| Background:At present, difficulty and high cost of medical treatment is one of the highlight issues in the field of medical and health. It is also one of the masses the people are most concerned about. In2009, a new round reform of medical and health system began and the implementation of the national essential medicine system is one of the key. The national essential medicine system has great significance in protecting the basic rights of drug use, changing the mechanism of compensation system for the medical cost through drug-selling profit and finally to realize the goal of primary healthcare for all. However, there are still some problems, such as barriers to the availability of essential drugs, unawareness of medical staff and the public about essential drugs. The public is the key factor of the implementation of national essential medicine system. As for now there are no comprehensive and systematic investigation and theory research about Knowledge-Attitude-Practice of community outpatient on national essential medicine system. Knowledge-Attitude-Practice(KAP) is a psychological cognitive model describe the interaction mechanism between knowledge, attitudes and behaviors. Now it is widely used in health behavior promotion research among different cultural backgrounds and demonstrated a better explanatory power.Objectives:The study surveyed community outpatient in Shandong province by face to face interview which used self-made questionnaire. The purpose was to understand the current situation of Knowledge-Attitude-Practice of community outpatient on national essential medicine system, analyze the determinants, explore path influence between the three by building structural equation model. In this foundation, political suggestions were putted forward to promote the implementation of National Essential Medicine System.Data and Methods:The study chosed sample by muti-stage stratified random sampling method. Questionnaire survey was conducted in Ji’nan, Wei’fang and Liao’cheng. First, each prefecture-level city randomly2districts. Secondly, two community health service centers, two government-run community health service stations and two non-government-run community health service stations were randomly chosed.25community outpatients from each of these community health services were surveyed by self-designed questionnaire.Main Results:1. The Cronbach’s a coefficient of Knowledge, attitude and behavior scale is respectively0.898,0.859and0.906, all over0.80. KMO is0.941. Bartlet test of sphericity statistically significant. Three common factors were pre-set, knowledge, attitude and behavior. Three principal components were extracted by exploratory factor analysis, which explained variance of the independent variable of68.182percent of all the cumulative.2.86.1percent of the sample got low cognitive score on national essential medicines system. Region, education level, occupation and number of visit to community health service have a statistically significant difference.3.68.1percent of the sample got low attitude score on national essential medicines system. Region, education level, occupation and number of visit to community health service have a statistically significant difference.4.77.9percent of the sample got low behavior score on national essential medicines system. Gender, sex, education level and occupation have a statistically significant difference.5. The structural relationship among the three latent variables were analyzed and tested by structural equation model. The evaluation index of structural equation model of was as follows:GFI=0.92, AGFI=0.89, RMSEA=0.075, RMR=0.031, CFI=0.98. The cognition of community outpatient has a significant and direct effect on belief and behavior. Belief has a significant and direct effect on the behavior. Cognition has an indirect effect on the behavior through belief. Conclusion and Suggestions:Conclusion:1) The reliability and validity of the questionnaire formulated by this study about knowledge, attitude, and behavior of national essential medicine system among community outpatients in Shandong province are in accordance with the requirements. The questionnaire is worthy to be promoted.2) The current level of knowledge about national essential medicine system among community outpatients in Shandong province is low. Region, education level, occupation and number of visits to the community will affect the level of knowledge of the community outpatient.3) The current level of attitude about national essential medicine system among community outpatients in Shandong province is low. Region, education level, occupation and number of visits to the community will affect the level of attitude of the community outpatient.4) The current level of behavior about national essential medicine system among community outpatients in Shandong province is low. Gender, age, education level and occupation will affect the level of behavior of the community outpatient.5) The raising of the level of community outpatient national essential drug system knowledge does contribute to the formation of a positive attitude and helpful behavior in Shandong province.Suggestions:1) Actively carrying out publicity and education work of the national essential medicines system to enhance the cognitive level of the crowd on the system, strengthen the sense of identity, establish the beneficial behavior.2) Take Measures jointly to promote the changes of knowledge, attitude and behavior of national essential medicines system in crowd.3) similar studies should be carried out in in other regions and other populations. |
PDF Full Text Request