【作者】 刘璐；

【导师】 卫平民；

【作者基本信息】 东南大学 ， 公共卫生（专业学位）， 2022， 硕士

【摘要】 背景公共场所是人们生产生活的重要区域,对国民经济有着重要影响,吸纳了数量巨大的从业人员。公共场所卫生学特点使得其卫生状况直接影响人们的健康甚至传染病的暴发、传播,而公共场所从业人员健康素养水平很大程度上影响着公共场所卫生状况。因此,研究公共场所从业人员健康素养的意义重大,但目前国内外健康素养方面的研究对公共场所从业人员这一群体关注较少。目的了解公共场所从业人员健康素养现状及其影响因素,分析不同公共场所从业人员健康素养水平的差异,为卫生监督部门开展有针对性的卫生监督指导,提升公共场所卫生水平提供依据,同时也为政府有关部门制定针对性的健康教育政策,提高该人群的健康素养水平提供依据。方法对无锡某城区的所有公共场所开展分层随机抽样,按照不同公共场所类型分类后抽取256家单位的所有从业人员进行问卷调查。采用2020版《全国居民健康素养监测调查问卷》,根据实际情况采取网上填报及现场调查相结合的方式开展问卷调查,采用χ~2检验或Fisher确切概率法筛选影响健康素养总体情况、三个方面及六类问题知晓的候选因素,采用多因素二项logistic回归对差异有统计学意义的因素进一步分析。通过森林图对回归分析结果进行可视化,呈现OR值及95%置信区间。统计分析选择双侧检验,检验水准α=0.05。结果(1)健康素养知晓率:此次共调查1001例公共场所从业人员,回收有效问卷959份。该地区公共场所从业人员的健康素养总体知晓率为38.37%,高于2020年全国居民健康素养总体知晓率(23.15%)及东部地区居民健康素养总体知晓率(29.06%)。不同类型公共场所的从业人员的总体健康素养知晓率分别为:宾馆29.28%、商场43.98%、其它类型28.57%。三个方面健康素养知晓率均超过40%,其中健康技能素养知晓率(46.09%)最高,其次是基本知识和理念素养知晓率(43.69%),最低的是健康生活方式与行为(41.71%);六类健康问题素养知晓率均超过30%,其中安全与急救(78.73%)最高,慢性病防治(30.87%)最低,余下分别是科学健康观(61.73%)、健康信息(60.36%)、传染病防治(37.85%)、基本医疗(37.12%)。(2)健康素养影响因素分析:文化程度和年龄是公共场所从业人员健康素养的主要影响因素。高中和大专及以上学历从业人员健康素养总体知晓率分别是初中及以下文化程度者的1.811倍(95%CI:1.271-2.581)和2.555倍(95%CI:1.734-3.762)。年龄≥45岁的从业人员健康素养总体知晓率显著低于年龄<26岁者(OR=0.572,95%CI:0.350-0.936)。(3)三个方面及六类问题素养知晓率的影响因素分析:年龄、人均年收入和文化程度是三个方面素养知晓率的影响因素,年龄越小、人均年收入越高、文化程度越高者基本知识和理念、健康生活方式与行为、健康技能健康素养知晓率越高。在六类问题素养中,文化程度对六类问题素养均有影响,表现为文化程度越高,六类问题素养知晓率越高;年龄对传染病防治类素养以外的其它几类问题素养均有影响,年龄≥45者的素养知晓率显著低于低年龄组;人均年收入对传染病防治类素养以外的其它几类问题素养均有影响,人均年收入更高者的素养知晓率明显高于收入较低者;户籍状况对健康信息及科学健康观素养有影响,本地户籍该二类问题素养知晓率更高;慢性病患病情况对科学健康观、慢性病防治、安全与急救、健康信息素养有影响,慢性病患病者该四类问题素养知晓率更高。结论调查地区公共场所从业人员健康素养总体知晓率较好,但不同方面和不同类型问题素养知晓率差异较大,不同类型公共场所健康素养知晓率差异也较大。在健康教育与健康促进工作中应根据公共场所从业人员特点制定相应的策略和措施,对年龄较大、文化程度较低者加强宣教,并结合不同方面和不同类型健康素养的薄弱环节采取有针对性的措施,以促进该类人群健康素养水平的全面提升。更多还原

