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目的描述医疗卫生机构二手烟暴露现况调查中的现场观察、拦截调查结果,评价不同方法结果的一致性,探讨现场观察法的应用条件。方法在天津、重庆、沈阳、哈尔滨、南昌、兰州和深圳7个城市分别通过简单随机抽样的方法,抽取各级医院(三级医院、二级医院、社区卫生服务中心)、疾病预防控制中心和健康教育所,进行现场观察和针对场所内来访者及工作人员的拦截调查。使用场所内有吸烟现象的观察点率(P1)、调查当天来访者看到有人在机构内的吸烟率(P2)、调查当天机构工作人员看到有人在机构内的吸烟率(P3)、工作人员暴露于二手烟的率(P4)指标来讨论不同调查方法的一致性。结果 7个城市共观察169家医院,86家疾病预防控制中心。在上述机构内完成来访者拦截调查2 368人,工作人员拦截调查2 515人。使用非参数检验比较P1与P2、P3、P4的分布一致性,结果发现,绝大多数城市内P1与P2、P3的分布一致,多数城市的P1、P4的分布不一致。结论现场观察法可以用于了解对外开放的公共场所吸烟现象的严重程度,但难以客观反映场所内工作人员真实的二手烟暴露程度。
Objective To describe the field observation of the investigation of the status quo of secondhand smoke exposure in medical and health institutions, intercept the survey results, evaluate the consistency of the results of different methods, and discuss the application conditions of field observation methods. Methods A total of 7 hospitals in Tianjin, Chongqing, Shenyang, Harbin, Nanchang, Lanzhou and Shenzhen were recruited by simple random sampling method to collect all levels of hospitals (tertiary hospitals, secondary hospitals, community health centers), CDCs and Health Education Institute to conduct on-site observation and interception of visitors and staff in the premises. (P1) on the use site, the percentage of visitors who saw someone smoking within the institution on the day of the survey (P2), the rate of smoking in the organization (P3) on the day of the survey, and the work Rates of Exposure to Secondhand Smoke (P4) Indicators were used to discuss the consistency of different survey methods. Results A total of 169 hospitals and 86 disease prevention and control centers were observed in 7 cities. In the above institutions, 2,368 interviews were conducted among visitors and 2,515 were intercepted by staff members. The results of nonparametric test showed that the distribution of P1, P2 and P3 were the same in most cities, and the distributions of P1 and P4 in most cities were inconsistent. Conclusion On-site observation can be used to understand the severity of smoking in open public places, but it is difficult to objectively reflect the true exposure of second-hand smoke to workers in the field.