中国湖南医学生结核病知识及影响因素的横断面研究。
Knowledge and determinants regarding tuberculosis among medical students in Hunan, China: a cross-sectional study.
机构信息
School Key Discipline of Nutrition and Food Hygiene, Public Health School, Changsha Medical University, Changsha, People's Republic of China.
Department of Dermatology and Venereology, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, People's Republic of China.
出版信息
BMC Public Health. 2018 Jun 13;18(1):730. doi: 10.1186/s12889-018-5636-x.
BACKGROUND
Tuberculosis (TB) is one of the most common infectious diseases worldwide. Insufficient TB knowledge may increase the risk of contracting the disease among medical students. The purpose of this study was to assess the level of TB knowledge and analyse related determinants among medical students.
METHODS
A cross-sectional study was performed among final-year medical students from three main undergraduate medical universities in Hunan Province. TB knowledge, attitude and practice were assessed using a questionnaire. A t-test and multiple linear regression analysis were conducted to explore the association between TB knowledge and influencing factors.
RESULTS
The total mean percentage of correct answers for TB knowledge was 44.4% (SD 13.5%), including 52.5% (SD 16.8%) for epidemiology and prevention, 35.7% (SD 16.1%) for diagnosis, and 47.5% (SD 22.7%) for treatment. Medical students who reported observing at least one TB case and an X-ray of a TB patient had a higher percentage of correct answers for epidemiology and prevention (54.4% vs 43.9%, p < 0.001; 54.3% vs 42.1%, p < 0.001), diagnosis (37.2% vs 29.0%, p < 0.001; 37.1% vs 27.5%, p < 0.001), treatment (50.0% vs 36.0%, p < 0.001; 49.5% vs 35.7%, p < 0.001) and total score (46.2% vs 36.2, p < 0.001; 46.0% vs 34.7%, p < 0.001). Older medical students (≥23 years) had greater knowledge than younger medical students (< 23 years) regarding diagnosis (37.2% vs 31.7%, p < 0.001). The multivariable linear regression analysis determined an association between observing at least one TB case and an X-ray of a TB patient and greater knowledge of epidemiology and prevention (β = 5.6, 95% CI: 2.3, 8.9; β = 8.2, 95% CI: 4.6, 11.8), diagnosis (β = 3.9, 95% CI: 0.8, 7.1; β = 5.7, 95% CI: 2.2, 9.2) and treatment (β = 10.1, 95% CI: 5.6, 14.5; β = 7.0, 95% CI: 2.2, 11.8) and a higher total score (β = 5.5, 95% CI: 2.9, 8.1; β = 6.6, 95% CI: 3.8, 9.5). Moreover, an older age (≥23 years) was associated with more accurate knowledge of diagnosis (β = 3.9, 95% CI: 1.8, 6.1) and a higher total score (β = 2.8, 95% CI: 1.1, 4.6).
CONCLUSION
Poor TB knowledge was observed among medical students, which implied a need to innovate our current infectious disease curriculum to promote TB knowledge and practices among medical students.
背景
结核病（TB）是全球最常见的传染病之一。医学学生对结核病知识的了解不足可能会增加他们感染这种疾病的风险。本研究的目的是评估医学学生的结核病知识水平，并分析相关决定因素。
方法
在湖南省三所主要本科医学院校的应届医学生中进行了一项横断面研究。使用问卷评估结核病知识、态度和实践。采用 t 检验和多元线性回归分析探讨结核病知识与影响因素之间的关系。
结果
结核病知识的总平均正确回答率为 44.4%（SD 13.5%），其中流行病学和预防方面为 52.5%（SD 16.8%），诊断方面为 35.7%（SD 16.1%），治疗方面为 47.5%（SD 22.7%）。报告至少观察过一例结核病病例和一张结核病患者 X 光片的医学生，在流行病学和预防（54.4%比 43.9%，p<0.001；54.3%比 42.1%，p<0.001）、诊断（37.2%比 29.0%，p<0.001；37.1%比 27.5%，p<0.001）、治疗（50.0%比 36.0%，p<0.001；49.5%比 35.7%，p<0.001）和总分（46.2%比 36.2%，p<0.001；46.0%比 34.7%，p<0.001）方面的正确回答率更高。年龄较大（≥23 岁）的医学生在诊断方面的知识比年龄较小（<23 岁）的医学生更为丰富（37.2%比 31.7%，p<0.001）。多变量线性回归分析确定，观察至少一例结核病病例和一张结核病患者 X 光片与流行病学和预防知识（β=5.6，95%CI：2.3，8.9；β=8.2，95%CI：4.6，11.8）、诊断（β=3.9，95%CI：0.8，7.1；β=5.7，95%CI：2.2，9.2）和治疗（β=10.1，95%CI：5.6，14.5；β=7.0，95%CI：2.2，11.8）以及总分（β=5.5，95%CI：2.9，8.1；β=6.6，95%CI：3.8，9.5）更高有关，年龄较大（≥23 岁）与更准确的诊断知识（β=3.9，95%CI：1.8，6.1）和更高的总分（β=2.8，95%CI：1.1，4.6）有关。
结论
医学学生的结核病知识水平较差，这表明需要创新我们当前的传染病课程，以促进医学学生对结核病知识和实践的了解。
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