p h l p don g i l n , d l thdc hien, hieu q u i v l an 6. Valerie A.Curtis, Lisa O.Danquah and tean chd ngddi benh. Robert V.Aunger (2009), Planned, motivated 5. Celik S, Kocaasli S (2008). Hygienic hand ^nd habitual hygiene behaviour an eleven washing among nursing students in Turkey. AppI country review. Health education research.
Nurs Res. 2008 Nov 21 (4): 207 - 11 Vol.24.No.4 2009, 655 - 673.
Summary
KNOWLEDGE ON HAND HYGIENE AMONG 6 - GRADE MEDICAL STUDENT OF HANOI MEDICAL UNIVERSITY OF VIETNAM 2010
A study was done in the Hanoi Medical University of Vietnam in 2010. Objective: To assess the knowledge on hand hygiene among 6 - grade medical students of Hanoi Medical University in Vietnam 2010. Method: A cross - sectional design was applied to interview directly 120 6 - grade medical students of Hanoi Medical University in 2010 using semi - structured questionnaires. Result:
92.5% respondents giving correct and sufficient answers about critical times of hand hygiene. 90%
medical students gave at least four of five its purposes. All study participants listed the aims of hand hygiene is to avoid additional infection for both the patient and the medical staff. However, only 35%
of them knew that hand hygiene could avoid infection for patient' relatives. Among 120 study participants, only 7.5% of them knowing that minimum duration of hand hygiene was 30 seconds.
Only 2.5% students gave totally correct answers for six steps of handwashing issued by Ministry of Health and 21.7% did not know this procedure. Conclusion: The knowledge on hand hygiene of grade - 6 medical students was not good. Despite they have good knowledge on when and why to hand hygiene but how to handwash was not clearly to them.
Keywords: hand hygiene, knowledge, medical students
THU^C TRANG HOAT DONG Y TE TR^CfNG HOC
• • • • •
TAI CAC TRUING PHO THONG VIET NAM
chu Van Thang, Le Thj Thanh Xuan, Dang Ngoc Lan TrUdng Dal Hgc Y Ha Ngi
Nghien cdu dugc tien hanh tai 3 vimg (thanh thi, dong bing va miin niii) tai 3 tinh dai dien cho 3 vimg miin ciia ca nUdc (Phu Thg, Quang Binh va Dong Nai). Muc tieu: md ta thtfc trang boat dgng ve y te trudng hgc tai cac trUdng pho thdng d Viet Nam nam 2008. Dd'i ttfgng va phtfang phap nghien cdu:
ap dung nghien ctfu cit ngang (djnh tinh va dinh Itfgng) de phdng van 355 cac cin bg y te hgc dtfdng cua trtfdng tieu hgc, trung hgc cd sd va trung hgc phd thdng trong 9 huyen thudc 3 tinh (Phii Thg, Quang Binh, Dong Nai) ciia 3 miin (Bic, Trung, Nam) va cho 3 vimg (mien nui, dong bang va thanh thj). Toan bg bio cio, sd lieu sd sach vi boat dgng YTTH ttf nam 2001 - 2006 tai cac trtfdng phd thdng diSu tra cimg dugc thu thap. Ke't qua: hoat dgng ma can bg Y te trUdng hgc (YTTH) da va dang thtfc hien khong nhiiu, chiem ty le ttf 13,2% den 71,6%o tong so can bg YTTH da tham gia nghien cdu. Ba boat dgng dugc can bg YTTH lua chgn nhiiu nhat Pa sd cap cdu (71,6%o), giio due sdc khde cho bgc
sinh (51,8%o) va kham stfc khde dinh ky (47,6%o). Dac biet cd rat it can bd YTTH tham gia boat ddng phdng chd'ng cong veo cot sd'ng vi phdng chd'ng can thi hgc dudng (chi cd 13,2%o va 19,7%o). Nhin chung cac hoai dgng YTTH dugc thtfc hien nhiiu hdn d khu vtfc thanh thj vi ddng bang so vdi khu vtfc miin nul (p < 0,05). Hoat dgng ma nhiiu can bg YTTH khdng cd kha nang thtfc bien nhieu nha't la khim va phat bien cac benb trUdng hgc (cong veo cot sd'ng, can thi). Hoat dgng cd t'y le % cin bg YTTH khdng cd kha nang thtfc hien tha'p nha't la lap ho sd theo ddi sdc khde hgc sinh (11,2%o tong so dleu tra). Ket luan: cac boat dgng YTTH da va dang thtfc hien tai trUdng pho thdng li sd cap cdu, giao due stfc kboe cho hgc sinh va khim sdc khde djnh ky. Rit it can bg YTTH tham gia thtfc hien boat ddng phdng chdng cong veo cot sd'ng vi phdng chdng can thj hgc dtfdng. Hiu hit cin bg YTTH khdng cd kha nang thtfc hien cac boat dgng YTTH, dac biet la cac hoat dgng vi kham va phit hien cic benh trtfdng hgc.
