上海2723名儿童照料者对小面积烧伤急救知识的认知水平:一项横断面调查与分析
[Cognitive level of first aid knowledge regarding small area burn among 2 723 child caregivers in Shanghai: a cross-sectional survey and analysis].
作者信息
Yu Q, Xiao Y Q, Hu X Y, Xia Z F
机构信息
Burn Institute of PLA, Department of Burn Surgery, the First Affiliated Hospital, Naval Military Medical University, Shanghai 200433, China.
出版信息
Zhonghua Shao Shang Za Zhi. 2019 Mar 20;35(3):198-204. doi: 10.3760/cma.j.issn.1009-2587.2019.03.007.
To assess the cognitive level of first aid knowledge regarding the small area burn among the child caregivers in Shanghai and improve the level of first aid for small area burn in children. From November 2017 to March 2018, 7 municipal districts in Shanghai were selected according to the random number table, from which 2 750 students of 4 nurseries, 5 kindergartens, 6 primary schools, and 2 junior middle schools were selected by adopting the convenience sampling method. Each student was limited to one caregiver as the research object. A cross-sectional survey was conducted on the cognitive level of first aid knowledge regarding small area burn among the caregivers with self-designed questionnaire through WeChat and Tencent QQ. The age, burn experience, and scarring after burns in children, the prevalence rate of burn in children of different age groups, the educational background of caregivers and their social relationship with their children, and the measures taken by caregivers firstly after small area burn occurred among their children were recorded. The choices of applying the folk prescription drugs to the wounds of their children made by caregivers and those with different educational backgrounds were recorded. The choices of applying daily necessities to the wound of their children made by caregivers were recorded. The caregivers' knowledge of standard first aid measures for small area burn, and the knowledge of caregivers with different educational backgrounds of all standard first aid measures for small area burn were recorded. The caregivers' choices of hospitals for treatment the first time, and the choices of going to the Grade Ⅲ Level A hospital with burn specialty for treatment made by caregivers with different knowledge levels about first aid measures for small area burn and those by caregivers whose children did or didn't have burn experience were recorded. The caregivers' choices of different types of medical institutions with burn specialty or specialized in burn treatment, and choices of going to burn department of comprehensive Grade Ⅲ Level A hospital for treatment made by caregivers with different knowledge levels about first aid measures for small area burn were recorded. Data were processed with Pearson chi-square test and partitions of chi-square test. The effective recovery rate of questionnaire was 99.0% (2 723/2 750). The ages of children were mainly 6-11 years [64.7% (1 762/2 723)]The prevalence of burn in children was 19.4% (527/2 723). There was no statistically significant difference in the overall comparison of burn prevalence of children among the age groups ((2)=1.424, >0.05). The percentage of scar formation after burn in children was 27.3% (144/527). The education backgrounds of caregivers were mainly undergraduate [40.2% (1 094/2 723)], and their social relationships with children were mainly children's mothers [74.6% (2 030/2 723)]. Assuming that their children suffered from minor burns, the measures firstly taken by 74.0% (2 016/2 723) of the caregivers was to immediately access cool running water and remove clothing on the wound of children. Totally 19.2% (523/2 723) of the caregivers chose to apply folk prescription drugs for their burn children by themselves, and the percentage of caregivers with education background of junior middle school choosing to apply folk prescription drugs for their burn children by themselves was significantly higher than that of caregivers with education background of junior college, undergraduate, or graduate ((2)=18.502, 20.642, 13.319, <0.05). Totally 49.2% (1 340/2 723) of caregivers chose to daub many kinds of daily necessities for their burn children by themselves. Totally 39.2% (1 068/2 723) of caregivers knew all standard first aid measures for small area burn, the percentage of caregivers with education background of undergraduate knowing all standard first aid measures for small area burn was significantly higher than that of caregivers with education background of senior high school and secondary specialized school ((2)=11.234, <0.05). Assuming that their children suffered from minor burns, 39.0% (1 063/2 723) of the caregivers chose to go to the nearest hospital for treatment the first time, the percentage of caregivers who knew all standard first aid measures for small area burn choosing to go to Grade Ⅲ Level A hospital with burn specialty for treatment the first time was similar with that of caregivers who did not know/did not fully know ((2)=3.528, >0.05), and the percentage of caregivers whose children had burn experience choosing to go to Grade Ⅲ Level A hospital with burn specialty for treatment in the first time was similar with that of caregivers whose children didn't have burn experience ((2)=3.521, >0.05). Among all medical institutions with burn specialty or specialized in burn treatment, 28.0% (762/2 723) of the caregivers chose to go to comprehensive Grade Ⅲ Level A hospital for treatment, and the percentage of caregivers who knew all standard first aid measures for small area burn choosing to go to comprehensive Grade Ⅲ Level A hospital for treatment was significantly higher than that of caregivers who did not know/did not fully know ((2)=4.890, <0.05). The caregivers of children are mainly children's mothers with education background of undergraduate in Shanghai, and caregivers' cognitive levels of first aid knowledge regarding the small area burn are low. Only a few caregivers know all standard first aid measures for small area burn, and there are still some caregivers who have the wrong idea of applying folk prescription drugs or daily necessities for children by themselves. The publicity and education of basic first aid knowledge of burn should be strengthened through various channels such as burn simulation exercise and network, and caregivers should be guided to take their children to hospitals with burn specialty for treatment after occurrence of burn in children, so as to obtain more professional medical treatment.
