目的 分析不同工作场所健康促进状态下员工的职业紧张状况,为后续开展工作场所健康促进提供参考.方法 以上海市闵行区企事业单位职工为研究对象.采用分阶段整群随机抽样的方法,在闵行区抽取25家单位,根据用人单位总人数确定所需调查的最小样本量,按照员工工号排序后随机抽取被调查人员名单.在知情同意和自愿参与的基础上,对单位员工实施横断面调查,收集研究对象的一般人口学特征和工作场所环境,采用《简明职业紧张问卷》调查其职业紧张情况.比较不同工作场所健康促进状态下受访者职业紧张状况.结果 纳入1356人,高职业紧张检出率为43.44％,工作要求、自主程度、社会支持、工作满意度各维度均分分别为(6.32±1.42)分、(6.28±1.18)分、(7.53±1.36)分、(6.22±1.49)分.与未开展健康创建的单位员工相比,已开展健康创建的单位员工的工作要求、自主程度、社会支持和工作满意度得分均较高(P<0.001),两类受访者的工作要求与自主程度(demand/control,D/C)比值无差异,高职业紧张检出率相当(P>0.05).单位若设有职业健康安全管理部门或部门内设有专人负责该工作,员工的自主程度、社会支持和工作满意度得分均较高(P<0.001),D/C比值相对较低,高职业紧张检出率较低(P<0.05).关注单位健康促进活动/培训或参加过单位组织的职业健康安全培训的受访者对工作要求的耐受度较强,感知相对较弱,工作要求得分较低(P<0.001);而对自主程度、社会支持的感知度较强(P<0.001);工作满意度也较高(P<0.001);D/C比值相对较低,高职业紧张检出率较低(P<0.05).结论 不同工作场所健康促进状态下员工的职业紧张存在差异.用人单位可以健康单位建设为抓手,提高劳动者对工作要求的适应和控制能力,降低员工职业紧张水平.

目的 对基于互联网大数据的"互动健康教育"模式下高血压病患者健康自管小组管理的效果进行评价.方法 2019年1-12月,采用自制调查问卷分析比较上海市闵行区参与"互动健康教育"健康自管小组(观察组)的高血压病患者和未参与的高血压病患者各300人的高血压病各指标、焦虑情况、服药依从性、生存质量、知识掌握情况及药品支付费用.结果 观 察组收缩压和舒张压分别为(133.33±9.35)和(77.54±5.34)mm Hg,血压达标率为72.0％,总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、体质指数(BMI)分别为(4.09±0.88)、(2.63±0.87)、(1.59±0.88)、(1.53±0.28)mmol/L和21.72±2.20,血脂达标率为85.7％,焦虑自评量表(SAS)评分为47.65±2.82,生存质量评分为65.98±1.68,Morisky服药依从性得分为7.65±2.82,知识掌握得分为13.84±1.22,年药品总费用和年人均药品自付费用分别为(2118.2±724.1)和(332.6±133.5)元,均优于对照组,差异均有统计学意义(均P＜0.05).结论 "互联网+互动健康教育"将互联网大数据引入健康教育,实现医生和居民的实时互动,是时代的进步,帮助医疗机构对慢性病患者进行有效管理,降低医药费用,值得进一步加强.

目的 对互联网互动健康教育下居民的健康素养进行研究,为本区制定健康教育与健康促进工作策略与规划提供科学依据.方法 2018年6—8月,对闵行区13个社区的15～69岁常住人口2,400人开展问卷调查.影响因素采用logistic逐步回归分析.结果 居民总体健康素养水平为28.5％.不同文化程度、职业、家庭人口数、年收入、患慢性病年数和自我健康状态人群的基本知识和理念素养、健康生活方式与行为素养、基本技能素养和总体健康素养水平差异有统计学意义(P<0.05).文化程度、家庭年收入和自我健康状况评估为基本知识和理念素养、健康生活方式与行为素养、基本技能素养和总体健康素养的共同促进因素,职业是共同影响因素.结论 "互联网+互动健康教育"的智慧服务,可以全方位进行健康知识宣教,提高居民健康素养水平.