Td khoa: Hoat dong Y te trddng hoc, trddng phd thong
I. DAT VAN DE
Theo b i o cao tdng hdp rinh hinh y te trddng hoe nam 2002 cda Bd Y te, ehi ed 44/61 rinh thanh phe cd bad e l o v l y te trddng hpe, trong dd 40/61 rinh t h i n h ed ban ehi dao cap rinh theo hddng dan eua lien Bd Y Te v l Bd G i l o due va Dao tao, 30/61 rinh ed van b i n lien nginh y te - g i l o due hddng dan d e cap thdc hien [7]. Chda ed rinh nao cd du ban ehi dao y te trddng hoc cap huyen. Cac boat ddng y te trddng hoc trien khai chda n h i l u , ndi cd trien khai eung chi ed mdt sd' ndi dung nhd tao phong trao xanh sach dep, eung ca'p nddc ud'ng eho hoe sinh, e l c cdng trinh ve sinh ed tien bd nhdng eung ehi dat k h o i n g 5 0 % yeu c l u , cdng tac k h l m sdc khoe djnh ky, q u I n ly hd sd sdc khde h i u het chda thu'c hien thee quy dinh.
Toan qudc chda cd so lieu ehinh thdc v l cac benh trddng hoc nhd can thj va eong veo cdt sd'ng d hoc sinh [6],[7]. Chinh vl vay, nghien edu mdt e l c h cd he thd'ng ve boat ddng y te trddng hoc tai nddc ta la mdt nhiem vu e i n thiet, nd giup cho eac nha q u I n ly va hoach djnh ehinh sleh day manh cac hoat ddng y te trddng hpe nham nang cao sdc khde cho hoc sinh trong thdi gian tdi.
Bai b i o nay la mdt phan ke't q u i trong d l tai nghien cdu cap Bd 2007 - 2009 nham muc tieu:
Mo ta thffc trang boat dgng ve y te trffdng bgc tai cac trffdng phd tbong d Viet Nam bien nay (nam 2008).
II. DOI TU'ONG VA PHU'ONG PHAP NGHIEN CLfu
1. Thiet ke nghien cufu
Nghien edu md t l e l t ngang (phd'i hop djnh lddng va djnh tinh)
2. Dja diem va thdi gian nghien cdu
Nghien cdd dddc tien h i n h tai 3 tinh cua 3 vung m i l n eua e l nddc: Phu Tho, Q u i n g Binh va Ddng Nai td thang 1/2008 - t h i n g 12/2008
3. Doi tddng nghien cii'u
C I c b i o d o , nghien edu, so lieu cd s i n v l y te trddng hoc tai d e trddng phd thdng td nam 2000 trd lai day
C I n bd y te trddng hoe tai eae trddng tieu hoc, trung hoc cd sd v l trung hoe phd thdng td nguyen v l ddng y tham gia v i o nghien edu
4. C6 mau va each chon mau
Tat d d c d n bd y te hpe dddng cua trddng tieu hoc, trung hoe ed sd va trung hoe phd thdng trong huyen Ida chpn dddc d i l u tra.