评估上海市儿童照料者对小儿小面积烧伤急救知识的认知水平,提高儿童小面积烧伤的急救水平。2017年11月至2018年3月,按照随机数字表法抽取上海市7个城区,采用方便抽样法从4所托儿所、5所幼儿园、6所小学和2所初中选取2750名学生,每名学生限选1名照料者作为研究对象。通过微信和腾讯QQ采用自行设计的问卷对照料者进行小儿小面积烧伤急救知识认知水平的横断面调查。记录儿童的年龄、烧伤经历及烧伤后瘢痕形成情况,不同年龄组儿童的烧伤患病率,照料者的文化程度及其与儿童的社会关系,儿童小面积烧伤发生后照料者首先采取的措施。记录照料者对儿童伤口自行涂抹民间方药的选择情况及不同文化程度照料者的选择情况。记录照料者对儿童伤口自行涂抹日常用品的选择情况。记录照料者对小儿小面积烧伤标准急救措施的知晓情况及不同文化程度照料者对所有小儿小面积烧伤标准急救措施的知晓情况。记录照料者首次就诊医院的选择情况,不同小面积烧伤急救知识水平照料者及儿童有无烧伤经历的照料者选择到有烧伤专科的三级甲等医院就诊的情况。记录不同小面积烧伤急救知识水平照料者对不同类型烧伤专科医院或专门治疗烧伤机构的选择情况及选择到综合三级甲等医院烧伤科就诊的情况。采用Pearson卡方检验及卡方分割检验进行数据处理。问卷有效回收率为99.0%(2723/2750)。儿童年龄主要为6~11岁[64.7%(1762/2723)]。儿童烧伤患病率为19.4%(527/2723)。各年龄组儿童烧伤患病率总体比较差异无统计学意义(χ²=1.424,P>0.05)。儿童烧伤后瘢痕形成率为27.3%(144/527)。照料者文化程度主要为本科[40.2%(1094/2723)],其与儿童的社会关系主要为儿童母亲[74.6%(2030/2723)]。假设其孩子发生轻度烧伤,74.0%(2016/2723)的照料者首先采取的措施是立即用流动凉水冲洗并脱去孩子伤口处衣物。共有19.2%(523/2723)的照料者选择自行给烧伤孩子涂抹民间方药,初中文化程度照料者自行给烧伤孩子涂抹民间方药 的比例显著高于大专、本科及研究生文化程度的照料者(χ²=18.502、20.642、13.319,P<0.05)。共有49.2%(1340/2723)的照料者选择自行给烧伤孩子涂抹多种日常用品。共有39.2%(1068/2723)的照料者知晓小儿小面积烧伤所有标准急救措施,本科文化程度照料者知晓小儿小面积烧伤所有标准急救措施的比例显著高于高中及中专文化程度的照料者(χ²=11.234,P<0.05)。假设其孩子发生轻度烧伤,39.0%(1063/2723)的照料者选择首次到附近医院就诊,知晓小儿小面积烧伤所有标准急救措施的照料者首次选择到有烧伤专科的三级甲等医院就诊的比例与不知晓/未完全知晓的照料者相似(χ²=3.528,P>0.05),儿童有烧伤经历的照料者首次选择到有烧伤专科的三级甲等医院就诊的比例与儿童无烧伤经历的照料者相似(χ²=3.521,P>0.05)。在所有烧伤专科医院或专门治疗烧伤机构中,28.0%(762/2723)的照料者选择到综合三级甲等医院就诊,知晓小儿小面积烧伤所有标准急救措施的照料者选择到综合三级甲等医院就诊的比例显著高于不知晓/未完全知晓的照料者(χ²=4.890,P<0.05)。上海市儿童照料者主要为本科文化程度的儿童母亲,其对小儿小面积烧伤急救知识的认知水平较低。仅少数照料者知晓小儿小面积烧伤所有标准急救措施,仍有部分照料者存在自行给儿童涂抹民间方药或日常用品的错误观念。应通过烧伤模拟演练、网络等多种渠道加强烧伤基本急救知识的宣传教育,指导照料者在儿童烧伤后带其到有烧伤专科的医院就诊,以获得更专业的救治。