目的 对2018年上海市闵行区健康自我管理小组效果进行评价,为上海市闵行区完善自管小组服务提供参考依据.方法 随机抽取上海市闵行区6组健康自我管理小组的121人进行问卷调查,问卷内容为健康自我管理小组活动中强调的健康素养知识的知晓率和健康生活方式的形成.干预半年后,对干预前后的数据进行对比分析.结果 干预后,居民的社会支持中8项指标得分明显提高(均P＜0.01),健康促进生活方式部分52个选项叶1,“每天吃蔬菜”、“会在运动时,测量自己的脉搏”、“会从关怀你的亲朋好友中,得到支持”、“运动时,会达到自己的日标心率”、“会感到有某种超自然的力量在身旁”、“会用讨论和折衷的办法,来解决和别人的冲突”6个项目干预前后,差异无统计学意义(P＞0.05),其他46个项目干预前后差异均有统计学意义(均P＜0.05).结论 上海市闵行区居民健康素养知晓率和健康行为形成均有提升空间,闵行区将继续深化和细化健康教育和健康促进工作,在社区进一步推广和落实健康自我管理小组项目,以提高居民的健康意识,促进居民健康.

目的 了解上海市闵行区社区卫生服务中心健康教育人力资源现状及存在问题.方法通过现况研究,采用自编问卷和访谈了解13家社区卫生服务中心的健康教育工作情况.结果全区防保科医务人员共有303人,其中男性74人(24.42％),女性229人(75.58％),平均年龄(32.21±7.86)岁.受教育程度以本科为主,共248人(81.85％);均为公共卫生或预防医学专业.调查对象平均工作年限4.32年.仅负责健康教育这一项工作的3人(23.08％),6人兼做包含健康教育工作在内的2项工作(46.15％),4人兼做3项工作(30.77％).2017年全区健康教育工作经费支出共计212.88万元,平均为17.74万元/社区卫生服务中心;全区共开展健康教育授课6,639节,平均讲课数为3.17节/居(村)委/季度.人员普遍感觉从事健康教育工作的困难主要来自项目调查和讲课的组织与落实.结论建议各社区卫生服务中心可以根据工作量提高健康教育人员配比,以保证社区健康教育人员的数量与质量和整合区内健康教育资源,从而促进社区健康教育工作开展.

OBJECTIVE To evaluate the effect of health promotion site construction in MinhangDistrict in 2018, and to improve the model of health promotion site construction in the district. METHODS From January to June 2018, the survey of healthy lifestyle and health literacy was carried out on the staff of 8 new health promotion units in the district by means of the personal survey questionnaire of new health promotion sites. RESULTS Varied lifestyle intervention were better after the intervention, the differences were statistically significant (P<0.05). CONCLUSION The establishment of new health promotion places could effectively improve the health behavior of the people in the places and improve their health literacy.It was worth further promote the sustainable development of health education and health promotion work, promote the health awareness and health level of the population in this area.

目的 采用第三方评价的方式全面了解医院住院患者的信任度行为情况及其影响因素,为医院提高住院患者信任度提供参考.方法 由专业的第三方评价机构对住院患者的信任度情况和信任度行为进行调查和评估,并对影响患者信任度行为的因素进行逐步回归分析.结果 不同年龄、性别、职业、文化程度、婚姻状况、医保形式、月收入、健康状况以及满意度的住院患者的信任度行为评分有显著差异(P<0.05).第三方信任度评价得分低于医院信任度自评(P<0.05).年龄、性别、文化程度、婚姻状况、医保形式、月收入、健康状况以及满意度是影响住院患者信任度行为的主要因素.结论 由专业的第三方评价机构对住院患者的信任度进行评价的结果与医院自评的结果存在差异性.对信任度行为的影响因素进行分析,有助于更加客观地了解医院医疗服务现况,改进医疗服务质量,为制定更完善的医疗保障制度提供参考依据.

Objective To investigate passive smoking status and to analyze health influencing factors among infants in Minhang District of Shanghai.Methods All 1 686 infants in Minhang District from May 2011 to May 2013 were recruited to be the subjects,and a questionnaire-based survey was conducted among their parents to collect the characteristics,passive smoking and health status of the infants.Results The prevalence of passive smoking in infants during their mothers' pregnancy and within one year after birth was 52.7％ and 19.2％,respectively.Total of 571 (33.9％) infants surveyed were reported to suffer from health problems.The investigated infants who suffered from passive smoking during mothers' pregnancy (OR =1.920,P＜0.001) and within one year after birth (OR=1.596,P＜0.001) were more likely to get health problems.Compared to the infants with six-month exclusive breast feeding,the infants with six-month artificially feeding were more likely to get health problems (OR=1.710,P＜0.001).Conclusions The prevalence of passive smoking for the investigated infants was high.Passive smoking during mothers' pregnancy as well as after birth were the risk factors for the infants' health.