Tdng cdng da phdng van dddc 355 d n bd YTTH d 3 rinh. Tai mdi tinh d i l u tra d i u Ida chon 3 huyen dai dien eho 3 khu vdc thanh thj, ddng bang, m i l n nui.
Toln bd b i o d o , sd lieu sd sleh v l hoat ddng YTTH td nam 2001 - 2006 tai d c trddng phd thdng d i l u tra
5. Ky thuat thu thap so' lieu
Phdng van d n bd y te' trddng hoc theo bd eau hdi thiet ke cd s i n v l e l e hoat ddng y te trddng hoc dddc thdc hien treng nam hoe 2006
- 2007. C I c bao d o va sd lieu cd s i n dddc thu thap thee m l u thie't ke cd s i n .
6. Xu" ly so' lieu
C I c so lieu dddc lam sach va nhap lieu bang chddng trlnh Epi - info 6.04 va Phan tieh e l e so' lieu thu ddcic bang phan m l m SPSS (13.0).
I I I . K E T Q U A
Bang 1. Sd buyen tbtfc bien cac cbtftfng trinh YTTH giai doan 2001 - 2006
Chu'dng trinh
Cham sdc sdc khde ban d i u Phdng chd'ng benh t r u y i n nhiem Phdng chd'ng thieu m l u
Phdng ehdng suy dinh dddng Chddng trlnh nha hpe dddng Chddng trlnh m i t hoc dddng Phdng ehdng HlV/AlDS Tai nan thddng tich Nddc sach - VSMT
Phu Tho 2/3 2/3 2/3 2/3 2/3 2/3 2/3 2/3 2/3
Quang Binh 1/3 1/3 - 2/3 2/3 2/3 2/3 2/3 2/3
Dong Nai 2/3 2/3 2/3 2/3 2/3 2/3 2/3 2/3 2/3
(So huyen cd thdng tin vi viec thtfc hien chtfdng trlnh tren tong so 3 huyen dtfdc khao sit tai mdi tinh)
Kit qua d bang tren cho thi'y cd tong so' 9 chtfdng trlnh CSSK cho hgc sinh dtfgc bao cao trien khai d 9 huyen tai 3 tinh nghien cdu. Nhin chung cac chuang trlnh CSSK cd ban diu dtfgc bio cao triin khai d cac huyen diiu tra. Nhtfng mac dii chi khao sat d 3 huyen mdi tinh, kit qua cung cho thay la khdng cd tinh nao cd 3/3 huyen cd thdng tin vi viec thtfc hien cac chtfdng trlnh CSSK cho hgc sinh. Trong 3 tinh bao cio thi so' lieu bao cio d tinh Quang Binh tha'p nhi't vl chUdng tnnh cham sdc sdc khde ban diu, phdng chd'ng benh truyin nhiem chi cd 1 huyen bao cio thtfc hien.
I Dong bang D Mien niii • Chung
KSKdinh SacSp ciiu Lap h6 sa CT Tir vSn GDSK HD ngoai Plrong ky(p<0.01) (p<0.001) TDSKHS CSSKHS (p<0.01) (p<0.01) khoa cli6ng
(p<0.001) (p<0,001) (p<0.01) CVCS (p<0,01) Hinh 1. Ty le % cac boat dgng YTTH ma can bg YTTH tbtfc bien
PC can thi {p<0.01)
Ghi chu: KSK = Kham sdc khde; TDSKHS = Theo ddi sdc khoe hgc sinh; GTGSSKHS = Chtfdng trlnh cham sdc sdc khde hgc sinh; GDSK = Giio due sdc khde; HD = Hoat dgng; CVCS = Gong veo cot song; HD = Hoat ddng.