【Abstract】 Background Public place is an important area for people’s production and life,which has an important influence on the national economy and attracts a large number of employees.The characteristics of hygiene in public places make the health status of public places directly affect people’s health and even the outbreak and spread of infectious diseases,and the health literacy level of employees in public places greatly affects the health status of public places.Therefore,it is of great significance to study the health literacy of employees in public places.However,there is little attention paid to the health literacy of employees in public places at home and abroad.Objectives In order to understand the current situation of health literacy of employees in public places in an urban area of Wuxi,explore the health literacy level of such people and its influencing factors,analyze the differences of health literacy level of employees in different public places,and provide reference basis for relevant government departments to carry out targeted health education for employees in public places in order to promote people’s health,At the same time,it also provides scientific basis for health supervision departments to improve the health level of public places and carry out targeted health supervision and guidance.Methods Stratified random sampling was carried out for all public places in an urban area of Wuxi.After classification according to different types of public places,all employees from 256units were selected for questionnaire survey.The 2020 national residents’health literacy monitoring questionnaire is adopted,and the questionnaire survey is carried out by combining online filling and on-site investigation according to the actual situationχ~2test or Fisher exact probability method to screen the candidate factors affecting the overall situation,three aspects and six types of problems of health literacy,and further analyze the factors with statistically significant difference by multivariate binomial logistic regression.The regression analysis results are visualized through forest Figure 3,showing the OR value and 95%confidence interval.Statistical analysis selects two-sided test and test levelα=0.05.Results(1)Health literacy level:a total of 1001 employees in public places were investigated.The overall health literacy rate of employees in public places in this region is 38.37%,which is higher than that of national residents in 2020(23.15%)and residents in eastern China(29.06%).The overall health literacy of employees in different types of public places were 29.28%in hotels,43.98%in shopping malls and 28.57%in other types.The rate of health literacy in the three aspects exceeded 40%,of which the rate of health skill literacy was the highest(46.09%),followed by the rate of basic knowledge and concept literacy(43.69%),and the lowest was healthy lifestyle and behavior(41.71%);From high to low,the literacy rates of six types of health problems are safety and first aid(78.73%),scientific outlook on health(61.73%),health information(60.36%),prevention and control of infectious diseases(37.85%),basic medical treatment(37.12%)and prevention and control of chronic diseases(30.87%).(2)Analyzing the influential factors on the overall possession rate of health literacy:education level and age are the main factors affecting the overall possession rate of health literacy of employees in public places.The overall possession rate of health literacy of employees with high school and college education or above was 1.811 times(95%CI:1.271-2.581)and 2.555 times(95%CI:1.734-3.762)higher than that of those with junior middle school education or below.The overall possession rate of health literacy of employees aged≥45 was significantly lower than that of those aged<26(OR=0.572,95%CI:0.350-0.936).(3)Analyzing the influential factors on literacy rate of three aspects and six class problem:firstly,age,annual per capita income and educational level is the influence factors of three aspects of literacy rate.The younger the age,the higher the per capita annual income,the higher the education level,the health literacy rate of the basic knowledge and concept,healthy lifestyle and behavior,health skills is higher.Among the six types of question literacy,the level of education has an impact on the six types of question literacy,the higher the level of education,the higher the literacy rate of the six types of question literacy;Age has an effect on the literacy of other kinds of problems except the literacy of infectious disease prevention.The literacy literacy rate of age≥45is obviously lower than that of the lower age group.Per capita annual income has an impact on several other types of literacy except infectious disease prevention and control literacy.The literacy attainment rate of people with higher per capita annual income is significantly higher than that of people with lower income.Household registration has an impact on the literacy of scientific health view and health information,and the literacy rate of these two types of problems is higher in local household registration.The prevalence of chronic diseases has an impact on safety and first aid,chronic disease prevention and treatment,the scientific view of health,and health information literacy,and the literacy rate of these four kinds of problems is higher in patients with chronic diseases.Conclusion The overall possession rate of health literacy of employees in public places in the survey area is good,but there are great differences in the overall possession rate of different aspects and different types of problems,and the health literacy attainment rate of employees in different types of public places also varies greatly.We should formulate corresponding strategies and measures according to the characteristics of employees in public places,strengthen publicity and education for older and less educated people,and take targeted measures in combination with the weak links of different aspects and different types of health literacy,so as to promote the overall improvement of the level of health literacy of such people.更多还原