基于结构方程模型的公众结核病防治知信行现状及相关性

doi:10.19982/j.issn.1000-6621.20250040

摘要/Abstract

摘要：

目的:了解社会公众的结核病防治知识、信念、行为现状,通过结构方程模型分析三者之间的关系,为探索适合社会公众的结核病防治手段和健康教育提供依据。方法:2022年10月至2023年4月期间采用分层整群随机抽样的方法抽取山东省济南市某高校、聊城市某医院和中国铁路济南局的社会公众人员进行问卷调查,共收集问卷854份,有效问卷833份,有效率为97.54%,调查内容包括基本信息、结核病防治核心知识知晓情况、结核病防治信念和行为。运用AMOS 24.0软件进行结构方程模型(structural equation modeling, SEM)的构建并分析知识、信念和行为之间的关系及其关联强度。结果:公众的结核病防治知识平均得分为(2.82±1.90)分(满分6分),结核病防治信念平均得分为(9.78±1.61)分(满分12分),结核病防治行为平均得分为(8.04±1.47)分(满分10分)。年龄(P=0.003)、职业(P<0.001)和月收入(P=0.003)对结核病防治核心知识的知晓率影响有统计学意义;公众结核病防治信念差异无统计学意义(P>0.05);年龄(P=0.022)、职业(P<0.001)、学历(P=0.004)和月收入(P<0.001)均会对结核病防治行为产生影响。结构方程拟合结果显示,结核病防治知识对行为产生正向作用,总效应值为0.488,其中直接效应值为0.460,间接效应值为0.028。结论:社会公众对结核病防治核心知识认知水平较低;良好的结核病认知情况和端正的防治信念均会对行为产生正向积极作用。

关键词: 结核, 健康知识, 态度, 实践, 问卷调查, 模型, 结构

Abstract:

Objective: To understand the knowledge-attitude-practice of tuberculosis prevention and control among public, analyze their correlations based on Structural Equation Modeling, to provide a basis for exploring suitable tuberculosis prevention and control measures and health education for the public. Methods: From October 2022 to April 2023, a stratified cluster random sampling method was used to select public personnel from a university in Shandong Province, a municipal hospital, and a municipal railway bureau for a questionnaire survey. A total of 854 pieces of questionnaire were collected, with 833 valid questionnaire, resulting in a valid response rate of 97.54%.The survey content included basic information, knowledge of tuberculosis prevention and control core knowledge, tuberculosis prevention and control attitude and practice. AMOS 24.0 software was used to construct a structural equation model and analyze the relationship and correlation strength among knowledge, attitude and practice. Results: The average score of tuberculosis control knowledge, attitude and practice were 2.82±1.90 (Full scale was 6), 9.78±1.61 (Full scale was 12), and 8.04±1.47 (Full scale was 10), respectively. There were significant differences in the awareness rates of tuberculosis prevention and control core knowledge among different age (P=0.003), occupation (P<0.001), and income (P=0.003) groups. There were no significant differences in tuberculosis prevention and control beliefs among different groups of the study population. Age (P=0.022), occupation (P<0.001), educational background (P=0.004), and income (P<0.001) all exerted a significant influence on tuberculosis prevention practice. Structural equation fitting result showed that tuberculosis prevention and control knowledge had a positive effect on practice, its total effect was 0.488, of which the direct effect was 0.460, the indirect effect was 0.028. Conclusion: The public had a relatively low awareness of tuberculosis prevention and control core knowledge. Good cognition of tuberculosis and correct attitude towards tuberculosis prevention and control will have a positive effect on practice.

Key words: Tuberculosis, Health knowledge, attitudes, practice, Questionnaire, Models, structural

中图分类号:

R52
R193

钟毅, 于胜男, 张宇琦, 景睿, 李秀君. 基于结构方程模型的公众结核病防治知信行现状及相关性[J]. 中国防痨杂志, 2025, 47(7): 855-862. doi: 10.19982/j.issn.1000-6621.20250040

Zhong Yi, Yu Shengnan, Zhang Yuqi, Jing Rui, Li Xiujun. Analysis of public knowledge, attitude and practice on tuberculosis prevention and control based on Structural Equation Modeling[J]. Chinese Journal of Antituberculosis, 2025, 47(7): 855-862. doi: 10.19982/j.issn.1000-6621.20250040

