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鄂尔多斯市妇幼保健院医务人员乳腺癌认知现状及其影响因素分析

Awareness of breast cancer knowledge and its influencing factors among medical staff of maternal and child health hospitals in Ordos city – a cross-sectional survey

  • 摘要:
    目的 了解鄂尔多斯全市各级妇幼保健院医务人员乳腺癌认知现状及其影响因素。
    方法 于2023年4 — 6月采用方便抽样方法抽取鄂尔多斯全市各级妇幼保健院886名医务人员以问卷星形式进行问卷调查,参考国家《乳腺癌筛查工作方案》中的乳腺癌防治健康教育核心知识自行设计调查问卷,内容包括一般人口学信息、乳腺癌防治知识、乳腺癌筛查认知和推荐适龄妇女接受乳腺癌筛查的意愿。采用SPSS 19.0软件进行多因素logistic回归模型分析医务人员乳腺癌知识掌握情况。
    结果  有效问卷862份,有效应答率为97.3%。调查对象乳腺癌防治知识平均得分为(15.08 ± 5.88)分,满分24分。多因素分析结果显示,医学专业(临床医学:OR = 7.50,95%CI = 2.90~19.42;护理学:OR = 4.93,95%CI = 1.92~12.66;其他医学专业:OR = 4.70,95%CI = 1.82~12.11)、超声科/影像科(OR = 2.01,95%CI = 1.03~3.92)、职称在副高级及以上(正高:OR = 3.54,95%CI = 1.30~9.63;副高:OR = 2.56,95%CI = 1.35~4.86)的医务人员乳腺癌防治知识掌握更好(均P < 0.05)。乳腺癌典型症状中,“乳房出现硬块”(82.48%)、“腋窝淋巴结肿大”(74.71%)和“乳房皮肤凹陷或褶皱”(74.48%)知晓率较高;乳腺癌危险因素中,“长期使用外源性雌激素”(64.39%)和“乳腺癌或卵巢癌家族史”(61.14%)知晓率较高;常见的乳腺癌筛查方法中,临床乳腺检查、乳腺超声检查和乳腺X线检查的知晓率均为90%左右;乳腺癌筛查工作方案推荐的筛查年龄知晓率为74.71%,但筛查时间间隔知晓率仅为24.25%。乳腺癌筛查工作者对筛查年龄和筛查时间间隔的知晓率(88.36%,33.33%)高于非乳腺癌筛查工作者(70.88%,21.69%)(P < 0.001)。分别有689人(79.93%)和684人(79.35%)认同乳腺癌筛查可以提高乳腺癌早期检出率和降低乳腺癌死亡率,有831人(96.40%)愿意推荐适龄妇女定期接受乳腺癌筛查。
    结论 鄂尔多斯市妇幼保健院医务人员乳腺癌筛查认知水平和推荐适龄妇女接受乳腺癌筛查的意愿较高,但乳腺癌防治知识掌握有待提高,应加强对当地医务人员乳腺相关理论知识的专业培训。

     

    Abstract:
    Objective To understand the awareness of breast cancer knowledge and its influencing factors among medical staff in maternal and child health hospitals of all levels in Ordos city.
    Methods From April to June 2023, a convenient sampling method was used to select 886 medical staff from maternal and child health hospitals at all levels in Ordos city, Inner Mongolia Autonomous Region to conduct a questionnaire survey using Questionnaire Star online platform with a self-designed questionnaire on general demographic information and core knowledge of breast cancer prevention and treatment health education introduced in the national “Breast Cancer Screening Work Plan”, and the willingness to recommend to women to have breast cancer screening at an appropriate age. SPSS 19.0 software was used for multivariate logistic regression model analysis.
    Results A total of 862 valid questionnaires were collected, with an effective response rate of 97.3%. The mean score of the respondents' knowledge of breast cancer prevention and treatment was 15.08 ± 5.88 out of a total score of 24. The results of multivariate analysis showed that the respondents with medical majors (clinical medicine: odds ratio OR = 7.50, 95% confidence interval 95%CI: 2.90 – 19.42; nursing: OR = 4.93, 95%CI: 1.92 – 12.66; other medical majors: OR = 4.70, 95%CI: 1.82 – 12.11), working in ultrasound/imaging departments (OR = 2.01, 95%CI: 1.03 – 3.92), and with a professional title of associate senior or higher (senior physician: OR = 3.54, 95%CI: 1.30 – 9.63; associate senior: OR = 2.56, 95%CI: 1.35 – 4.86) had better awareness of breast cancer prevention and treatment knowledge (all P < 0.05). Among the typical symptoms of breast cancer, the awareness rates of "breast lump" (82.48%), "axillary lymph node enlargement" (74.71%), and "breast skin depression or wrinkling" (74.48%) were higher; among the risk factors for breast cancer, the awareness rates of "long-term use of exogenous estrogen" (64.39%) and "family history of breast or ovarian cancer" (61.14%) were higher; among the common breast cancer screening methods, the awareness rates of clinical breast examination, breast ultrasound, and breast x-ray were all around 90%; the awareness rate of the recommended screening age in the breast cancer screening work plan was 74.71%, but the awareness rate of the screening time interval was only 24.25%. The awareness rates of screening age and screening time interval among breast cancer screening personnel (88.36%, 33.33%) were higher than those of non-breast cancer screening personnel (70.88%, 21.69%) (P < 0.001). Of the respondents, 689 (79.93%) and 684 (79.35%) agreed that breast cancer screening can improve the early detection rate and reduce the mortality rate of breast cancer, respectively, and 831 (96.40%) were willing to recommend regular breast cancer screening to women of appropriate age.
    Conclusion The awareness of breast cancer screening and the willingness to recommend breast cancer screening to women of appropriate age among medical staff in maternal and child health hospitals in Ordos city are relatively high, but the awareness of breast cancer prevention and treatment knowledge needs to be improved. Professional training in breast related knowledge should be strengthened for local medical staff.

     

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