Article(id=1325535477826347566, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325535161890398372, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025351, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1751299200000, receivedDateStr=2025-07-01, revisedDate=1760803200000, revisedDateStr=2025-10-19, acceptedDate=null, acceptedDateStr=null, onlineDate=1793961885171, onlineDateStr=2026-11-06, pubDate=1766592000000, pubDateStr=2025-12-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793961885171, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793961885171, creator=13701087609, updateTime=1793961885171, updator=13701087609, issue=Issue{id=1325535161890398372, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='12', pageStart='1673', pageEnd='1824', issueExtLink='null', onlineDate='null', pubDate='1766592000000', pubDateStr='2025-12-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793961809846, creator='13701087609', updateTime=1793961809846, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1706, endPage=1710, ext={EN=ArticleExt(id=1325535490333762096, articleId=1325535477826347566, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Status of tuberculosis prevention and control knowledge with perceived stress among college and middle school students with pulmonary tuberculosis in Yantai, columnId=1259565859148804482, journalTitle=Chinese Journal of School Health, columnName=Health Education and Promotion, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the current status of tuberculosis prevention and control knowledge and perceived stress among college and middle school students with pulmonary tuberculosis (PTB) in Yantai City, and to analyze the related factors, so as to provide a basis for the school to carry out health education and psychological counseling.

Methods

A matched case-control study was conducted, with 100 PTB student patients in junior high school and above who were diagnosed at designated medical institutions from October 2020 to October 2024. Four healthy control students of the same gender, same dormitory, or same class were selected for each case. Therefore, 100 cases and 400 controls were investigated by questionnaire. The following information was collected: personal basic information; tuberculosis prevention and control awareness; and scores of the Chinese Perceived Stress Scale (CPSS). Conditional Logistic regression model and mixed linear models were used to compare the PTB prevention and control awareness rate, as well as the perceived stress between the case and control groups. Multiple linear regression analysis was used to analyze the factors that may affect the perceived stress of students with PTB.

Results

The awareness rates of four tuberculosis knowledge items (symptoms of PTB, main causes of onset after infection, consequences of PTB patients not receiving standardized and complete treatment, the most important method to prevent PTB) were higher in the case group (40.00%, 72.00%, 38.00%, 49.00%) than the control group (21.50%, 57.50%, 22.25%, 31.25%) and the differences were statistically significant (Wald χ2=18.44, 8.78, 13.20, 16.89, all P < 0.01). The tension score (10.49±4.20), loss of control score (11.21±4.58), and total score (21.70±6.88) in the case group were higher than the control group (9.35±4.73, 9.75±5.60, 19.09±8.36) and the differences were statistically significant (t=2.21, 2.42, 2.88, all P < 0.05). The results of multiple linear regression analysis showed that age ≥18 years and family history of tuberculosis were the related factors affecting the overall perceived stress and tension of college and middle school students with PTB (Btotal scores=4.50, 5.91; Btension score=2.39, 3.23, all P < 0.05).

Conclusions

The tuberculosis prevention and control awareness rate, and the perceived stress of college and middle school students with PTB in Yantai are both higher than students without tuberculosis. Moreover, the perceived stress of students with PTB who are aged ≥18 years or have a family history of tuberculosis is even higher.

, authors=Jing ZHOU1, Lili ZHEN1, Jingyu LIU1, Shulei WANG1, Huihui HE1, Xiaohua REN1, Yanqing LIU2, Lei YAN3, Yuelei WANG*, 1, authorsList=Jing ZHOU, Lili ZHEN, Jingyu LIU, Shulei WANG, Huihui HE, Xiaohua REN, Yanqing LIU, Lei YAN, Yuelei WANG, authorCompany=null, correspAuthors=Yuelei WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1325535496730075697, articleId=1325535477826347566, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=烟台市大中学生肺结核患者结核病防治知识和知觉心理压力状况, columnId=1259565859903779205, journalTitle=中国学校卫生, columnName=健康教育与健康促进, runingTitle=null, highlight=null, articleAbstract=
目的

