【摘要】 目的 了解河南省临床医生丙型肝炎（简称丙肝）防控专业知识素养水平及影响因素，为其提升专业技能提供依据。方法 采用多阶段分层抽样方法，于2021年6—9月在河南省18个省辖市和10个省直管县（市）抽取省、市和县（区）三级医疗机构临床医生进行面对面问卷调查，对4 523名调查对象的一般人口学信息、丙肝防控专业知识和接受培训情况进行频数和百分比的描述，了解河南省临床医生丙肝防控专业知识素养水平并分析影响因素。结果 4 523名调查对象中具备丙肝防控专业知识素养人数为2 081人，丙肝防控专业知识素养水平46.0%(95%CI:44.6%～47.5%)。其中，男性为41.9%(95%CI:39.9%～43.9%)，女性为50.3%(95%CI:48.2%～52.4%);46～60岁[47.6%(95%CI:44.4%～50.9%)]较高。不同特征中，硕士及以上[54.4%(95%CI:51.1%～57.7%)]、高级职称[46.6%(95%CI:43.7%～49.5%)]、住院部医生[46.2%(95%CI:44.6%～47.8%)]、感染与肝病科医生[65.9%(95%CI:57.8%～74.0%)]、工作年限11年及以上[47.6%(95%CI:45.5%～49.7%)]和省级医院[51.0%(95%CI:46.1%～55.9%)]较高。16道丙肝防控专业知识与技能问题中，“丙肝的病原体”“丙肝确诊病例的诊断依据”和“慢性丙肝的定义”回答正确率较高，达99.5%(95%CI:99.3%～99.7%)、89.3%(95%CI:88.4%～90.2%)和86.8%(95%CI:85.8%～87.8%)，“丙肝临床诊断病例的诊断依据”“丙肝病例的诊断分类”和“丙肝病例诊断后的处置”回答正确率较低，为35.9%(95%CI:34.5%～37.3%)、38.6%(95%CI:37.2%～40.0%)和49.8%(95%CI:48.8%～51.3%)。多因素logistic回归分析结果显示，临床医生丙肝防控专业知识素养水平较高的影响因素包括女性（OR=1.420,95%CI:1.247～1.617）、文化程度为硕士及以上（OR=1.663,95%CI:1.365～2.025）、科室分类为感染与肝病科（OR=2.039,95%CI:1.383～3.007）、工作年限为11年及以上（OR=1.327,95%CI:1.114～1.581）以及近一年接受丙肝相关培训（OR=6.056,95%CI:4.871～7.530）。结论 2021年河南省临床医生丙肝防控专业知识素养水平为46.0%，应加快针对新进和受教育程度较低，感染与肝病科以外其他临床科室以及近年来未接受过丙肝专业技能培训的临床医生进行相关培训，培训应侧重诊断分类和治疗知识，从而提升医生的实际应用能力。更多还原

【Abstract】 Objective To understand the literacy level and its influencing factors of knowledge about hepatitis C prevention and control among the clinicians in Henan Province so as to provide a basis for enhancing their professional skills. Methods From June to September 2021, the multi-stage stratified sampling method was used to select the clinicians from provincial, municipal,and county-level medical institutions in the 18 prefecture-level cities and 10 counties(cities) directly administered by Henan provincial government for a face-to-face questionnaire survey. The demographic characteristics, professional knowledge about hepatitis C prevention and control, and training received among 4 523 respondents were described with frequencies and percentages. The literacy level of knowledge about hepatitis C prevention and control among clinicians in Henan Province was calculated, and the influencing factors were investigated. Results Among 4 523 respondents, 2 081 demonstrated professional knowledge about hepatitis C prevention and control, with a literacy level of 46.0%(95%CI: 44.6%-47.5%). The literacy level was 41.9%(95%CI: 39.9%-43.9%) in males, and 50.3%(95%CI: 48.2%-52.4%) in females. The literacy level was relatively high in clinicians aged 46-60 years [47.6%(95%CI: 44.4%-50.9%)]. The levels were relatively high in those with a master’s degree or above [54.4%(95%CI: 51.1%-57.7%)], senior profession title [46.6%(95%CI: 43.7%-49.5%)], inpatient clinicians[46.2%(95% CI: 44.6%-47.8%)], clinicians from the department of infection and liver diseases [65.9%(95% CI: 57.8%-74.0%)], clinicians working for 11 years or longer [47.6%(95%CI: 45.5%-49.7%)] and in province-level hospitals [51.0%(95%CI: 46.1%-55.9%)]. Among the 16 questions on professional knowledge and skills of hepatitis C prevention and control, the correct answer rates of “Pathogen of hepatitis C”, “Diagnostic criteria of confirmed cases of hepatitis C” and “Definition of chronic hepatitis C” were high at 99.5%(95%CI: 99.3%-99.7%), 89.3%(95%CI: 88.4%-90.2%), and 86.8%(95%CI: 85.8%-87.8%), respectively; the correct answer rates of “Clinical diagnostic criteria of hepatitis C”,“Clinical classification of hepatitis C” and “Management of diagnosed hepatitis C cases” were low at 35.9%(95%CI: 34.5%-37.3%), 38.6%(95%CI: 37.2%-40.0%), and 49.8%(95% CI: 48.8%-51.3%), respectively. Multivariate logistic regression analysis results showed that influencing factors associated with high literacy level of professional knowledge about hepatitis C prevention and control among clinicians included female(OR=1.420, 95%CI: 1.247-1.617), master’s degree or above(OR=1.663, 95%CI: 1.365-2.025),department of infection and liver diseases(OR=2.039, 95%CI: 1.383-3.007), clinicians working for 11 years or longer(OR=1.327, 95% CI: 1.114-1.581), and training received(OR =6.056, 95% CI: 4.871-7.530). Conclusions The literacy level of professional knowledge about hepatitis C prevention and control among the clinicians was 46.0% in Henan Province in 2021. It is necessary to accelerate the targeted training for the clinicians who are new to the profession, have low-education level, work in the departments other than infection and liver diseases, as well as those who have not received professional training on hepatitis C in recent years. The training should focus on diagnostic classification and treatment knowledge, thereby enhancing doctors’ practical application abilities.更多还原