their attitude is positive, and their self-rated health status are poor. To enhance their health status and health education level, and improve the MUD diagnosis and treatment, it is necessary to strengthen the training and practical guidance of MUD health education in the future.
- Medical staff /
- Medically unspecified disease /
- Health education /
- Knowledge-attitude-practice /
- Status survey

HTML全文

表 1 医护人员MUD健康科普知信行单因素分析(x±s，分)

Table 1. Univariate analysis of knowledge, attitude, and practice regarding MUD Health education among healthcare professionals(x±s, points)

项目	类别	例数	知识得分	信念得分	行为得分	总分
性别	男性	319	74.34±13.77	83.57±14.40	79.09±14.20	78.17±10.70
	女性	994	74.32±11.77	84.76±12.94	79.70±13.21	78.54±9.91
t值			0.021	1.312	0.701	0.759
P值			0.984	0.190	0.483	0.448
年龄	25~34岁	730	74.73±12.20	83.95±13.25	79.08±13.59	78.47±10.01
	35~44岁	460	74.52±11.86^a	85.31±13.26	80.04±13.24	78.99±9.51
	≥45岁	123	71.25±13.88^ab	84.42±13.87	80.49±13.44	77.30±10.68
F值			4.321	1.479	1.050	1.467
P值			0.013	0.228	0.350	0.231
学历	专科及以下	324	72.93±10.71	83.37±13.64	78.29±13.44	77.26±9.28
	本科	891	74.13±12.64	84.86±13.28	79.75±13.43d	78.61±10.07d
	硕士及以上	98	80.75±11.97^cd	84.57±12.48^c	81.94±13.43^cd	82.15±9.51^cd
F值			16.910	1.494	3.079	9.360
P值			0.001	0.225	0.046	0.001
BMI	偏瘦(BMI＜18.5)	115	69.94±13.42	79.76±6.03	75.22±15.09	74.07±12.04
	正常(18.5＜BMI＜23.9)	740	75.43±11.02^e	85.71±12.22^e	80.26±12.75^e	79.59±8.56^e
	偏胖(BMI＞24.0)	458	73.65±13.59^ef	83.65±13.97^ef	79.49±13.94^ef	77.96±10.95^ef
F值			10.141	9.281	5.833	13.313
P值			＜0.001	＜0.001	0.003	＜0.001
婚姻状况	未婚	322	75.17±10.64	83.03±12.47	77.50±13.52	78.03±8.98
	已婚	959	74.07±12.75	84.88±13.52^j	80.16±13.35^j	78.68±10.17
	离异或丧偶	32	73.66±13.33	86.63±14.64	81.88±13.96	79.41±10.76
F值			1.197	2.770	5.241	0.708
P值			0.307	0.063	0.005	0.496
职业	护士	789	72.37±11.94	82.52±13.68	77.52±12.59	76.57±9.95
	医生	524	77.28±12.21	87.41±12.19	82.60±12.66	81.51±9.08
t值			7.233	6.625	6.820	9.305
P值			＜0.001	＜0.001	＜0.001	＜0.001
居住地	村镇	340	72.49±12.10	84.20±13.84	79.12±13.61	77.49±9.76
	城市	973	74.97±12.28	84.57±13.14	79.70±13.40	78.91±9.93
t值			3.214	0.438	0.689	2.266
P值			＜0.001	0.662	0.491	0.024
参与健康科普	经常	862	76.92±10.93	87.78±11.49	82.30±12.72	81.36±8.37
	不经常	451	69.37±13.18	78.27±14.35	74.29±13.26	73.15±10.37
t值			10.438	12.098	10.681	14.533
P值			＜0.001	＜0.001	＜0.001	＜0.001
熬夜习惯	经常熬夜	616	74.18±12.36	83.88±12.92	78.85±13.06	78.13±9.49
	偶尔熬夜	469	73.75±12.71	83.94±14.13	79.32±13.87	78.06±10.69
	几乎不熬夜	228	75.92±11.03^g	87.18±12.33^gk	81.93±13.44^gk	80.65±9.06^gk
F值			2.492	5.728	4.502	7.173^a
P值			0.083	0.003	0.011	＜0.001
运动习惯	经常运动	280	76.14±12.51	86.93±12.97	82.55±13.11	80.82±9.97
	偶尔运动	615	74.52±12.30	84.66±13.53^h	79.86±13.21^h	78.76±9.92^h
	几乎不运动	418	72.83±11.95^hi	82.56±13.21^hi	77.08±13.61^hi	76.69±9.49^hi
F值			6.301	9.269	14.474	15.206
P值			0.002	＜0.001	＜0.001	＜0.001
注：与25~34岁组比较，^aP＜0.05；与35~44岁组比较，^bP＜0.05；与专科及以下组比较，^cP＜0.05；与本科组比较，^dP＜0.05；与偏瘦组比较，^eP＜0.05；与正常组比较，^fP＜0.05；与未婚组比较，^jP＜0.05；与经常熬夜组比较，^gP＜0.05；与偶尔熬夜组比较，^kP＜0.05；与经常运动组比较，^hP＜0.05；与偶尔运动组比较，ⁱP＜0.05。