了解烟台市大中学生肺结核患者对结核病防治知识的知晓现状及知觉心理压力,并分析其相关因素,为学校开展结核病健康教育和心理辅导工作提供依据。

方法

采用病例对照研究,选取2020年10月至2024年10月经结核病定点医疗机构确诊的初中及以上新发学生肺结核患者100例作为病例组,每例患者按照“同性别、同寝室或同班级”的匹配条件选择4名健康学生作为对照组进行问卷调查。收集研究对象的个人基本信息及结核病防治知识知晓情况、中文版知觉压力量表得分(CPSS)。采用条件Logistic回归模型和混合线性模型比较病例组与对照组的结核病防治知识知晓率及知觉压力,采用多重线性回归分析可能影响学生肺结核患者知觉压力的因素。

结果

结核病知识条目中,“肺结核的症状”“感染后发病的主要原因”“肺结核患者不接受规范完整治疗的后果”“预防肺结核最主要的方法”4项知识知晓率,病例组(40.00%,72.00%,38.00%,49.00%)均高于对照组(21.50%,57.50%,22.25%,31.25%),差异均有统计学意义(Wald χ2值分别为18.44,8.78,13.20,16.89,P值均 < 0.01);病例组的紧张感得分(10.49±4.20)、失控感得分(11.21±4.58)及知觉心理压力总分(21.70±6.88)均高于对照组(9.35±4.73,9.75±5.60,19.09±8.36),差异均有统计学意义(t值分别为2.21,2.42,2.88,P值均 < 0.05)。多重线性回归分析结果显示,年龄≥18岁、有结核病家族史是大中学生肺结核患者总体知觉心理压力和紧张感的相关因素(B知觉心理压力总分值分别为4.50,5.91;B紧张感值分别为2.39,3.23,P值均 < 0.05)。

结论

烟台市大中学生肺结核患者的结核病防治知识知晓率及知觉心理压力均高于未患结核病的学生,且年龄≥18岁、有结核病家族史的学生肺结核患者知觉压力更高。

, authors=周静1, 甄丽丽1, 刘靖宇1, 王淑蕾1, 何荟荟1, 任晓华1, 刘延庆2, 闫磊3, 王曰雷*, 1, authorsList=周静, 甄丽丽, 刘靖宇, 王淑蕾, 何荟荟, 任晓华, 刘延庆, 闫磊, 王曰雷, authorCompany=null, correspAuthors=王曰雷, authorNote=

周静(1996-),女,山东潍坊人,硕士,医师,主要研究方向为传染病防控

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王曰雷,E-mail:
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周静(1996-),女,山东潍坊人,硕士,医师,主要研究方向为传染病防控

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周静(1996-),女,山东潍坊人,硕士,医师,主要研究方向为传染病防控

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(in Chinese), articleTitle=null, refAbstract=null)], funds=[Fund(id=1325535549997736571, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535477826347566, awardId=null, language=CN, fundingSource=山东省医药卫生科技发展计划项目(2019WS263);山东省医药卫生科技项目(202412050245), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1325535502497243698, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535477826347566, xref=1, ext=[AuthorCompanyExt(id=1325535502581129779, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535477826347566, companyId=1325535502497243698, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Department of Tuberculosis Prevention and Control, Yantai Center for Disease Control and Prevention, Yantai 264003, Shandong Province, China), AuthorCompanyExt(id=1325535502925062708, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535477826347566, companyId=1325535502497243698, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1烟台市疾病预防控制中心结核病防制科,山东 264003)]), AuthorCompany(id=1325535503403213365, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535477826347566, xref=2, ext=[AuthorCompanyExt(id=1325535503734563382, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535477826347566, companyId=1325535503403213365, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2海阳市疾病预防控制中心结核病防制科)]), AuthorCompany(id=1325535504636338743, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535477826347566, xref=3, ext=[AuthorCompanyExt(id=1325535504657310264, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535477826347566, companyId=1325535504636338743, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3芝罘区疾病预防控制中心结核病防制科)])], figs=[ArticleFig(id=1325535540812210804, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535477826347566, language=EN, label=Tab.1, caption=

