关键词: 结核, 肺/预防和控制, 社区卫生服务, 医务人员, 问卷调查, 评价研究, 北京市

Abstract: Objective To investigate the status of community health center staff members who are responsible for TB control and prevention and their working status on management of patients with tuberculosis (TB), to further evaluate the affects of community-based management model on improving case-finding and quality of patients treatment so as to development a community-based TB control model in Beijing. Methods August 2012, a questionnaire investigation was conducted among TB staff members who were from 256 community health centers (in which a community-based TB case-management model has been implemented) of 16 districts/counties (including Xuanwu and Chongwen districts) in Beijing. The questionnaire was designed by Beijing Health Bureau Officers and experts of Beijing Research Institute for Tuberculosis Control. Basic personal information of the TB staff was collected, such as age, educational background, professional position, etc.; staff knowledge, understanding, experience and comments towards the community-based TB case-management were also collected. t test and Chi-square test were used for comparing means and proportions. A total of 270 questionnaires were distributed and all of them were responded and valid. So the effective response rate was 100.0%.  Results Among the 270 community health center TB staffs, the mean age was (35.6±10.3) years; the education level mainly was college degree or below, accounting for 65.2%(176/270); 66.7%(180/270) of health workers at community health centers were assigned to at least three tasks per day related to disease control and prevention; length of working for TB was (5.6±5.6) years and the staff in the suburb community health centers had longer time working for TB, the difference was statistically significant(t=5.01, P=0.026); 46.7%(126/270) of community TB staff were responsible for taking drugs for TB patients from the municipal level and the staff proportion who were doing this work at urban community health centers (90.9%，80/88) was higher than that at rural community health centers (25.3%,46/182), the difference was statistically significant (χ²=102.67, P<0.05); the use of telephone was most common way for TB staff and patients to contact each other, accounting for 99.3% (268/270); 84.1% (227/270) of community health center TB staff reported to work overtime for patients visits; 90.4%(244/270)of community health center TB staff thought they were familiar with medications of the patients; 61.1%(165/270)of community health center TB staff thought the number of community health service facility was inadequate and needs to be increased; 73.0%(197/270)of community health center TB staff thought they need separate rooms, 46.7%(126/270) thought a certain of disinfection facilities were needed and 35.9%(97/270) thought medicine cabinets were needed. Among 270 community health workers who received this investigation, although 98.5% (266/270) of them participated in received or the relevant training organized by their units or high level units, there were still 72.2%(195/270) of them thought the training on psychological rehabilitation and support of TB patients is essential.  Conclusion The education level of TB staff from community health center in Beijing is low and the tasks assigned to them are heavy. The staff working at the suburban community health centers are steady. The urban community health centers provide more services for TB patients on taking anti-TB drugs. The community health services for TB patients needs to be further improved, and the comprehensive training related to TB patients management is needed.

Key words: Tuberculosis, pulmonary/prevention &, control, Community health services, Medical staff, Questionnaires, Evaluation studies, Beijing city