中国防痨杂志2025，Vol.47Issue(4)：398-407,10.DOI:10.19982/j.issn.1000-6621.20240427
结核病防治医务工作者开展预防性抗结核治疗工作意愿调查及影响因素分析
Investigation on the willingness of tuberculosis health-care workers to implement tuberculosis preventive treatment and analysis of influencing factors
摘要
Abstract
Objective:To investigate the willingness of tuberculosis health-care workers(TB-HCWs)to implement tuberculosis preventive treatment(TPT)and analyze influencing factors,providing reference for scaling up TPT in China.Methods:A cross-sectional survey was conducted across 11 provinces in China,targeting TB-HCWs from general hospitals,chronic disease hospitals,TB-specialized hospitals,TB control institutes,centers for disease control(CDC)and prevention and primary healthcare institutions.A self-designed questionnaire was used to assess TB-HCWs'willingness to implement TPT,screening method and treatment method.Multivariate logistic regression models were applied to identify influencing factors.Results:Among 14 291 participants,92.20％(13 176/14 291)expressed willingness to implement TPT.Multivariate analysis revealed that higher willingness among TB-HCWs with high school or lower education,college diplomas,and bachelor's degrees compared to those with postgraduate degrees(OR=1.782,95％CI:1.196-2.626,P=0.004;OR=1.866,95％CI:1.291-2.657,P=0.001;OR=1.841,95％CI:1.295-2.577,P＜0.001).Staff in primary healthcare institutions and other institutions showed higher willingness than CDC personnel(OR=1.542,95％CI:1.140-2.077,P=0.005;OR=2.745,95％CI:1.699-4.589,P＜0.001).Notably,TB-HCWs in TB-designated medical institutions demonstrated greater willingness than those in non-designated facilities(OR=1.217,95％CI:1.043-1.423,P=0.013).The primary motivations for willingness included reducing TB incidence(97.24％(12 813/13 176)),protecting high-risk populations(81.32％(10 715/13 176)),and availability of professional guidance(71.33％(9398/13 176)),whereas concerns about drug resistance(75.41％(138/183)),adverse reactions(72.68％(133/183)),and efficacy uncertainty(65.03％(119/183))were predominant barriers.52.25％(6885/13 176)of willing TB-HCWs had previously participated in TPT.Among them,TB-HCWs using tuberculin skin test(PPD),TBST,and IGRAs as screening methods accounted for 94.89％(6533/6885),62.02％(4270/6885),and 57.60％(3966/6885),respectively.TB-HCWs adopting 3HR,6-9H,immunoprophylaxis,3HP,and 4R as treatment regimens accounted for 74.09％(5101/6885),64.71％(4455/6885),59.23％(4078/6885),57.47％(3957/6885),and 49.75％(3425/6885),respectively.Conclusion:TB-HCWs in China currently exhibit high willingness to implement TPT,yet disparities exist across educational backgrounds,institutional levels,and facility types.Targeted training and policy support are critical to accelerate TPT implementation and reduce tuberculosis burden.关键词
结核/医务人员/问卷调查/预防和防护用药/干预性研究/因素分析,统计学Key words
Tuberculosis/Medical staff/Questionnaires/Protective agents/Intervention studies/Factor analysis,statistical分类
临床医学引用本文复制引用
李锦浩,胡冬梅,徐彩红..结核病防治医务工作者开展预防性抗结核治疗工作意愿调查及影响因素分析[J].中国防痨杂志,2025,47(4):398-407,10.基金项目
2025年结核病预防控制项目 Tuberculosis Prevention and Control Project in 2025 （）