Conditional Logistic regression analysis of knowledge awareness rate of tuberculosis prevention and control in case group and control group

, figureFileSmall=null, figureFileBig=null, tableContent=
结核病防治知识病例组(n=100)对照组(n=400)Wald χ2值P值OR值OR值95%CI
对肺结核的认识90(90.00)347(86.75)0.830.361.410.67~2.96
肺结核的传播途径89(89.00)359(89.75)0.060.820.910.45~1.94
肺结核的症状40(40.00)86(21.50)18.44< 0.013.421.95~6.00
结核病定点医院92(92.00)348(87.00)2.240.141.940.82~4.61
肺结核的诊疗72(72.00)298(74.50)0.330.560.850.49~1.48
对结核潜伏感染的认识42(42.00)145(36.25)1.490.221.380.82~2.30
感染后发病的主要原因72(72.00)230(57.50)8.78< 0.012.251.32~3.84
学生预防肺结核的关键措施97(97.00)383(95.75)0.440.511.670.36~7.69
结核病是否能治愈47(47.00)210(52.50)1.070.300.780.49~1.25
肺结核患者不接受治疗可能造成的风险73(73.00)277(69.25)1.690.191.710.76~3.86
肺结核患者不接受规范完整治疗的后果38(38.00)89(22.25)13.20< 0.012.831.61~4.95
预防肺结核最主要的方法49(49.00)125(31.25)16.89< 0.013.872.03~7.37
国家减免政策61(61.00)251(62.75)0.130.720.910.56~1.50
), ArticleFig(id=1325535541894341237, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535477826347566, language=CN, label=表1, caption=

病例组与对照组结核病防治知识知晓率的条件Logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
结核病防治知识病例组(n=100)对照组(n=400)Wald χ2值P值OR值OR值95%CI
对肺结核的认识90(90.00)347(86.75)0.830.361.410.67~2.96
肺结核的传播途径89(89.00)359(89.75)0.060.820.910.45~1.94
肺结核的症状40(40.00)86(21.50)18.44< 0.013.421.95~6.00
结核病定点医院92(92.00)348(87.00)2.240.141.940.82~4.61
肺结核的诊疗72(72.00)298(74.50)0.330.560.850.49~1.48
对结核潜伏感染的认识42(42.00)145(36.25)1.490.221.380.82~2.30
感染后发病的主要原因72(72.00)230(57.50)8.78< 0.012.251.32~3.84
学生预防肺结核的关键措施97(97.00)383(95.75)0.440.511.670.36~7.69
结核病是否能治愈47(47.00)210(52.50)1.070.300.780.49~1.25
肺结核患者不接受治疗可能造成的风险73(73.00)277(69.25)1.690.191.710.76~3.86
肺结核患者不接受规范完整治疗的后果38(38.00)89(22.25)13.20< 0.012.831.61~4.95
预防肺结核最主要的方法49(49.00)125(31.25)16.89< 0.013.872.03~7.37
国家减免政策61(61.00)251(62.75)0.130.720.910.56~1.50
), ArticleFig(id=1325535543240712822, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535477826347566, language=EN, label=Tab.2, caption=

Comparison of perceived stress scores among college and middle school students with pulmonary tuberculosis in different demographic characteristics(x±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
人口统计指标选项例数统计值紧张感失控感总分
性别男5110.86±4.1011.24±4.3922.10±6.50
女4910.10±4.3011.18±4.8121.29±7.29
t值0.930.060.59
P值0.370.960.56
年龄/岁< 18158.67±4.1410.13±3.7018.80±6.57
≥188510.81±4.1511.40±4.7122.21±6.84
t值-1.85-0.99-1.79
P值0.070.330.08
民族汉族9510.46±4.2611.03±4.5821.49±6.93
其他511.00±3.0014.60±3.2925.60±4.78
t值-0.28-1.72-1.31
P值0.780.090.20
户籍农村5611.23±4.4010.89±4.3422.13±6.62
城市449.55±3.7611.61±4.8821.16±7.23
t值2.03-0.780.70
P值0.050.440.49
寄宿是7011.03±4.0310.97±4.1122.00±6.86
否309.23±4.3711.77±5.5621.00±6.98
t值1.99-0.800.67
P值0.050.430.51
学校类型大学4511.24±3.9312.16±4.5523.40±6.81
高职822.25±5.1510.88±2.3622.25±5.15
中职719.86±6.20319.86±6.2019.86±6.20
普高2820.21±7.1820.21±7.1820.21±7.18
初中1219.50±7.1311.75±5.0319.50±7.13
F值1.821.281.49
P值0.130.280.21
结核病家族史有1113.09±5.8712.91±4.2826.00±5.64
无8910.17±3.8711.00±4.5921.17±6.85
t值2.221.312.24
P值0.030.190.03
), ArticleFig(id=1325535544104739447, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535477826347566, language=CN, label=表2, caption=