下载: 导出CSV

表 2 医护人员MUD健康科普知信行之间的相关性(r值)

Table 2. Correlation between MUD health education knowledge, attitude and behavior of medical staff(rvalue)

项目	总分	知识分	态度分	行为分
总分	1	0.763^a	0.808^a	0.735^a
知识分		1	0.293^a	0.200^a
态度分			1	0.757^a
行为分				1
注：^aP＜0.01。

下载: 导出CSV

表 3 医护人员MUD健康科普的知信行得分影响因素分析

Table 3. Analysis of influencing factors on MUD health education KAP score of medical staff

变量	B	SE	β	t值	P值
偏瘦^a	-3.802	0.887	-0.109	-4.287	0.001
肥胖^a	-1.786	0.524	-0.086	-3.406	0.001
本科^b	-1.489	0.638	-0.070	-2.334	0.020
硕士及以上^b	-2.136	1.188	-0.057	-1.798	0.072
医生^c	4.108	0.587	0.203	7.002	0.001
城市^d	0.516	0.571	0.023	0.903	0.366
经常参与健康科普^e	7.251	0.525	0.348	12.809	0.001
偶尔熬夜^f	-2.142	0.715	-0.104	-2.995	0.003
经常熬夜^f	-1.442	0.700	-0.073	-2.059	0.040
偶尔运动^g	1.243	0.570	0.063	2.181	0.029
经常运动^g	2.671	0.706	0.110	3.781	0.001
注：^a表示以BMI正常为参照；^b表示以专科及以下为参照；^c表示以护士为参照；^d表示以村镇为参照；^e表示以否认经常参与健康科普为参照；^f表示以不熬夜为参照；^g表示以不运动为参照。自变量赋值如下，偏瘦=1，肥胖=2；专科=1，本科=2，硕士及以上=3；护士=1，医生=2；村镇=1，城市=2；不经常参与健康科普=1，经常参与健康科普=2；几乎不熬夜=1，偶尔熬夜=2，经常熬夜=3；几乎不运动=1，偶尔运动=2，经常运动=3。

下载: 导出CSV

参考文献(17)

