目的 了解西安市妇产科、妇女保健、儿科、儿童保健医师对维生素D及钙营养知(K)、信(A)、行(P)的掌握情况及影响因素,为有针对性地对临床医师开展相关知识培训提供依据.方法 在西安市城六区二级甲等以上医院中分层随机抽取有代表性的16家医院,发放KAP调查问卷,共调查128名临床医师,其中三级甲等医院医师占72.7%;儿科医师占53.1%.问卷包括12道知识题和5道态度、行为题.结果 128名应答医师回答知识得分为61.3±13.9分(25.0～91.7分);平均答对题项为7.4个;回答合格率为50.0%,无完全回答正确者;经单因素比较,合格率(三甲医院48.3%,三乙100.0%,二甲41.4%)除与医院的等级比较差异有统计学意义(χ2=6.933,P<0.05)外,与医师所在医院的级别及其年龄、性别、专业、职称、学历、工作年限等差异均无统计学意义(均P>0.05);仅21.1%的医师在近3年内接受过相关知识的培训;受调查医师KAP之间存在正相关关系,但相关系数不高(r=0.261,P=0.004).结论 各级医师对维生素D及钙营养KAP掌握普遍不足,亟待提高;妇、儿医师相关知识与健康教育技能水平的高低对孕产妇及其婴幼儿的维生素D营养和相关保健工作非常重要;提示对各级医师进行相关知识的培训非常有必要.%To investigate the knowledge-attitude-practice ( KAP ) of clinicians in obstetrics and gynecology, maternal health care, pediatrics and child health care about vitamin D and calcium nutrition and the influencing factors, so as to provide basis for further targeted training of vitamin D and related health care knowledge for them. Methods Sixteen typical hospitals of grade II level A or superior level were selected with stratified random sampling method in six districts of Xi an city. KAP questionnaires were delivered to 128 clinicians, among whom 72. 7% were clinicians in grade III level A and 53. 1% were pediatricians. The questionnaire included 12 questions on knowledge and 5 on attitude and practice. Results The score on knowledge of 128 clinicians was 61. 3 ± 13. 9 ( 25. 0-91. 7 ) points. The average number of questions answered correctly was 7.4, and none of the subjects gave correct answers to all of questions. The qualified rate of answering was 50. 0%. Single element contrast method indicated that the difference in qualified rate ( 48. 3% in grade III level A, 100. 0% in grade Ⅲ level B, 41. 1% in grade Ⅱ level A ) was statistically significant regarding to grade of hospitals (x2 =6. 933, P <0. 05 ), and that the differences were not significant regarding to level of hospitals, clinician' age, gender, speciality, job title, academic career and working lifetime ( all P > 0. 05 ). Only 21. 1% clinicians attended relative training in last three years. There was a positive correlation among knowledge, attitude and practice of vitamin D and calcium nutrition among investigated clinicians, but the correlation coefficient was not so high ( r =0. 261, P = 0. 004 ). Conclusion KAP of vitamin D and calcium nutrition of clinicians at all levels is generally insufficient and it is urgent to be improved. Related knowledge and health education technique level of clinicians in gynecology and pediatrics are very important to vitamin D nutrition and related care of pregnant women and infants, which suggests that it is quite necessary to train clinicians of all levels about related knowledge.
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