不同人口统计学特征大中学生肺结核患者知觉压力得分比较(x±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
人口统计指标选项例数统计值紧张感失控感总分
性别男5110.86±4.1011.24±4.3922.10±6.50
女4910.10±4.3011.18±4.8121.29±7.29
t值0.930.060.59
P值0.370.960.56
年龄/岁< 18158.67±4.1410.13±3.7018.80±6.57
≥188510.81±4.1511.40±4.7122.21±6.84
t值-1.85-0.99-1.79
P值0.070.330.08
民族汉族9510.46±4.2611.03±4.5821.49±6.93
其他511.00±3.0014.60±3.2925.60±4.78
t值-0.28-1.72-1.31
P值0.780.090.20
户籍农村5611.23±4.4010.89±4.3422.13±6.62
城市449.55±3.7611.61±4.8821.16±7.23
t值2.03-0.780.70
P值0.050.440.49
寄宿是7011.03±4.0310.97±4.1122.00±6.86
否309.23±4.3711.77±5.5621.00±6.98
t值1.99-0.800.67
P值0.050.430.51
学校类型大学4511.24±3.9312.16±4.5523.40±6.81
高职822.25±5.1510.88±2.3622.25±5.15
中职719.86±6.20319.86±6.2019.86±6.20
普高2820.21±7.1820.21±7.1820.21±7.18
初中1219.50±7.1311.75±5.0319.50±7.13
F值1.821.281.49
P值0.130.280.21
结核病家族史有1113.09±5.8712.91±4.2826.00±5.64
无8910.17±3.8711.00±4.5921.17±6.85
t值2.221.312.24
P值0.030.190.03
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Multiple linear regression analysis of the total score and tension score of perceived stress among college and middle school students with pulmonary tuberculosis (n=100)

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常量与自变量选项总分紧张感
B值标准误β值t值P值B值标准误β值t值P值
常量12.723.61—3.53< 0.018.952.91—3.07< 0.01
年龄/岁≥184.501.890.242.390.022.391.170.212.050.04
户籍城市-1.230.82-0.15-1.510.13
寄宿否-1.130.90-0.12-1.250.21
结核病家族史有5.912.150.272.75< 0.013.231.310.242.470.02
), ArticleFig(id=1325535548324209274, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535477826347566, language=CN, label=表3, caption=

大中学生肺结核患者知觉压力紧张感及总分的多重线性回归分析(n=100)

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常量与自变量选项总分紧张感
B值标准误β值t值P值B值标准误β值t值P值
常量12.723.61—3.53< 0.018.952.91—3.07< 0.01
年龄/岁≥184.501.890.242.390.022.391.170.212.050.04
户籍城市-1.230.82-0.15-1.510.13
寄宿否-1.130.90-0.12-1.250.21
结核病家族史有5.912.150.272.75< 0.013.231.310.242.470.02
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烟台市大中学生肺结核患者结核病防治知识和知觉心理压力状况
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周静 1 , 甄丽丽 1 , 刘靖宇 1 , 王淑蕾 1 , 何荟荟 1 , 任晓华 1 , 刘延庆 2 , 闫磊 3 , 王曰雷 *, 1
中国学校卫生 | 健康教育与健康促进 2025,46(12): 1706-1710
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中国学校卫生 |健康教育与健康促进 2025 , 46 (12) : 1706 -1710
烟台市大中学生肺结核患者结核病防治知识和知觉心理压力状况
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周静1, 甄丽丽1, 刘靖宇1, 王淑蕾1, 何荟荟1, 任晓华1, 刘延庆2, 闫磊3, 王曰雷*, 1
作者信息
  • 1烟台市疾病预防控制中心结核病防制科,山东 264003
  • 2海阳市疾病预防控制中心结核病防制科
  • 3芝罘区疾病预防控制中心结核病防制科
通讯作者:
王曰雷,E-mail:
作者简介:

周静(1996-),女,山东潍坊人,硕士,医师,主要研究方向为传染病防控

Status of tuberculosis prevention and control knowledge with perceived stress among college and middle school students with pulmonary tuberculosis in Yantai
Jing ZHOU1, Lili ZHEN1, Jingyu LIU1, Shulei WANG1, Huihui HE1, Xiaohua REN1, Yanqing LIU2, Lei YAN3, Yuelei WANG*, 1
Affiliations
  • 1Department of Tuberculosis Prevention and Control, Yantai Center for Disease Control and Prevention, Yantai 264003, Shandong Province, China
出版时间: 2025-12-25 doi: 10.16835/j.cnki.1000-9817.2025351
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目的

了解烟台市大中学生肺结核患者对结核病防治知识的知晓现状及知觉心理压力,并分析其相关因素,为学校开展结核病健康教育和心理辅导工作提供依据。

方法

采用病例对照研究,选取2020年10月至2024年10月经结核病定点医疗机构确诊的初中及以上新发学生肺结核患者100例作为病例组,每例患者按照“同性别、同寝室或同班级”的匹配条件选择4名健康学生作为对照组进行问卷调查。收集研究对象的个人基本信息及结核病防治知识知晓情况、中文版知觉压力量表得分(CPSS)。采用条件Logistic回归模型和混合线性模型比较病例组与对照组的结核病防治知识知晓率及知觉压力,采用多重线性回归分析可能影响学生肺结核患者知觉压力的因素。

结果

结核病知识条目中,“肺结核的症状”“感染后发病的主要原因”“肺结核患者不接受规范完整治疗的后果”“预防肺结核最主要的方法”4项知识知晓率,病例组(40.00%,72.00%,38.00%,49.00%)均高于对照组(21.50%,57.50%,22.25%,31.25%),差异均有统计学意义(Wald χ2值分别为18.44,8.78,13.20,16.89,P值均 < 0.01);病例组的紧张感得分(10.49±4.20)、失控感得分(11.21±4.58)及知觉心理压力总分(21.70±6.88)均高于对照组(9.35±4.73,9.75±5.60,19.09±8.36),差异均有统计学意义(t值分别为2.21,2.42,2.88,P值均 < 0.05)。多重线性回归分析结果显示,年龄≥18岁、有结核病家族史是大中学生肺结核患者总体知觉心理压力和紧张感的相关因素(B知觉心理压力总分值分别为4.50,5.91;B紧张感值分别为2.39,3.23,P值均 < 0.05)。

结论

烟台市大中学生肺结核患者的结核病防治知识知晓率及知觉心理压力均高于未患结核病的学生,且年龄≥18岁、有结核病家族史的学生肺结核患者知觉压力更高。

结核,肺  /  知识  /  压力  /  回归分析  /  学生
Objective

To understand the current status of tuberculosis prevention and control knowledge and perceived stress among college and middle school students with pulmonary tuberculosis (PTB) in Yantai City, and to analyze the related factors, so as to provide a basis for the school to carry out health education and psychological counseling.

Methods

A matched case-control study was conducted, with 100 PTB student patients in junior high school and above who were diagnosed at designated medical institutions from October 2020 to October 2024. Four healthy control students of the same gender, same dormitory, or same class were selected for each case. Therefore, 100 cases and 400 controls were investigated by questionnaire. The following information was collected: personal basic information; tuberculosis prevention and control awareness; and scores of the Chinese Perceived Stress Scale (CPSS). Conditional Logistic regression model and mixed linear models were used to compare the PTB prevention and control awareness rate, as well as the perceived stress between the case and control groups. Multiple linear regression analysis was used to analyze the factors that may affect the perceived stress of students with PTB.