Objective To explore health literacy and the related factors among enterprise employees in Minhang District of Shanghai,and to provide scientific basis for the development of health literacy promotion strategies for occupational population.Methods Through cluster random sampling,15 manufacturing enterprises of Minhang District were selected.The information of health-supportive environment in the workplace was collected through field observation.And the general demographic characteristics,occupational characteristics,health literacy and self-efficacy of the subjects were collected through the survey.Results Only about 28.36％ of the 1 421 employees surveyed possessed basic health literacy.Education level,marital status,working nature and payment pressure were the factors affecting the health literacy level of respondents.Compared with the employees who had at least a bachelor degree,the health literacy level of the employees who had a lower degree of bachelor was relatively low (P＜0.05).The health literacy level of employees in non-marital status was relatively lower than those who were married (OR =1.515,P =0.021).Compared with the managers,the health literacy levels of clericals,production operators and logistical service personnel were low (P ＜0.05).Employees who had the pressure to pay possessed a low level of health literacy (OR =1.641,P＜0.001).Conclusions The health literacy level of employees in this region was better than the average level of Chinese citizen,but it was still not optimistic.The health literacy level of enterprise employees was affected by many factors,and these factors were closely related.Improving the health supportive environment in the workplace may be an effective strategy for promoting health literacy among occupational populations.

目的 探讨认知访谈技术在职业人群健康素养量表编制中的应用.方法 通过专业人员小组访谈收集职业人群健康素养评价指标,结合国内外相关量表问题,形成初测问卷.通过实施认知访谈,查找受试者与研究者之间的认知偏差,优化问题结构、提问方式及语词使用.结果 本研究共实施2轮认知访谈,第一轮访谈从事职业卫生相关工作的人员12名,重点探讨职业健康素养的相关概念;第二轮访谈各类在职人员26名,重点关注问卷条目的设计.通过对受试者认知过程的分析,发现初测问卷在提问方式、用词及选项设置方面的问题,对问卷进行修改完善.结论 认知访谈是一种验证问卷质量的方法,可发现受试者在答题过程中遇到的问题,从而发现和改善问卷设计上的缺陷,提高问卷的信度和效度.

Objective To explore the relationship between quality life and TCM constitutions of elderly patients with hypertension in a community in Shanghai; To provide the basis for the suitable and feasible community elderly hypertension management method. Methods Through multistage stratified sampling method, 808 elderly patients with hypertension in the community were investigated for their life quality and TCM constitutions on the basis of inform consent and voluntary participation. The life quality and TCM constitution characteristics as well as the relationship were analyzed by applying the statistic analysis software. Results Among the investigated elderly patients with hypertension in the community, 97.28% cases’ overall life quality was above the middle level and 91.46% cases’ self-evaluated health and quality of life scores were above the middle level. 54.70% cases were gentleness type, and the biased constitution was dominated by qi deficiency, yang asthenia, yin asthenia and phlegmatic hygrosis. The relationship between life quality and TCM constitutions may be existent. If TCM constitutions tended to be gentleness type, the physical score and the psychological score would be higher, which leaded to better quality of life. Conclusion TCM constitution characteristics are associated with quality life of elderly hypertension patients in the community. Intervention targeted on the results of TCM constitution identification would be better to prevent and control hypertension and improve health level and quality of life.

[目的]了解上海市闵行区社区家庭医生的职业倦怠状况,探讨职业倦怠的影响因素. [方法]采用通用职业倦怠问卷、工作要求-自主-社会支持模式简明职业紧张问卷以及自行设计的基本情况问卷于2015年4-6月对闵行区全体家庭医生进行问卷调查.采用X2检验和logistic回归分析职业倦怠的影响因素. [结果]共发放问卷415份,回收有效问卷414份,回收率为99.8％.家庭医生职业倦怠阳性率为79.2％.男性家庭医生中,社会支持得分越高,职业倦怠阳性率越低(OR=0.188,P=0.005).女性家庭医生中,年龄大于等于50岁(相对于年龄小于30岁者,OR=6.431,P=0.032)、参与轮班(OR=4.368,P=0.001)、职业紧张表现为阳性(OR=53.959,P=0.001)者具有较高的倦怠阳性率;而社会支持得分越高,倦怠阳性率越低(OR=0.234,P=0.001). [结论]阂行区家庭医生的职业倦怠状况较为严重.男性家庭医生职业倦怠的主要影响因素为社会支持,女性家庭医生职业倦怠的主要影响因素为年龄、轮班情况、社会支持和职业紧张.

