A survey on training needs of basic level children's health service personnel in Beijing based on the common diseases of children
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摘要:
目的 了解北京市基层常见儿童疾病，探索基于儿童常见病不同岗位儿童健康服务人员相对个性化的能力培训需求，为加强基层儿童健康服务人员培训提供参考。 方法 抽取北京市城区、近郊区和远郊区7个样本区的社区卫生服务中心作为样本单位，采用自行设计的调查问卷，由样本中心医疗岗和保健岗儿童健康服务人员自愿匿名在线填写，共成功调查940例。采用Excel进行数据整理，采用SAS 9.1统计学软件进行数据处理。 结果 北京市基层常见儿童疾病病种排序前5位的疾病为急性上呼吸道感染、肺炎、腹泻、湿疹、龋齿。针对5种常见儿童疾病，每种疾病有培训需求的人数占比分别为65.11%、40.53%、55.00%、58.72%和31.17%，每种疾病对应的不同培训内容需求总人次数分别为1 113、648、902、1 003和460人次。基层医疗岗和保健岗儿童健康服务人员对上述5种儿童常见疾病的培训需求人次总数分别为1 307人次和2 359人次。 结论 北京市不同基层岗位儿童健康服务人员针对不同儿童疾病的培训需求存在差异，应科学设计培训内容，尽可能提高培训的针对性和精准性，满足不同岗位对不同病种的差异化培训需求。 Abstract:Objective To understand the common children's diseases in Beijing and explore the relative personalised ability training needs of children's health service personnel in different positions based on common children's diseases to provide reference for strengthening the training of children's health service personnel at the grassroots level. Methods Community health service centres in 7 sample areas of Beijing City were selected as sample units. A self-designed questionnaire was used to fill in the questionnaire voluntarily and anonymously by the medical and health care staff of the sample centres. A total of 940 cases were successfully investigated. Excel was used for data processing and SAS 9.1 statistical software was used for data processing. Results The top five diseases in Beijing were acute upper respiratory tract infection, pneumonia, diarrhoea, eczema and caries. According to the five common children's diseases, the number of health personnel with training needs for each disease accounted for 65.11%, 40.53%, 55.00%, 58.72% and 31.17%, respectively. The total number of health personnel with different training contents corresponding to each disease were 1 113, 648, 902, 1 003 and 460, respectively. The total number of training needs for the above-mentioned five common diseases of children by the children's health service personnel of primary medical post and health care post were 1 307 and 2 359, respectively. Conclusion There are differences in the training needs of children's health service personnel in different grassroots positions in Beijing. The training contents should be designed scientifically to improve the pertinence and accuracy of the training as much as possible, thereby meeting the different training needs of different positions for varying diseases. -
Key words:
- Primary health /
- Children care /
- Training needs /
- Common disease
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表 1 基层儿童健康服务人员基本情况
Table 1. Basic characteristics of basic level child health service personnel