Results

The awareness rates of four tuberculosis knowledge items (symptoms of PTB, main causes of onset after infection, consequences of PTB patients not receiving standardized and complete treatment, the most important method to prevent PTB) were higher in the case group (40.00%, 72.00%, 38.00%, 49.00%) than the control group (21.50%, 57.50%, 22.25%, 31.25%) and the differences were statistically significant (Wald χ2=18.44, 8.78, 13.20, 16.89, all P < 0.01). The tension score (10.49±4.20), loss of control score (11.21±4.58), and total score (21.70±6.88) in the case group were higher than the control group (9.35±4.73, 9.75±5.60, 19.09±8.36) and the differences were statistically significant (t=2.21, 2.42, 2.88, all P < 0.05). The results of multiple linear regression analysis showed that age ≥18 years and family history of tuberculosis were the related factors affecting the overall perceived stress and tension of college and middle school students with PTB (Btotal scores=4.50, 5.91; Btension score=2.39, 3.23, all P < 0.05).

Conclusions

The tuberculosis prevention and control awareness rate, and the perceived stress of college and middle school students with PTB in Yantai are both higher than students without tuberculosis. Moreover, the perceived stress of students with PTB who are aged ≥18 years or have a family history of tuberculosis is even higher.

Tuberculosis, pulmonary  /  Knowledge  /  Pressure  /  Regression analysis  /  Students
周静, 甄丽丽, 刘靖宇, 王淑蕾, 何荟荟, 任晓华, 刘延庆, 闫磊, 王曰雷. 烟台市大中学生肺结核患者结核病防治知识和知觉心理压力状况. 中国学校卫生, 2025 , 46 (12) : 1706 -1710 . DOI: 10.16835/j.cnki.1000-9817.2025351
Jing ZHOU, Lili ZHEN, Jingyu LIU, Shulei WANG, Huihui HE, Xiaohua REN, Yanqing LIU, Lei YAN, Yuelei WANG. Status of tuberculosis prevention and control knowledge with perceived stress among college and middle school students with pulmonary tuberculosis in Yantai[J]. Chinese Journal of School Health, 2025 , 46 (12) : 1706 -1710 . DOI: 10.16835/j.cnki.1000-9817.2025351