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参考文献 31

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特征	≥3分[名 (构成比,%)]	<3分[名 (构成比,%)]	χ²值	P值
性别			3.197	0.074
男性	299(51.7)	279(48.3)
女性	149(58.4)	106(41.6)
年龄组(岁)			11.808	0.003
<30	99(49.0)	103(51.0)
30~55	261(52.2)	239(47.8)
≥56	88(67.2)	43(32.8)
婚姻状况			0.342	0.559
已婚	327(54.4)	274(45.6)
未婚及其他	121(52.2)	111(47.8)
职业			66.474	<0.001
医学相关专业工作者	52(91.2)	5(8.8)
专业技术人员(如律师、建筑工程师等)	29(52.7)	26(47.3)
国企单位、国家机关、公务员等公职人员	210(47.5)	232(52.5)
服务业人员	91(47.4)	101(52.6)
农、林、牧、渔、水利业生产人员	6(60.0)	4(40.0)
私营企业工作人员、个体工商户	16(80.0)	4(20.0)
自由职业者	41(83.7)	8(16.3)
其他从业人员	3(37.5)	5(62.5)
学历			8.948	0.062
小学及以下	18(75.0)	6(25.0)
初中	74(58.7)	52(41.3)
高中/职高/中专	94(47.5)	104(52.5)
大专	156(53.2)	137(46.8)
本科及以上	106(55.2)	86(44.8)
月收入(元)			14.047	0.003
<3000	36(50.0)	36(50.0)
3000~5000	107(65.2)	57(34.8)
5001~10000	182(54.3)	153(45.7)
>10000	123(46.9)	139(53.1)

特征	≥10分[名 (构成比,%)]	<10分[名 (构成比,%)]	χ²值	P值
性别			0.203	0.652
男性	360(62.3)	218(37.7)
女性	163(63.9)	92(36.1)
年龄组(岁)			5.147	0.076
<30	119(58.9)	83(41.1)
30~55	311(62.2)	189(37.8)
≥56	93(71.0)	38(29.0)
婚姻状况			3.477	0.062
已婚	389(57.8)	212(42.2)
未婚及其他	134(64.7)	98(35.3)
职业			3.429	0.064
医学相关专业工作者	41(71.9)	16(28.1)
专业技术人员(如律师、建筑工程师等)	27(49.1)	28(50.9)
国企单位、国家机关、公务员等公职人员	272(61.5)	170(38.5)
服务业人员	118(61.5)	74(38.5)
农、林、牧、渔、水利业生产人员	6(60.0)	4(40.0)
私营企业工作人员、个体工商户	18(90.0)	2(10.0)
自由职业者	38(77.6)	11(22.4)
其他从业人员	5(62.5)	3(37.5)
学历			0.760	0.383
小学及以下	17(70.8)	7(29.2)
初中	78(61.9)	48(38.1)
高中/职高/中专	114(57.6)	84(42.4)
大专	187(63.8)	106(36.2)
本科及以上	127(66.1)	65(33.9)
月收入(元)			1.639	0.651
<3000	49(68.1)	23(31.9)
3000~5000	99(60.4)	65(39.6)
5001~10000	214(63.9)	121(36.1)
>10000	161(61.5)	101(38.5)

特征	≥8分[名 (构成比,%)]	<8分[名 (构成比,%)]	χ²值	P值
性别			0.169	0.681
男性	369(63.8)	209(36.2)
女性	159(62.4)	96(37.6)
年龄组(岁)			7.621	0.022
<30	141(69.8)	61(30.2)
30~55	315(63.0)	185(37.0)
≥56	72(55.0)	59(45.0)
婚姻状况			3.084	0.079
已婚	370(61.6)	231(38.4)
未婚及其他	158(68.1)	74(31.9)
职业			36.104	<0.001
医学相关专业工作者	47(82.5)	10(17.5)
专业技术人员(如律师、建筑工程师等)	32(58.2)	23(41.8)
国企单位、国家机关、公务员等公职人员	305(69.0)	137(31.0)
服务业人员	95(49.5)	97(50.5)
农、林、牧、渔、水利业生产人员	4(40.0)	6(60.0)
私营企业工作人员、个体工商户	10(50.0)	10(50.0)
自由职业者	31(63.3)	18(36.7)
其他从业人员	4(50.0)	4(50.0)
学历			15.608	0.004
小学及以下	15(62.5)	9(37.5)
初中	69(54.8)	57(45.2)
高中/职高/中专	110(55.6)	88(44.4)
大专	203(69.3)	90(30.7)
本科及以上	131(68.2)	61(31.8)
月收入(元)			22.302	<0.001
<3000	29(40.3)	43(59.7)
3000~5000	101(61.6)	63(38.4)
5001~10000	233(69.6)	102(30.4)
>10000	165(63.0)	97(37.0)

拟合指标	CMIN/DF	RMSEA	GFI	AGFI
模型指标	4.372	0.064	0.940	0.914
参考范围	<5	<0.08	>0.9	>0.9

知识—>行为	估计值	标准误	B-95%CI值	P值	P-95%CI值	P值
总效应	0.488	0.033	0.421~0.551	<0.001	0.421~0.551	<0.001
直接效应(94.26%)	0.460	0.035	0.391~0.528	<0.001	0.391~0.528	<0.001
间接效应(5.74%)	0.028	0.010	0.012~0.051	0.001	0.011~0.049	0.002