项目 类别 人数 百分比(%) 性别 男性 82 8.72 女性 858 91.28 年龄 25岁以下 32 3.40 26~30岁 150 15.96 31~40岁 414 44.04 41~50岁 243 25.85 50岁以上 101 10.75 编制 在编 706 75.11 非在编 234 24.89 学历 大专以下 42 4.47 大专 242 25.74 本科 587 62.45 硕士以上 69 7.34 职称 高级 43 4.58 中级 456 48.51 初级 422 44.89 无职称 19 2.02 专业 临床 293 31.17 预防 319 33.94 护理 300 31.91 其他专业 28 2.98 岗位 医疗岗 290 30.85 保健岗 650 69.15 合计 940 100.00 
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表 2 不同岗位接诊的常见儿童疾病病种及排序
Table 2. Common children's diseases and their ranking in different positions
病种 医疗岗 保健岗 病种 医疗岗 保健岗 人数 分值 排序 人数 分值 排序 人数 分值 排序 人数 分值 排序 呼吸系统 五官及皮肤 急性上呼吸道感染 245 1 156 1 367 1 517 1 视力发育不良 23 50 14 82 174 14 肺炎 110 376 5 271 979 4 鼻炎、鼻窦炎 61 145 10 54 110 15 支气管炎 169 547 2 157 481 9 龋齿 81 204 7 212 539 7 哮喘 70 175 9 74 201 12 湿疹 147 396 3 405 1 226 2 消化系统 荨麻疹 34 67 13 52 107 16 腹泻 152 395 4 365 1 101 3 扁桃体炎 111 259 6 42 82 17 阑尾炎 2 4 22 5 9 23 运动系统 急腹症 12 25 17 18 43 20 关节发育不良 10 20 18 30 63 18 传染病 关节脱位 6 10 19 12 30 22 水痘 17 46 15 260 847 6 骨折等外伤 2 3 23 3 5 24 麻疹 3 6 21 79 232 10 生长发育 百日咳 2 3 23 23 51 19 营养不良 33 72 12 82 199 13 手足口病 42 109 11 312 907 5 佝偻病 16 33 16 20 40 21 流行性腮腺炎 4 9 20 104 222 11 单纯性肥胖症 76 199 8 193 500 8
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表 3 部分病种不同岗位儿童健康服务人员培训内容需求
Table 3. Training demands of child health service personnel in different positions for some main diseases
病种 岗位 例(%) 危险情况识别[例(%)] 急诊急救技术[例(%)] 诊断与鉴别诊断[例(%)] 药物治疗[例(%)] 非药物治疗技术[例(%)] 合计(人次) 上呼吸道感染 医疗 245(84.48) 77(31.43) 80(32.65) 119(48.57) 113(46.12) 104(42.45) 493 保健 367(56.46) 98(26.70) 80(21.80) 174(47.41) 129(35.15) 139(37.87) 620 合计 612(65.11) 175(28.59) 160(26.14) 293(47.88) 242(39.54) 243(39.71) 1 113 肺炎 医疗 110(37.93) 39(35.45) 33(30.00) 56(50.91) 47(42.73) 42(38.18) 217 保健 271(41.69) 68(25.09) 67(24.72) 122(45.02) 91(33.58) 83(30.63) 431 合计 381(40.53) 107(28.08) 100(26.25) 178(46.72) 138(36.22) 125(32.81) 648 腹泻 医疗 152(52.41) 42(27.63) 36(23.68) 79(51.97) 74(48.68) 64(42.11) 295 保健 365(56.15) 87(23.84) 75(20.55) 163(44.66) 136(37.26) 146(40.00) 607 合计 517(55.00) 129(24.95) 111(21.47) 242(46.81) 210(40.62) 210(40.62) 902 湿疹 医疗 147(50.69) 35(23.81) 33(22.45) 76(51.70) 76(51.70) 82(55.78) 302 保健 405(62.31) 89(21.98) 78(19.26) 197(48.64) 157(38.77) 180(44.44) 701 合计 552(58.72) 124(22.46) 111(20.11) 273(49.46) 233(42.21) 262(47.46) 1 003 龋齿 临床 81(27.93) 16(19.75) 14(17.28) 25(30.86) 29(35.80) 51(62.96) 135 保健 212(32.62) 42(19.81) 27(12.74) 73(34.43) 64(30.19) 119(56.13) 325 合计 293(31.17) 58(19.80) 41(13.99) 98(33.45) 93(31.74) 170(58.02) 460 手足口病a 保健 312(48.00) 87(27.88) 66(21.15) 159(50.96) 112(35.90) 102(32.69) 526 肥胖a 保健 193(29.69) 37(19.17) 21(10.88) 55(28.50) 39(20.21) 130(67.36) 282 注：a表示该常见疾病在医疗岗排序靠后，不属于常见儿童疾病故省略。
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