[1]	任菁菁, 江孙芳, 尹朝霞. 全科常见未分化疾病诊疗手册[M]. 3版. 北京: 人民卫生出版社, 2013. REN J J, JIANG S F, YIN C X. The treatment of common medically unspecified disease in general practice[M]. 3nd edition. Beijing: People' s Medical Publishing House, 2013.
[2]	潘琦, 任菁菁, 张萌, 等. 未分化疾病如何与全科医学同频共振?[J]. 中国全科医学, 2023, 26(31): 3877-3883. PAN Q, REN J J, ZHANG M, et al. How Can Undifferentiated Diseases Be Synchronized with General Practice?[J]. Chinese General Practice, 2023, 26(31): 3877-3883.
[3]	WANGLER J, JANSKY M. Somatoform disorders in primary care-an exploratory mixed-methods study on experiences, challenges and coping strategies of general practitioners in The Federal Republic of Germany[J]. Int J Environ Res Public Health, 2024, 21(7): 901. DOI: 10.3390/ijerph21070901.
[4]	陆亿娴, 余晶晶, 刘红, 等. 知信行健康教育模式对乳腺癌患者术后的应用效果研究[J]. 中华全科医学, 2021, 19(11): 1901-1904. LU Y X, YU J J, LIU H, et al. Clinical application effect of the health education model of knowledge, attitude, belief and practice on postoperative breast cancer patients Chinese[J]. Chinese Journal of General Practice, 2021, 19(11): 1901-1904.
[5]	陈明娟, 池亚琴. 以知信行理论为基础的健康教育在糖尿病患者临床护理中的应用[J]. 实用临床医药杂志, 2019, 23(5): 23-26. CHEN M J, CHI Y Q. Application of health education based on knowledge-belief-behavior in clinical nursing of diabetic patients[J]. Journal of Clinical Medicine in Practice, 2019, 23(5): 23-26.
[6]	朱文涛, 高海亮, 张梦培, 等. 中医生命质量评价量表(CQ-11D)的研制[J]. 中国药物经济学, 2022, 17(5): 10-15, 39. ZHU W T, GAO H L, ZHANG M P, et al. Development of the Chinese Medicine Life Quality Evaluation Scale(CQ-11D)[J]. China Journal of Pharmaceutical Economics, 2022, 17(5): 10-15, 39.
[7]	中国医师协会精神科医师分会综合医院工作委员会, "医学难以解释的症状"临床实践中国专家共识组. "医学难以解释的症状"临床实践中国专家共识[J]. 中华内科杂志, 2017, 56(2): 150-156. The Federation of Mental Health in General Hospital, Chinese Psychiatrist Association, The Chinese Expert Consensus on Clinical Practice of "Medically Unexplained Symptoms" Group. The Chinese expert consensus on clinical practice of "medically unexplained sympto ms"[J]. Chinese Journal of Internal Medicine, 2017, 56(2): 150-156.
[8]	PAN J, HAN Q, ZHOU P, et al. Assessing health-related quality of life of Chinese population using CQ-11D[J]. Health Qual Life Outcomes, 2024, 22(1): 34. DOI: 10.1186/s12955-024-02250-1.
[9]	薛艳芝, 鲁显福, 胡啸玲, 等. 疼痛性别差异的表观遗传学研究进展[J]. 中国疼痛医学杂志, 2019, 25(12): 928-932. XUE Y Z, LU X F, HU X L, et al. Advances in epigenetic research on sex differences in pain[J]. Chinese Journal of Pain Medicine, 2019, 25(12): 928-932.
[10]	PENG K, JIANG J, JIANG N, et al. Self-rated health and its related influencing factors among emergency department physicians: a national cross-sectional study[J]. Front Public Health, 2023, 11: 1147403. DOI: 10.3389/fpubh.2023.1147403.
[11]	MARIMAN A, VERMEIR P, CSABAI M, et al. Education on medically unexplained symptoms: a systematic review with a focus on cultural diversity and migrants[J]. Eur J Med Res, 2023, 28(1): 145. DOI: 10.1186/s40001-023-01105-7.
[12]	王坤, 毛阿燕, 孟月莉, 等. 我国公共卫生体系建设发展历程、现状、问题与策略[J]. 中国公共卫生, 2019, 35(7): 801-805. WANG K, MAO A Y, MENG Y L, et al. Development history, current situation, problems and strategies of public health system construction in China[J]. Chinese Journal of Public Health, 2019, 35(7): 801-805.
[13]	PENG J, YIN L, WANG K, et al. A study on the relationship between adolescent health behavior, BMI, and blood physical and chemical properties[J]. Front Public Health, 2022, 10: 766101. DOI: 10.3389/fpubh.2022.766101.
[14]	DULKO D, ZANGARO G A. Comparison of factors associated with physician and nurse burnout[J]. Nurs Clin North Am, 2022, 57(1): 53-66. doi: 10.1016/j.cnur.2021.11.004
[15]	THURSBY S, DISMORE L, SWAINSTON K. Clinical skills development for healthcare practitioners working with patients with persistent physical symptoms (PPS) in healthcare settings: a systematic review and narrative synthesis[J]. BMC Med Educ, 2024, 24(1): 328. DOI: 10.1186/s12909-024-05306-4.
[16]	BYRNE A K, SCANTLEBURY A, JONES K, et al. Communication interventions for medically unexplained symptom conditions in general practice: a systematic review and meta-analysis of randomised controlled trials[J]. PLoS One, 2022, 17(11): e0277538. DOI: 10.1371/journal.pone.0277538.
[17]	SITNIKOVA K, FINCH A P, LEONE S S, et al. A brief cognitive behavioural intervention is cost-effective for primary care patients with medically unexplained physical symptoms compared to usual care[J]. J Psychosom Res, 2020, 138: 110217. DOI: 10.1016/j.jpsychores.2020.110217.