[目的]探讨孕期健康及行为相关因素对足月新生儿低出生体重的影响. [方法]采用队列研究,将上海某区孕期＜20周的孕早期妇女纳入队列,最后分娩单胎足月活产儿的孕妇共2768人.采用x2检验和logistic回归分析孕期被动吸烟、文化程度、经济状况等因素和低出生体重的关系. [结果]在2768名产妇中,有1284人(46.4％)至少在孕早期或孕晚期有二手烟暴露的情况,孕妇低身高(模型1:OR=0.9,95％CI为0.840～0.996;模型2:OR=0.9,95％CI为0.860～0.998)及怀孕后患有疾病(模型1:OR=2.7,95％CI为1.1～6.5;模型2:OR=2.7,95％CI为1.1～6.6)会增加发生低出生体重儿的风险,孕早期或孕晚期的被动吸烟史对胎儿的出生体重没有影响. [结论]本研究并未发现孕期被动吸烟与胎儿低出生体重发生率之间的关联.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的了解上海市闵行区在职孕妇各领域身体活动现状,并探讨各领域身体活动的影响因素。方法2011年5月—2012年5月将符合入组条件的2 170名孕妇招募入组,采用问卷调查方式对其进行调查。结果在职孕妇参与交通行程身体活动比例为26.77%,在各领域身体活动参与比例中最高,在职孕妇在工作、交通行程和闲暇时间中身体活动活跃率分别为4.38%、9.26%和1.11%,每天静坐时间为（408.12±183.35）min;在职孕妇工作中等强度运动参与情况与年龄呈负相关,而闲暇时间中等强度运动与年龄呈正相关;在职孕妇交通行程身体活动参与情况与年龄呈正相关,但与孕周数和家庭经济情况呈负相关;在职孕妇为初产妇时,其越有可能在交通行程中采用步行或骑自行车方式,但是在工作中就越不可能进行中等强度运动。结论在职孕妇各领域身体活动水平均较低,但是其参与交通行程身体活动比例最高;在职女性在孕期的身体活动与年龄、孕周数、是否为初产妇和家庭经济状况相关。</span>

Objective:To know the operation of community health counseling spots in a district of Shanghai and to provide evidence for standardizing and upgrading the service status of community health counseling spots. Methods:A questionnaire survey was conducted to evaluate the basic information,equipped room space,personnel and hardware facilities as well as the services delivered. Results:In the district,there were 402 health counseling spots,equipped with 597 consulting service personnel. A total of 87.8%spots were located in the neighborhood committee. The personnel were mainly made up of health promotion volunteers(72.2%). Totally 64.8%of the personnel had medical background. Meanwhile,the average service time per week was 3.8 hours. Conclusion:Under the new circumstance of community health service transition,serious consideration and the development of practice should be made to the reasonable localization as well as capacity building of the spots and the normative entry as well as management of consultants.

[Objective] To develop a Chinese version of health literacy scale for occupational population, and to assess its reliability, validity, and application through a pilot study. [Methods] Currently employed residents were recruited from urban and rural de jure residents in one district of Shanghai. Initial items of the scale were generated on the basis of literature review and experts consultation. Cognitive interviews were conducted in employees from various job categories to revise the initial items and develop a scale draft. Communites, buildings, and families were selected by multistage cluster random sampling method. All the members in the selected families were interviewed on demographics, health literacy, behavior characteristics, and other information after informed consent obtained. Epi Data 3.1 software was used to establish database, and reliability, validity, and application effect of the scale were evaluated using SPSS 18.0 software. [Results] The health literacy scale for employed residents consisted of 26 items under 7 dimensions(information evaluation and utilization, workfare utilization, health care information accessibility, job hazard identification ability, job hazard protection capability, right-protection awareness of occupational health, and health awareness). The seven common factors explained 55.762% variance variation and KMO(Kaiser-Meyer-Olkin) value was 0.873 in the factor analysis. The factor load coefficients were between 0.438 and 0.928. The Cronbachu0027s α value of the scale was 0.887, and that of each dimension of the scale ranged from 0.654 to 0.900; the ICC value of the health literacy level measured in the two surveys was 0.938, and that of each item ranged from 0.779 to 0.956, indicating high internal consistency and test-retest reliability. The result indicated that the scale showed competent to distinguish health literacy level of occupational population. [Conclusion] The health literacy scale for occupational population has acceptable reliability, validity, and application effect, thus could be applied to assess the health literacy in occupational population.

