目的 探讨应用结构方程构建安全用药的知信行(knowledge,attitude,practice,KAP)模型,分析各因子间的作用机制,并比较不同教育情况差异,为有针对性地提升我国妇女人群安全用药水平提供干预依据。方法 检索中国科协“智爱妈妈行动”项目《中国妇女用药安全行为风险KAP调查研究》2017~2020年数据库,采用单因素方差分析探索产生KAP水平差异的人口学特征,采用结构方程模型探索影响安全用药KAP模型拟合度和主要影响因子,采用多组结构方程探索不同教育情况下各潜变量的内部关联是否存在差异。结果 知识得分(27.88±6.36)分(10~50),态度得分(15.19±5.03)分(6~30),行为得分(35.22±7.75)分(10~50),不同居住地在知识态度行为得分上均存在统计学差异,不同年龄、教育情况和工作状况在知识和态度得分上存在统计学差异。结构方程模型潜变量间作用机制,知识对安全用药行为影响的直接效应为-0.128,而通过态度产生影响的间接效应为0.078,安全用药知识对安全用药行为影响的总效应为-0.050。安全用药态度对行为的直接效应是0.154。多组结构方程结果,不同教育水平KAP模型形态基本一致,结构权重检验不一致(Δχ2=386.71,Δdf=23,P＜0.01)。不同教育情况安全用药KAP模型作用机制,路径系数均有统计学意义,但作用强度存在差异。结论 知识不足和行为误区是导致受我国妇女人群用药安全隐患的重要原因,知识通过态度对行为起影响作用,并不直接影响行为。不同教育水平的KAP模型潜变量之间的路径系数存在差异,因此对于不同教育水平应采取不同的安全用药KAP水平提升策略。
Abstract
OBJECTIVE To reconstruct the knowledge, beliefs and behaviors(knowledge, attitude, practice, KAP) model of safe medication, analyze the mechanism of action among various factors, and compare differences in different educational situations, and provide intervention basis for targeted improvement of women's safe medication level. METHODS Using the 2017-2020 database of the Chinese Association for Science and Technology “Smart Mother Action” project “Chinese Women's Drug Safety Behavior Risk KAP Survey Research”, one-way analysis of variance was used to explore the demographic characteristics of the difference in KAP levels, and the structural equation model is used to test the fit of the KAP model and explore the influencing factors of the KAP model, using multiple sets of structural equations to explore whether there are differences in the internal correlations of the latent variables under different education situations. RESULTS The knowledge score is( 27.88±6.36 )points(10-50), the attitude score is(15.19±5.03) points(6-30), and the behavior score is(35.22±7.75) points(10-50). There are statistical differences in knowledge, attitude and behavior scores in different places of residence. There are statistical differences in knowledge and attitude scores for different ages, education conditions and work conditions. In the structural equation model, the direct effect of knowledge on safe medication behavior is -0.128, while the indirect effect through attitude is 0.078, and the total effect of safe medication knowledge on safe medication behavior is -0.050. The direct effect of safe medication attitude on behavior is 0.154. The results of multiple sets of structural equations showed that the KAP models of different education levels were basically the same, and the structural weight test was inconsistent(Δχ2=386.71,Δdf=23, P＜0.01). The mechanism and path coefficient of the KAP model of safe drug use in different educational situations are statistically significant, but the intensity of action is different. CONCLUSION Insufficient knowledge and misunderstandings of behavior are important reasons for the hidden dangers of drug use among women in my country. Knowledge affects behavior through attitudes, and does not directly affect behavior. There are differences in the path coefficients between the latent variables of the KAP model of different education levels, so different KAP levels of safe medication should be improved for different education levels.
关键词
安全用药 /
知信行模型 /
多组结构方程模型 /
问卷调查 /
妇女人群
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Key words
safe medication /
KAP model /
multi group structural equation model /
questionnaire survey /
female population
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中图分类号：
R95
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参考文献
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脚注
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基金
北京市医院管理中心临床医学发展专项经费资助(ZYLX202119)
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