学校结核病暴发流行在我国时有发生[1],学生罹患肺结核后不仅会耽误学业,还会对其身心健康造成损害[2],因此做好校园结核病防控工作势在必行。学生群体对新知识的学习和传播能力较强[3],在学校开展结核病健康教育活动不仅能够增强学生对结核病防治知识的了解,还能促进知识在家庭、社区,乃至社会上的辐射性传播,意义深远[2]。
知觉压力是个体在感受到外部环境威胁性刺激时所产生的一种紧张状态[4],通常以紧张、不适、失控等形式存在[5]。有研究表明,知觉压力是影响个体身心健康的关键因素之一,长期承受较大压力会引发焦虑、抑郁等心理问题[6],还可能阻碍人格和行为的正常发展[7]。学生本来就面临升学、就业、情感、社交等多方面压力,被诊断为结核病后也会出现一些心理障碍[8],如不能及时调节,不仅会影响身心健康,还会降低学习积极性和生活满意度,进而导致环境适应能力降低、人际关系不协调等系列问题[9]。
本研究旨在了解烟台市大中学生肺结核患者的结核病防治知识知晓水平和知觉压力现状,探讨并分析其相关因素,为学校更好地开展结核病防治宣教及心理辅导工作提供参考依据。
纳入标准:2020年10月至2024年10月之间,经结核病定点医疗机构确诊的初中及以上新发学生肺结核(包含结核性胸膜炎)患者。排除标准:在校时间不足2个月者;患有与结核病症状相似的其他疾病者;患有慢性病等免疫功能低下者;拒绝或无法配合问卷调查者。对符合条件的103名病例发放调查问卷,将作答时间太短、规律答题明显的问卷剔除,回收有效问卷100份,有效率97.09%,其中男生51名,女生49名;年龄为13~27岁。
纳入标准:采用1∶4配比,每例患者按照“同性别、同寝室或同班级”的匹配条件选择4名同一时期的健康学生作为对照组。排除标准:在校时间不足2个月者;肺部有可疑病变者;近2周内有呼吸道感染症状者;拒绝或无法配合问卷调查者。对符合条件的412名学生发放调查问卷,将作答时间太短、规律答题明显的问卷剔除,回收有效问卷400份,有效率97.09%,其中男生204名,女生196名;年龄12~27岁。研究经烟台市疾病预防控制中心伦理委员会批准(伦理审批号:YYLLS K2024-06),所有调查对象均签署书面知情同意书。
使用自行设计的调查问卷对学生进行面对面调查,调查内容包括3个方面:(1)个人基本信息,包括性别、年龄、民族、户籍、寄宿情况、现就读学校类型、结核病家族史等。(2)结核病防治知识知晓情况,内容参考《学校结核病防控工作规范(2017版)》[10]进行设计,共13道题,选项设置包括单选和多选,答案选择正确即为知晓。单一知识知晓率=正确回答某一知识的人数/该知识答题总人数×100%;总知晓率=全部调查对象正确回答的条目总数/全部调查对象答题总条目数×100%。(3)中文版知觉压力量表(Chinese Perceived Stress Scale, CPSS),该量表由杨廷忠[5]根据Cohen等[11]研发的知觉压力量表(Perceived Stress Scale, PSS)修订编制而成,能全面客观地反映个体的压力水平[4]。量表由14项条目组成,反映压力的紧张感和失控感2个维度,采用Likert 5级评分法,根据反应程度分为“从来没有”“极少有”“有时有”“经常有”和“很多”(分别记0~4分),总得分范围0~56分,分值越高说明心理压力越大[12]。该量表在国内研究中被广泛使用,在各类人群中均具有良好的信、效度[13-17]。本研究中该量表Cronbach α系数为0.86。
为保障研究结果的准确性及有效性,在正式调研前,通过专家咨询和预调查的方式对问卷内容进行制定、修改与完善。调查前,对所有调查员进行统一培训,调查员需告知被调查者填写问卷的具体要求并确保所回收问卷的信息完整。调查结束后,采用双盲双录入的形式将问卷数据录入到EpiData 3.1软件,并导出到Excel 2013中建立数据库进行核实、校正,以保障数据质量。
采用SPSS 26.0软件,计量资料经Q-Q图检验符合近似正态分布,用(x±s)进行描述;计数资料采用频数(n)和百分比(%)进行描述。以是否患结核病(病例组=1,对照组=0)为因变量,以是否知晓某一知识(知晓=1,不知晓=0)为自变量进行条件Logistic回归,分析病例组与对照组的结核病防治知识知晓情况;两组的CPSS评分结果采用混合线性模型进行比较。学生肺结核患者知觉压力的单因素分析采用独立样本t检验和方差分析,多因素分析采用多重线性回归分析。检验水准α=0.05。
见表1。
被试学生结核病防治知识总知晓率为61.69%(4 010/6 500),其中,病例组总知晓率为66.31%(862/1 300),对照组为60.54%(3 148/5 200)。调查对象对“学生预防肺结核的关键措施”的知晓率最高,达96.00%。对“肺结核的症状”和“肺结核患者不接受规范完整治疗的后果”两项知识的知晓率较低,均不足30%。条件Logistic回归分析结果显示,病例组和对照组对“肺结核的症状”“感染后发病的主要原因”“肺结核患者不接受规范完整治疗的后果”和“预防肺结核最主要的方法”4项知识的知晓率差异均有统计学意义(P值均 < 0.05),且病例组均高于对照组。
