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目的探讨标准化干预路径在提高儿童麻疹疫苗初免依从性中的应用和效果。方法根据预防接种门诊工作实际,设计制定麻疹疫苗初免依从性标准化干预路径。采用整群抽样方法,在干预实施后,选择2013年4月1日~6月30日出生,在湖州市中心城区预防接种门诊建证的所有儿童为干预组,选择2012年同期出生,在同一接种门诊建证的所有儿童为对照组,比较标准化干预实施前后两组儿童麻疹疫苗初免接种率和接种及时率差异,调查未及时接种原因。结果干预组及干预组中本地户籍儿童麻疹初免接种率和及时率分别为97.96%、98.92%和90.14%、75.05%,对照组分别为94.50%、95.34%和87.40%、72.82%,差异有统计学意义(χ2值分别为13.206和15.793、52.256和51.160,P值均<0.01)。干预后,本地户籍儿童接种率增幅总体高于外地户籍,差异有统计学意义(t=3.67,P<0.05)。因病不能接种(57.76%)是干预组不能及时接种麻疹疫苗的主要原因,其中本地户籍儿童主要是因患病未去接种(77.36%),而外地户籍儿童则主要是因患病门诊不予接种(63.64%),差异有统计学意义(χ2=7.33,P<0.01)。外地户籍儿童因联系电话关停机(23.68%)、忘记接种日期(18.42%)、家长没时间带小孩去接种(15.79%)而未接种疫苗的比例高于本地户籍(分别占2.74%、5.48%和4.11%),差异有统计学意义(P值分别为0.036、0.001和0.041)。结论实施标准化干预路径能有效提高儿童麻疹疫苗初免依从性,具有较大的推广应用价值。
Objective To explore the application and effect of standardization intervention in improving the compliance of children with measles immunization. Methods According to the practice of vaccination clinics, we designed and established a standardized intervention path of measles vaccine initial compliance. Using cluster sampling method, all the children born in April 1, 2013 to June 30, 2013 in outpatient vaccination clinic in Huzhou city center were selected as the intervention group after the implementation of the intervention. They were born at the same period of 2012, Outpatient evidence of all children as a control group, standardized intervention intervention before and after the implementation of the two groups of children immunized with measles vaccine initial vaccination rate and vaccination time differences, the reasons for the investigation did not timely vaccination. Results The rates of initial immunization and timely immunization of local children with measles were 97.96%, 98.92% and 90.14%, 75.05% respectively in the intervention group and the intervention group, while those in the control group were 94.50%, 95.34% and 87.40%, 72.82% respectively Statistical significance (χ2 values were 13.206 and 15.793,52.256 and 51.160, P values were <0.01). After the intervention, the increase rate of the local registered children’s immunization rate was generally higher than that of the overseas household registration, with a significant difference (t = 3.67, P <0.05). Inability to inoculate due to illness (57.76%) was the main reason why the measles vaccine could not be timely vaccinated in the intervention group. Among them, the local registered children were mainly uninoculated due to illness (77.36%), while the non-vaccinated children Inoculation (63.64%), the difference was statistically significant (χ2 = 7.33, P <0.01). Children from rural areas registered for phone shut down (23.68%), forgot the date of vaccination (18.42%), parents did not have time to take children to vaccination (15.79%) and those who did not receive vaccines were higher than local residents (2.74% and 5.48 % And 4.11%), the difference was statistically significant (P values were 0.036,0.001 and 0.041). Conclusion The implementation of standardized intervention pathway can effectively improve the compliance of children immunization with measles vaccine, which has great value in popularization and application.