Ket qua d hinh 1 cho thay hoat dgng ma cin bg YTTH da vi dang thUc hien khdng nhiiu, chiem ty le td 13,2%o den 71,6%o tong so' can bg YTTH da tham gia nghien cdu. Ba hoat dgng dUdc cin bg YTTtT Itfa chgn nhiiu nha't la sd cap cdu (71,6%o), giao due sdc khde cho hgc sinh (51,8%o) vi khim sdc khde djnh ky (47,6%o). Dac biet cd rat it can bg YTTH tham gia hoat dgng phdng chdng CVCS va phdng chd'ng can thj hgc dUdng (chi cd 13,2%o va 19,7%o). Nhin chung cac hoat dgng YTTH dtfgc thtfc hien nhiiu han d khu vtfc thanh thj vi dong bing so vdi khu vUc mien nui (p<0,01).
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KSK djnh ky IJp ho so' Tu van GDSK Hoat dong ngoai Kham, phat hien Kham, phat hien (p<0,01) TDSKHS (p<0,01) khoa (p<0,05) can thi (p<0,001) CVCS (p<0,001)
(p<0,05)
Hinh 2. Kha nang tbtfc bien cac boat dgng YTTH cua can bg YTTH
Ghi chu: KSK = Kham sdc khde; TDSKHS = Theo ddi sdc khde hgc sinh; GDSK = Giao due sifc khde; CVCS = Gong veo cot song
De dinh gia kha nang thtfc hien cac hoat ddng ciia cac cin bd YTTH, nghien cdu da dimg ciu hdi: "Xin anh/chi cho bie't mlnh cd kha nang lim dugc cac hoat dgng dtfdi day khdng?" vi doi iugng tu dinh gia cho tdng hoat ddng da trlnh biy d hinh 2 theo cic mde: ttf lim dtfgc, lam dtfgc cin cd stf hd trg, chi tham gia hd trg vi khdng cd kha nang thtfc hien. Kit qua d hinh tren cho thay hoat dgng ma nhiiu can bg YTTH khdng cd kha nang thUc hien nhieu nha't li kham va phat hien cic benh trUdng hgc (cong veo cdt sd'ng, can thi). Hoat ddng cd ty le % cin bg YTTH khdng cd kha nang thtfc hien tha'p nha't la lap ho sd theo ddi sdc khde hgc sinh (11,2%o tong so diiu tra). Dac biet, trong sd' cac can bd cd kha nang thtfc hien thi hiu hit d trlnh do lam cin cd sU hd trg hoac chi tham gia hd trg, chi cd 1 - 2 cin bd ttf dinh gia cd kha nang lim viec ddc lip. Gd stf khac biet cd y nghia thd'ng ke vi cic t'y le nay theo vimg cho tdng hoat ddng (p < 0,05).
I V . B A N L U A N d n bd YTTH tai 27 trddng nghien cdu bang De t r i Idi cau hdi cd nhdng hoat ddng nao each dat cau hdi "Anh chj da va dang tham gia v l Y te trddng hoc da va dang dddc tien hanh, cdng t i c YTTH nao?" va eho e l c Ida chon s i n chung tdi da tien hanh phdng van trdc tie'p 355 cd kem xem xet t l i lieu s i n ed v l cdng t i e
YTTH. Ket qua d hinh 1 eho thay hau het d c boat ddng YTTH dang dddc thdc hien nhdng chd yeu 11 sd cap cdu, giao due sdc khde cho hpe sinh v l k h l m sdc khde djnh ky edn elc hoat ddng phdng chdng benh cong veo cdt sd'ng va can thj hoc dddng cdn it dddc ehu y. Ke't q u i eung eho tha'y hau het elc chddng trlnh cham sdc sdc khde hoc sinh da dddc thdc hien tai tat c l eac huyen nghien cdu nhdng mde dd khdng gidng nhau.
