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初级医疗保健提供者的积极态度预示着更好的乙肝预防措施:来自乌干达中部瓦基索区横断面调查的证据。

A positive attitude among primary healthcare providers predicts better hepatitis B prevention practices: evidence from a cross-sectional survey in Wakiso district, Central Uganda.

作者信息

Ssekamatte Tonny, Isunju John Bosco, Zirimala Paul Alex Kimoga, Etajak Samuel, Kamukama Saul, Seviiri Mathias, Nakafeero Mary, Nalugya Aisha, Tsebeni Wafula Solomon, Atusingwize Edwinah, Bukenya Justine N, Mugambe Richard K

机构信息

Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.

Department of Health, Wakiso District Local Government, Wakiso, Uganda.

出版信息

Health Psychol Behav Med. 2021 Apr 7;9(1):298-314. doi: 10.1080/21642850.2021.1904935.

Abstract

Hepatitis B Virus (HBV) infection is an important occupational health risk among primary healthcare providers (PHCPs). However, there is limited evidence on whether PHCPs' level of knowledge and attitude can predict better HBV infection prevention practices. This study established the relationship between knowledge, attitude, and HBV infection prevention practices among PHCPs in Wakiso district, Central Uganda. A cross-sectional study design was used. Data were collected from 306 PHCPs, using a structured questionnaire. PHCPs were randomly selected from 55 healthcare facilities. STATA version 14.0 was used to analyse data. A 'modified Poisson' regression model was used for inferential statistics. About 42.2% of PHCPs exhibited poor knowledge of HBV infection transmission and prevention, 41.8% had a negative attitude, and 41.5% exhibited poor prevention practices. Age (PR 1.82, 95% CI: 1.24-2.66) was positively associated with the level of knowledge. Healthcare facility level (PR 0.53, 95% CI: 0.34-0.84), main department of work (PR 0.69, 95% CI: 0.51-0.95), years in service (PR 0.66, 95% CI: 0.44-0.99), working in private not-for-profit healthcare facilities (PR 0.59, 95% CI: 0.34-0.99), and public healthcare facilities (PR 0.58, 95% CI: 0.42-0.80) were negatively associated with the level of knowledge. There was a negative association between the location of healthcare facility (PR 0.76, 95% CI: 0.62-0.93) and attitude, and a positive association between level of knowledge (PR 1.36, 95% 1.12-1.65) and attitude. Working in a public healthcare facility (PR 0.80, 95% CI: 0.64-0.99) was negatively associated with practices while having a positive attitude (PR 1.60, 95% CI: 1.28-1.99) predicted better HBV infection prevention practices. PHCPs who were more knowledgeable about HBV infection were more likely to have a positive attitude. In turn, having a positive attitude was associated with better HBV infection prevention practices. There is a need to sensitise PHCPs on HBV infection, and provision of screening and vaccination services in order to address the KAP gaps.

摘要

乙肝病毒(HBV)感染是基层医疗服务提供者(PHCPs)面临的一项重要职业健康风险。然而,关于PHCPs的知识水平和态度能否预测更好的HBV感染预防措施,证据有限。本研究确定了乌干达中部瓦基索区PHCPs的知识、态度与HBV感染预防措施之间的关系。采用了横断面研究设计。使用结构化问卷从306名PHCPs收集数据。PHCPs是从55家医疗机构中随机选取的。使用STATA 14.0版本分析数据。采用“修正泊松”回归模型进行推断统计。约42.2%的PHCPs对HBV感染传播和预防的知识掌握较差,41.8%态度消极,41.5%预防措施不力。年龄(PR 1.82,95%CI:1.24 - 2.66)与知识水平呈正相关。医疗机构级别(PR 0.53,95%CI:0.34 - 0.84)、主要工作部门(PR 0.69,95%CI:0.51 - 0.95)、工作年限(PR 0.66,95%CI:0.44 - 0.99)、在私立非营利性医疗机构工作(PR 0.59,95%CI:0.34 - 0.99)以及在公立医疗机构工作(PR 0.58,95%CI:0.42 - 0.80)与知识水平呈负相关。医疗机构的位置(PR 0.76,95%CI:0.62 - 0.93)与态度呈负相关,知识水平(PR 1.36,95% 1.12 - 1.65)与态度呈正相关。在公立医疗机构工作(PR 0.80,95%CI:0.64 - 0.99)与预防措施呈负相关,而态度积极(PR 1.60,95%CI:1.28 - 1.99)预示着更好的HBV感染预防措施。对HBV感染了解更多的PHCPs更有可能态度积极。反过来,态度积极与更好的HBV感染预防措施相关。有必要提高PHCPs对HBV感染的认识,并提供筛查和疫苗接种服务,以弥补知识、态度和行为方面的差距。

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