目的 通过构建学生结核病防治KAP结构方程模型,分析模型各因素间的作用机制,并比较不同学生组别间的模型差别.方法 利用2006年全国公众结核病防治知识信念行为调查的数据,采用结构方程对数据进行拟合评估构建学生结核病防治的KAP模型.并从形态、参数两方面分别对小学生、初中生和高中/职高生的KAP模型进行多组比较.结果 结核病卫生知识和政策知识的及格率仅为25.7％和38.1％;有59％和54.5％的学生表示很愿意获得结核病的防治知识和参与结核病防治活动;学生主动了解和主动向别人讲过结核病防治知识的仅占12.5％和9.3％.结构方程模型的拟合效果较佳.多组结构方程分析结果显示不同学习阶段学生的KAP模型形态一致,但是模型参数不同(Δx2=63.519,Δdf =8,P ＜0.01);三组学生结核病知识分别对态度、行为的直接作用的路径系数均有统计学意义(P＜0.01),但作用强度不同;态度对行为均呈现较弱的负效应(P＞0.05).结论 学生结核病防治知识有待提高、主动执行防治行为的比例明显低于态度.不同学习阶段学生的KAP模型中有关知识对态度和行为的作用强度不同,因此对于不同学习阶段学生结核病的健康教育应该采取不同的策略.

结核病是一种严重危害人类健康的慢性传染病.2000年全国结核病流行病学抽样调查结果显示全国活动性肺结核患病率仍高达367/10万[1].有效遏制结核病不仅需要政府的投入和医务人员的努力,更需要公众对结核病的认知和相关政策的知晓.在以农村人口为主题的中国,没有公众结核病知识的提高和对防治结核病的正确态度以及对卫生服务的主动利用,控制结核病几乎是无法完成的任务,我国于2001年发布的<全国结核病防治规划(2001～2010)年>[2]中明确提出到2010年全民结核病防治知识的知晓率应达到80%.

目的了解我国农村医生（简称"村医"）结核病防治核心信息、政策知晓率以及结核病相关医疗行为和健康教育与健康促进工作现状,为制定结核病健康教育和健康促进工作计划提供依据。方法多阶段整群抽样,全国共抽取45个县270个村的村医326名。使用统一设计的调查问卷对村医进行面对面询问式调查。结果74.8%的村医知道咳嗽、咳痰3星期以上有可能是肺结核,83.1%的村医知道新发现的肺结核病人必须进行6个月以上的规范治疗。93.9%的村医知道在结核病防治所做痰检免费,53.1%的村医知道在结核病防治所获取治疗肺结核的药物部分免费。62.6%的村医发现过可疑的肺结核病人。发现过可疑肺结核病人的村医中,75.0%村医对病人进行了登记,77.0%的村医将其转诊至结核病防治所,20.5%村医将病人转诊至其他医院,2.5%村医没有将病人转诊。57.7%的村医经常主动向村民讲解防治肺结核病的知识。66.9%的村医经常宣传国家防治肺结核病的免费政策。大多数村医拿到过宣传画和折页等宣传材料。结论村医的肺结核病防治核心信息和政策知晓率总体较好。大多数村医能够将发现的病人进行登记并转诊,村医主动向病人宣传结核病知识与政策的比例还较低。

Objective To explore TB knowledge level of TB patients,and to provide the emphases of TB health education.Methods 144 TB patients accounting in their own words were selected by multistage systematic randomized sampling in 60 counties of 19 provinces.With uniformed questionnaire,the survey was conducted by face-to-face inquiry.Results The awareness rate of key messages on TB prevention and treatment among surveyed TB patients was 73.4%.66.7% of them knew the mostly symptom of lung TB was cough and sputum.95.1%of them knew lung TB was an infections disease.82.6% of them believed lung TB could be cured.84.7%of them knew national policies on free TB check-up and cure.Conclusion Taking full advantage of media and personal communication measures,we should strengthen health education for TB patients during check-up,treatment and supervision.

Objective To explore the awareness status of key messages on TB prevention and cure knowledge among national public people,and to provide the emphases of TB health education. Methods 69253 urban and rural residents were selected by multistage systematic randomized sampling in 60 counties of 19 provinces. With unified questionnaire,the survey was conducted by face-to-face inquiry. Results The awareness rate of key messages on TB prevention and cure among surveyed people was 73.4%. The groups of aged 12～19,low educational level people,farmer and students had lower awareness rate. The majority of them knew the infectivity and spread route of TB,while less of them or only half of them knew "There is professional hospital to examine and cure TB","TB patients should examine and cure TB in the professional hospital","TB can be cured","There are national policies on examine and cure TB for free","TB patients should not be discriminated". Especially,only 16.0% of them knew "Person who has had the symptom of cough and sputum for 3 weeks or has the symptom of emptysis and blood sputum should go to examine TB". ConclusionAccording to local awareness status of TB prevention and cure knowledge among residents,local policies should be established and ommunication activities should be carried out and evaluate the effect in time.

Objective:To explore the influential factors of cognitive change among Chinese oldest-old.Method: Three waves of data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)were analyzed with a two-level repeated measures model.Results:In baseline,the male had a higher mean MMSE score than the female(27.0±3.7/24.4±5.6,P<0.001).There were significant differences in the mean score of 80～89,90～99 and 100～105 years old(26.6±3.8,24.6±5.4,21.1±7.4,P<0.001).According to the years of schooling,the old were classified into three groups(0,1～4,5 years and more).The mean MMSE score of the 0 year's group statisti- cally differed from the other two groups(24.4±5.6/27.1±3.2,27.7±3.3,P<0.001).In addition,the main occupation before age 60,current status of the marriage,living habits,individual characteristics were also associated with the old's cognitive functions.The two-level analysis showed the variance estimate between oldest-olds was highly significant in zero model.We elaborated the model by adding more explanatory variables such as age-group in baseline, gender and so on,and found that the cognition functioning of oldest-olds who were elder,female,non-educated,peas- ant or housework as occupation,widow or had passive feelings was lower(β=-0.7,-1.2,-0.6,-0.6,-0.9 and-0.6,respectively),but oldest-olds who had habits of exercising,raising domestic animals,watching TV or lis- tening to radio,playing cards/Mab-jong regularly had higher cognition(β=0.7,1.3,1.1 and 1.0,respectively). Conclusion:Cognitive decline among Chinese oldest-old is correlated with biological,social and psychological factors.

目的通过综合指标定量反映某-类别地区的整体水平,对不同地区妇幼卫生状况进行综合评价和比较.方法利用我国五省114个县的农村妇幼卫生服务现况调查资料中10个有代表性的指标进行归一化处理,对处理后的指数值作Q型聚类分析及平均指数法分析.结果样本县的妇幼卫生情况波动范围较大.聚类后三个类别的平均指数和五省的平均指数较好地反映了样本地区妇幼卫生状况总体水平.结论本研究所用的综合评价方法不仅可进行组间的地区比较,还可作组内的指标比较,并针对不同地区的重点内容提出了改善农村妇幼卫生状况的合理建议.