Thed djnh nghia eua Td chdc Y te The gidi [10], trddng hoe nang eao sdc khde (health - promoting school) c i n cd 4 ndi dung cd ban la 1) nang eao hieu q u i g i l o due sdc khde trong trddng hoc (qua Idng ghep v i o cac mdn hoc chinh khda, trien khai d c hoat ddng truyin thdng GDSK thdng qua eae hoat ddng ngoai khda, sinh hoat tap the v l tai lieu truyin thdng, td ehde d c boat ddng Idng ghep gida nhai trddng - gia dinh - edng ddng), 2) td ehde e l c djch vu sdc khde trddng hoe, 3) xay difng cd sd vat chat va mdi trddng hoe dddng v l 4) thdc hien d c ehinh sleh n l n g cao sdc khde hoe dddng. Ket q d l nghien cdu eho thay hien tai d c trddng hoc mdi chu yeu tap trung vao ndi dung cd ban d i u tien, cdn d c heat ddng k h i c edn rat md nhat. Mac du ed hdat ddng da trien khai dddc thdc hien ra't khdng ddng bd, mdi mang tinh chat sd vii, khdng thddng xuyen.
D i n h gia chung, d c hoat ddng tren d i u phu hdp vdi e l c hoat ddng YTTH dddc d l cap den treng thdng td lien bd sd 03/2000/TTLT - BYT - BGD&OT n g l y 1/3/2000 v l viec hddng d i n thdc hien cdng t i e y te trddng hoc [4]. Tuy nhien, khdng phai ta't c l e l e trddng tai 3 rinh nghien cdu d i u thdc hien ddng nha't ta't c l e l e hoat ddng tren. N g o l i d e boat ddng mang rinh thddng xuyen nhd sd cap cdd ban d i u , k h l m sdc khde djnh ky, phdng ehdng benh tat thddng gap d Ida tudi hpe dddng, ve sinh mdi trddng, an t o l n thdc pham... dddc trien khai d hau khap eae trddng. Cdn nhdng hoat ddng mang rinh
Idng ghep trong e l c chddng trinh ngoai khda nhd g i l o dgc sdc khde, t r u y i n thdng... tuy thude vao sd nang ddng trong e l c h thdc trien khai cua d n bd e l c trddng. Dae biet 11 d c hoat ddng v l phdng ehdng benh trddng bpc nhd eong veo cdt sdng, can thj hoc dddng cdn it dddc d c d n bo YTTH thifc hien vi it cd k h i nang. D i l u n l y can dddc chu y hdn trong thdi gian sap tdi.
V. KET LUAN
C I c ndi dung boat ddng v l YTTH da dddc thifc hien nhdng chda ddng bd v l thd'ng nha't gida e l e trddng phd thdng. C I c hoat ddng da va dang thdc hien la giao due sdc khde (ehu yeu Idng ghep d d c bai g i l n g ehinh khda, boat ddng ngoai khda), td chdc d c boat ddng YTTH (kham sdc khde djnh k'y, sd cap cdu ban d i u , trien khai d e chddng trinh CSSK ban diu) tuy nhien d e heat ddng nay khdng thddng xuyen nen mdi dat d hieu q u i nha't djnh (mdi ed hdn mpt p h i n ba bpc sinh d i l u tra dddc k h l m sdc khde djnh ky hang nam va cd hd sd theo ddi sdc khde tai trddng).
Hoat ddng v l tuyep truyen, k h l m va phlt hien can thj va cong veo cdt sd'ng cdn it dddc thdc hien. Chi cd 13,2% va 19,7% d n bd YTTH tham gia hoat ddng phdng chd'ng CVCS v l phdng ehdng can thj hpe dddng.
KHUYEN NGH!
C i n ed nhdng chinh sach va hddng d i n cu the cho d c trddng phd thdng lap ke hoach va thifc hien d c hoat ddng v l YTTH ddng bd va thddng xuyen, dac biet la d e boat ddng k h l m v l p h l t hien eac benh trddng hoc eho c i n bd YTTH tai d e trddng phd thdng trong c l nddc.