目的 了解上海市闵行区居民生活满意度和社会支持、应对方式现况,分析其相互关系,为社区开展心理健康干预提供依据.方法 采用简单随机抽样方法,对年满18周岁常住居民开展调查.测评工具选用“简明幸福与生活质量满意程度量表”、“社会支持评定量表”和“简单应对方式问卷”.结果 共调查1 440人,居民生活满意度得分为(51.16±6.62)分,社会支持总分为(41.02±7.30)分,积极应对得分为(1.57±0.63)分,消极应对得分为(1.05±0.55)分.生活满意度与社会支持的3个维度及应对方式的二个维度间呈正相关(P＜0.05).结论 社区居民的生活满意度与社会支持状况较好,但应对相时不足.未来在不断改善促进健康的客观支持环境的同时,更应关注人们的主观感知度,改善认知,提高意识与自我效能.

目的 了解高血压患者血压控制现状,探讨高血压患者社会支持、药物治疗依从性与血压控制间的关系.方法 2011年8月至11月,选取上海市某区慢性病管理系统中的高血压患者为调查对象,以调查对象自填问卷的方式完成调查.采用社会支持量表和药物治疗依从性问卷,对患者的社会支持和药物治疗依从性进行评估.结果 共调查正在服药的高血压患者1059例,66.2％调查对象血压控制在目标水平(＜140/90 mm Hg),70.5％调查对象药物治疗依从性佳；正在服药的高血压患者的社会支持总得分为(39.64±7.19)分,主观支持、客观支持和支持利用度得分分别为(24.23±4.73)分、(8.51±2.56)分和(6.91±2.20)分；Spearman等级相关分析显示,支持利用度评分与药物治疗依从性得分明显相关(‘=0.86,P＜0.01)；多因素分析示支持利用度高(OR 1.56,95％ CI 1.17～2.07)、高血压病程长(＞5～10年:OR 1.99,95％ CI 1.40～2.83;＞10年:OR 1.44,95％ CI 1.03～2.02)、家庭人均月收入高(OR 2.10,95％ CI1.33～3.30)是药物治疗依从性的保护因素；男性(OR0.58,95％ CI 0.44～0.76)、高血压分级高(OR 0.33,95％ CI 0.16～0.67)是血压控制的危险因素；药物治疗依从性佳(OR 1.48,95％ CI1.11～1.98)是血压控制的保护因素(均P＜0.05).结论 构建有效的社会支持系统,提高患者的社会支持利用度,并着重对高血压病程短、家庭人均月收入低、男性和高血压分级高者进行干预,对进一步提高高血压患者的药物治疗依从性和高血压控制率更有意义.

Objective To understand the health literacy level of country adults in Minhang Distruct, and provide an effective and reasonable basis for further adjusting public health policy, allocating the health resources, and developing health literacy intervention activities. Methods A survey was conducted on 150 residents of 15-69 years old in two villages in Minhang District. Results The rate of health literacy was 30.24% among community residents in the monitored areas. The rate of basic knowledge and conceptual literacy was the highest (41.19%). Health skills training listed as the second (33.43%). The rate of healthy life style and behavior literacy (30.15%) listed in the end, which was popular among residents with different characteristics. Conclusion Through the implementation of targeted interventions in Minhang District, the overall rate of health literacy for people in the monitored areas in 2011 has increased to 30.24%, higher than that in 2010 (10.67%), also higher than that for Shanghai citizens ( 10.99%) in 2010.

OBJECTIVE To understand knowledge,attitudes and demands of reproductive health among first-year college students in Shanghai,and to provide evidence for implementing reproductive health education in universities.METHODS A survey using self-designed questionnaires was employed in participants who were selected from a university in Shanghai by cluster random sampling method.RESULTS Participants had quite good AIDS-related health knowledge but were not well aware of general knowledge on reproductive health and other sexually transmitted diseases.Compared to the students who never attended reproductive health lectures,those who ever attended such lectures showed better knowledge only on a minority of questions,the difference of which was non-significant.The top three channels from which college students get reproductive health knowledge are:health lecture,health consultation and text message.CONCLUSIONS The awareness of reproductive health knowledge was not comprehensive in Shanghai college students.According to the students' demands of reproductive health education,teaching contents need constant improvement.Health lectures,health consultation and text message could help universities promote reproductive health education.