摘要
目的通过调查医务人员和艾滋病患者对新冠疫情的感受,分析疫情期间大英县各基层医疗机构艾滋病监测检测、随访管理、抗病毒治疗等重要措施所受影响情况,为本辖区更好推动艾滋病防治工作提供参考。方法2021-06/08大英县采用问卷调查和工作绩效分析两种方式进行。利用SPSS 23.0软件,采用卡方检验、Logistic回归分析数据,以P<0.05为差异有统计学意义。结果被调查医务人员中,艾滋病防治工作人员与非艾滋病防治工作人员两组之间性别构成比存在差异,年龄分布和文化程度构成情况无统计学差异;在对待新冠疫情感知方面,两组医务人员对待“是否影响自身工作”(χ^(2)=3.419,P=0.064)、“医院是否重视艾防工作”(χ^(2)=2.308,P=0.129)没有明显差异;而对于“新冠肺炎防控期间是否影响艾滋病防治工作”(χ^(2)=4.514,P=0.034)、“工作量是否增加”(χ^(2)=6.825,P=0.009)、“是否同时承担多项工作”(χ^(2)=46.163,P<0.001)、“能否按要求完全既定工作任务”(χ^(2)=7.630,P=0.006)、“是否感觉工作有压力”(χ^(2)=54.261,P<0.001)存在差异。参与问卷调查的艾滋病感染者和病人共155人,男女性别比为4.31∶1,平均年龄54.95岁,文化程度主要为小学;确诊不足1年的患者中,41岁及以上年龄组、小学及以下文化程度的患者比例相较确诊1年以上患者更多;59.35%的患者认为新冠疫情对自身存在影响;医务人员是否关心患者的行为与患者对待新冠疫情的感受呈负相关性(OR=0.137,P=0.003),接受医学随访频率是否减少与患者对待新冠疫情的感受呈正相关性(OR=5.016,P=0.015);患者对疫情的各项顾虑均与患者对待新冠疫情的感受呈正相关性。工作指标方面,发现分别截止2019-08、2020-08、2021-08三年同期的筛查覆盖率呈逐年提高的趋势,随访检测率2020年较2019年升高后,2021年出现下降趋势,抗病毒治疗覆盖率2020年较2019年升高后,2020年与2021年同期指标无明显差异。结论新冠疫情防控加大了基层艾滋病防治工作人员工作压力。艾滋病患者对待新冠疫情的感知情况受到医务人员的影响。新冠疫情防控对艾防工作利弊共存,新冠疫情虽然对艾滋病防治工作带来了挑战,但是依然为我们创造了机遇,在新冠防控期间利用群众外出务工体检、新冠疫苗接种等契机,实现了筛查覆盖率逐年递增,为克服异地随访管理的现状,可探索由省市牵头的多地联动工作模式,坚持“以人为本”,运用便捷的信息系统落实患者属地管理,让患者“人在哪里、服务就在哪里”。
Objective To investigate the feelings of medical staff and AIDS patients about the COVID-19,to analyze the impact of COVID-19 on local HIV surveillance and testing,follow-up management,antiviral treatment and other important measures in primary care institutions in Daying County during the outbreak of COVID-19,so as to provide reference for the local AIDS prevention and control work.Methods From June to August,a questionnaire survey and routine monitoring index analysis were conducted in Daying County in 2021.Using SPSS 23.0 software,chi-square tests and Logistic regression analysis were performed.Results There were significant differences in the gender composition between AIDS prevention and treatment workers and nonAIDS prevention and treatment workers,but no significant differences in the age distribution and the composition of educational level.There were no significant differences in the perception of COVID-19 between two groups in the items of“Does the COVID-19 epidemic affect your work?”(χ^(2)=3.419,P=0.064)and“Does the hospital attach importance to AIDS prevention”(χ^(2)=2.308,P=0.129).However,significant differences were observed in the items of“Whether the prevention and control of COVID-19 affected the prevention and control of AIDS”(χ^(2)=4.514,P=0.034),“Whether the workload increased”(χ^(2)=6.825,P=0.009),“Whether the work was undertaken at the same time”(χ^(2)=46.163,P<0.001),“Whether the work was completed as required”(χ^(2)=7.630,P=0.006)and“Whether the work was stressful”(χ^(2)=54.261,P<0.001).A total of 155AIDS patients participated in the questionnaire survey.The sex ratio was 4.31∶1,with an average age of 54.95 years.Among patients diagnosed for less than 1 year,the proportion of patients aged41 years and older,and with education level of primary school or below was higher than that of patients diagnosed for more than 1 year.59.35%of patients reported that the COVID-19 epidemic had an impact on them.There was a negative correlation between the medical staff′s caring behaviors and the patients′feeling towards the COVID-19(OR=0.137,P=0.003).The frequency of medical follow-up was positively correlated with the patients′perception of COVID-19(OR=5.016,P=0.015).In terms of routine monitoring indicators,the coverage rate of screening increased in the ending of three time points,i.e.,August 2019,August 2020 and 2021 August.The follow-up detection rate increased in 2020 compared with that in 2019,while the follow-up detection rate decreased in 2021.The antiviral treatment coverage in 2020 increased compared to that in 2019.However,there is no significant difference of antiviral treatment coverage in the same period of 2020 and 2021.Conclusions The COVID-19 prevention and control has increased the work pressure of staff undertaking grass-roots AIDS prevention and control.The perception of COVID-19 of HIV patients is influenced by health workers.The COVID-19 epidemic has both advantages and disadvantages for HIV prevention.Although the epidemic has brought challenges to AIDS prevention and control,it still creates opportunities for us to take advantage of the physical examination of migrant workers during the prevention and control work of COVID-19.To overcome the current situation of remote follow-up management,a multi-place linkage mode dominated by provinces and cities should be explored.Based on the people-oriented principle,convenient information system can be used to implement local management of patients,so that patients can serve where they are.
作者
佘勇
SHE Yong(Daying Center for Disease Control and Prevention,Suirting 629300,Sichuan Province,China)
出处
《职业卫生与病伤》
CAS
2022年第2期105-110,共6页
Occupational Health and Damage