TAI LIEU THAM KHAO
1. Bo Y te, Bo Giao due dao tao. To chiJc Y te The gidi (2002), Hddng d i n thdc hien trddng hoe nang cao sdc khde.
2. B6 Y te. Bo Giao due dao tao, To chu'c Y 5. Nguyin Huy Nga, Le Thu Hien va cong sd te the gidi (2002), Nang cao hieu q u i g i l o due (2002), Thdc trang y te trddng hpe tai mdt sd sdc khde trong trddng tieu hoc. trddng phd thdng t h i n h phd H I i Phdng.
3. Chu van Thang, Le Thj Thanh Xuan va 6. To' chu'c Plan tai Viet Nam (2004) "Thdc cong sd (2003), Tinh hinh cong veo cdt sd'ng v l trang boat ddng y te trddng hoe v l djnh hddng can thj cua hoe sinh thanh phd Ha Ndi. Thdc x l y ddng md hinh nang eao sdc khde trddng trang va g i i i p h l p phdng ngda, D l tai nghien hpe". B i o d o k i t q d l nam 2004, 97.
cdu KHCN cap Bd ma sd B2000 - 40 - 87, phdi _ , , ^ ...' . , , . r,„ .^ ..- / ^ « „ o \ • ,
^ • ^ 7. Vu Y te dd phong. Bo Y te (2002), Bao hdp vdi Vu giao due the chat, Bd Giao due va , _•, , ,s , , . . ,,- ,. ,
•^ o . / . cao tong hc?p tmh hinh y te trddng hoc.
Dao tao, 78.
8. Vu Y te du- phdng. Bo Y te (2004), B i o 4. Lien tich Y t e - G i a o due va Dao tao (2001), , - , . , , -
cao tong hdp tmh hinh y te trddng hoe.
sd 03/2000/TTLT - BYT - BGD&DT, Thdng td lien
tjch hddng d i n thdc hien edng t i e y te' trddng hpe, ^- ^"^ ^ *^' ^"^ P^°"^' ^^ ^ *^' (^007), B i o do ngdyen Bd trddng Bd G i l o due va D I o tao ^ ^ ° ^°"8 ^^P ^'"^ ^'""^ V '^ ^^^^"8 l^^^'
Nguyin Minh Hien va nguyen Bd Trddng Bd Y te 10. WHO (2007), W H O Information Series Dd Nguyen Phddng ky ngay 1/3/2001. on School Health.
Summary
SITUATION ANALYSIS OF SCHOOL HEALTH ACTIVITIES IN VIETNAM
A study was conducted in three provinces, representative for 3 regions of Northern, Central and Southern of Vietnam (PhuTho, QuangBinh va DongNai). Objectives: to describe the situation of school health activities at primary, secondary and high levels in Vietnam in 2008. Methods: A cross - sectional study (both quantitative and qualitative) applied to interview 355 school health actors of 9 schools of primary, secondary and high levels in 9 districts of 3 provinces that representative for three areas (mountainous, plain and urban). All secondary data on school health activities done period 2001 - 2006 collected. Results: School health activities were limited. The percentage of study participants responded to school health ranged from 13.2% to 71.6%. Three most common activities were first - aids (71.6%), school - based health education (51.8%) and periodical health exams (47.6%).
Attentionally, very few respondents reported that they performed school health actions to prevent scoliosis and myopia (accounted for 13.2% and 19.7% accordingly). There was a trend that activities of school health were done more in urban and plain areas than that of mountainous area (p < 0.05).
The most unable - to - perform activity was finding out and examination of school diseases (scoliosis and myopia). The lowest percentage of school health activity that the staff unable to do was health recording skills (only 11.2% of study participants could perform). Conclusion: The common activities of health school were currently first - aids, health education and periodical health exams. Prevention of school - based scoliosis and myopia was limited. Almost of school health aetivitists unable to perform school health activities, detecting school diseases particularly..
Keywords: health activities, schools