متدولوژي و يافته‌هاي اوليه طرح سنجش آگاهي، نگرش و عملكرد ساكنين شهر تهران نسبت به سلامت و بيماري در سال 1390

The study on the knowledge, attitude and practice of Tehran citizens about Health and Disease in 2011 (KAP): overview of methodology and primary results

زمينه و هدف: بررسي وضعيت دانش و نگرش و عملكرد مردم در زمينه سلامت گامي اساسي در برنامه‌ريزي سلامت است. اين مطالعه با هدف تعيين آگاهي، نگرش و عملكرد ساكنين شهر تهران به منظور ارزيابي سلامت عمومي انجام شده است. روش بررسي: اين پژوهش يك مطالعه مقطعي-توصيفي در شهريور 1390، بر روي 13 هزار نفر از كل ساكنين شهر تهران و تحت نظارت در دانشگاه علوم پزشكي ايران انجام شد. معيار ورود تمامي ساكنين شهر تهران بود. نمونه‌گيري خوشه‌اي و پرسشنامه معتبر و پايا به روش خود ايفا براي گرد‌آوري داده‌ها به‌كار رفت. تمامي متغيرهاي وضعيت سلامت عمومي، عادت‌هاي غذايي و وضعيت اقتصادي-اجتماعي اين افراد مورد ارزيابي قرار گرفت. يافته‌ها: 13 هزار نفر از ساكنين شهر تهران مورد مطالعه قرار گرفتند. نرخ بي‌پاسخي آنان 8/6% بود. داده‌هاي 11753 پرسشنامه مورد بررسي قرار گرفت. از افراد شركت‌كننده، ميانگين سن 38 (±15/6) سال و 43/6 درصد مرد بودند، 50% داراي چاقي يا اضافه وزن بودند و فقط 29/5% فعاليت ورزشي مطلوب داشتند. از پاسخ دهندگان 37/6% در خانوار، فردي مصرف‌كننده دخانيات گزارش كردند و 4/5% افراد تاكنون مواد مخدر را تجربه كرده بودند. در جمعيت مورد بررسي، 44/8% آگاهي مناسب و 89/1% نگرش مناسبي در زمينه سلامت و بيماري داشتند. نتيجه‌گيري: نتايج نشان‌دهنده وجود كاستي‌هاي در آگاهي، نگرش و عملكرد شهروندان تهران در زمينه سلامت و بيماري است، به‌طوري‌كه درصد چشمگيري از شهروندان تهراني مبتلا به اضافه وزن، چاقي، پرفشاري خون، ديابت، چربي خون بالا و مصرف بالاي دخانيات و استفاده بيش از چهار ساعت از تلويزيون و رايانه در شبانه روز بودند.

Background: The study of their knowledge, attitude, and behavior toward health is an essential step for health planning. In the urban area, there are several concerns about environmental pollution, health status, the dangers of insecurity, and bad dietary habits. The aim of the study was the determination of knowledge, attitude, and behavior of Tehran citizens in order to plan better municipal services. Methods: This descriptive, cross-sectional study was conducted on 13000 participants between 15-84 years in 22 districts of Tehran, Iran University of Medical Sciences, in August and September of 2011. Cluster sampling and self-administered reliable and valid questionnaire were used for data gathering. The inclusion criteria are all of citizens of Tehran. Age, sex, marital and job status, obesity, physical activity, hypertension, myocardial infarction, accidents, diabetes, nutrition, stroke, psychological behavior, smoking, addiction and drugs, musculoskeletal, sexual behavior, anemia, physical environment, fat blood, cancer, chronic obstructive pulmonary disease, dietary habits and socioeconomic status were measured under standard protocols and by using calibrated instruments. Results: From 13000 participants in the study, 11753 (90%) was fulfilled the questioners. Nonresponse rate from 11753 participants was 8.6%. The proportion of obesity/overweight was 50% and 29.5% of people had appropriate physical exercise, 37.6% reported a tobacco consumer in their family and 4.5% reported an experience of substance misuse. Also, 29.2% and 24.8% from these had anomalistic consuming of salt and soft drink, respectively. Of the participants, 44.8%, 89.1% had a good knowledge and attitude, respectively. Cronbach alpha coefficient was 0.82 and 0.79 for knowledge, attitude and behavior, respectively. In additional, the correlation coefficient between test and re-test questions was 0.91. Conclusion: This study was a comprehensive study to measure the knowledge, attitude and practice of Tehran citizens using reliable and valid questionnaires about general health status. A considerable percentage of Tehran citizens suffering from overweight, obesity, hypertension, diabetes, high blood lipids and smoking consuming and using anomalistic from TV and computer. The results can be used as a framework and guide to prioritize problems and planning health education interventions in Tehran.