Sim Shin Wei, Moey Kirm Seng Peter, Tan Ngiap Chuan
Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore 119228.
Singapore Med J. 2014 Mar;55(3):160-7. doi: 10.11622/smedj.2014037.
Acute respiratory infections are prevalent and pose a constant threat to society. While the use of facemasks has proven to be an effective barrier to curb the aerosol spread of such diseases, its use in the local community is uncommon, resulting in doubts being cast on its effectiveness in preventing airborne infections during epidemics. We thus aimed to conduct a literature review to determine the factors that influence the use of facemasks as a primary preventive health measure in the community.
A search for publications relating to facemask usage was performed on Medline, PubMed, Google, World Health Organization and Singapore government agencies' websites, using search terms such as 'facemask', 'mask', 'influenza', 'respiratory infection', 'personal protective equipment', 'disease prevention', 'compliance' and 'adherence'. Findings were framed under five components of the Health Belief Model: perceived susceptibility, perceived benefits, perceived severity, perceived barriers and cues to action.
We found that individuals are more likely to wear facemasks due to the perceived susceptibility and perceived severity of being afflicted with life-threatening diseases. Although perceived susceptibility appeared to be the most significant factor determining compliance, perceived benefits of mask-wearing was found to have significant effects on mask-wearing compliance as well. Perceived barriers include experience or perception of personal discomfort and sense of embarrassment. Media blitz and public health promotion activities supported by government agencies provide cues to increase the public's usage of facemasks.
Complex interventions that use multipronged approaches targeting the five components of the Health Belief Model, especially perceived susceptibility, are needed to increase the use of facemasks in the community. Further studies are required to evaluate the effectiveness of implemented interventions.
急性呼吸道感染很常见，对社会构成持续威胁。虽然事实证明使用口罩是遏制此类疾病气溶胶传播的有效屏障，但在当地社区中口罩的使用并不普遍，这引发了人们对其在疫情期间预防空气传播感染有效性的质疑。因此，我们旨在进行一项文献综述，以确定影响在社区中将使用口罩作为主要预防性健康措施的因素。
在医学文献数据库（Medline）、PubMed、谷歌、世界卫生组织以及新加坡政府机构网站上搜索与口罩使用相关的出版物，使用的搜索词包括“口罩”“面罩”“流感”“呼吸道感染”“个人防护装备”“疾病预防”“依从性”和“坚持性”。研究结果按照健康信念模型的五个组成部分进行梳理：感知易感性、感知益处、感知严重性、感知障碍和行动提示。
我们发现，由于感知到感染危及生命疾病的易感性和严重性，个人更有可能佩戴口罩。虽然感知易感性似乎是决定依从性的最重要因素，但佩戴口罩的感知益处对佩戴口罩的依从性也有显著影响。感知障碍包括个人不适的体验或感受以及尴尬感。媒体宣传以及政府机构支持的公共卫生促进活动提供了增加公众使用口罩的行动提示。
需要采用针对健康信念模型五个组成部分、尤其是感知易感性的多管齐下的复杂干预措施，以增加社区中口罩的使用。需要进一步研究来评估已实施干预措施的有效性。