病例组学生的紧张感得分(10.49±4.20)、失控感得分(11.21±4.58)及总分(21.70±6.88)均高于对照组(9.35±4.73,9.75±5.60,19.09±8.36),差异均有统计学意义(t值分别为2.21,2.42,2.88,P值均 < 0.05)。
农村户籍和寄宿的学生患者比城市户籍和非寄宿的学生患者紧张感得分更高,有结核病家族史的学生患者其紧张感得分及知觉压力总分均高于无结核病家族史的学生患者(P值均 < 0.05)。见表2。
分别以学生肺结核患者知觉压力总分和紧张感得分为因变量,以单因素分析中P < 0.1的因素为自变量,变量筛选采用Enter法,建立多重线性回归模型,2个模型均有统计学意义(F值分别为5.48,4.01,P值均 < 0.01),且方差膨胀因子均 < 10,表明模型有效且自变量间无多重共线性。多重线性回归分析结果显示,年龄≥18岁、有结核病家族史是学生肺结核患者总体知觉压力和紧张感的相关因素(P值均 < 0.05)。见表3。
知识是行为改变的基础[18],学生对结核病防治知识的了解程度与其对待结核病的行为之间存在相互影响[1],对结核病了解程度高的学生往往更倾向于主动学习和传播相关知识,罹患肺结核后也更愿意主动告知老师和同学,这在一定程度上能够降低肺结核在校园内传播的风险。
从本次调查结果来看,研究对象的结核病防治不同知识的知晓率差别较大,大中学生对肺结核的预防措施普遍比较了解,但对肺结核患者可能出现的症状及不进行规范治疗的风险了解甚少,说明结核病知识健康教育存在薄弱环节,今后应有针对性地开展宣教。本研究还发现,病例组有4项知识知晓率高于对照组,提示在结核病知识健康教育过程中加入门诊教育可能会比单纯的校园科普教育具有更好的效果。
在接受正确且规律的治疗后,85%的肺结核患者可以被治愈[19],治疗期间采取科学有效的预防措施,一般不会传染给他人。但由于人们对结核病防治知识缺乏了解,部分人群对该疾病仍然存在恐惧心理,对肺结核患者也存在歧视现象[20],这些因素都会加重结核病患者的心理负担,从而产生心理障碍[21]。本研究发现,病例组比对照组学生更容易感受到紧张感、失控感和感觉到更大的压力。可能是由于结核病是一种呼吸道传染病,学生得知自己患病后,部分害怕传染给身边的人,受到同学或亲友的疏远及冷落;部分则担心药物不良反应或疗程长影响学习成绩,从而产生恐惧、焦虑、孤独和自卑等情绪,无法进行良好的自我调整。
多重线性回归分析结果显示,年龄≥18岁、有结核病家族史的学生肺结核患者总体知觉压力和紧张感更高。分析原因包括以下几点:(1)成年的学生往往需要承担更多的家庭和社会责任,患有结核病可能会影响他们的职业发展、家庭计划、经济状况等,这些都可能导致他们在面对疾病时表现出更明显的紧张感,从而增加心理压力;(2)有结核病家族史的学生患者对结核病的治疗过程和可能带来的副作用有更直观的认识,从而对病情的严重性及治愈的可能性产生过度担忧。有研究指出,对学生肺结核患者实施准确及时的治疗并给予针对性的心理干预措施,能够有效促进学生身心健康、加快结核病治愈[8]。因此,应特别关注大中学生肺结核患者的心理健康状况,通过心理疏导帮助他们解除焦虑与恐慌,引导学生正确面对疾病,提高心理健康水平。
本研究存在一定的局限性:研究虽纳入了目标时间段内符合条件的全部学生肺结核患者,但样本量仍相对有限,可能影响多因素分析的统计效力和结果的稳定性。此外,影响因素分析中未纳入家庭经济条件、密切接触史等变量,限制了结果的全面性。未来需扩大样本量并纳入上述因素进行更深入探讨。
  • 山东省医药卫生科技发展计划项目(2019WS263);山东省医药卫生科技项目(202412050245)
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2025年第46卷第12期
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doi: 10.16835/j.cnki.1000-9817.2025351
  • 接收时间:2025-07-01
  • 首发时间:2026-11-06
  • 出版时间:2025-12-25
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  • 收稿日期:2025-07-01
  • 修回日期:2025-10-19
基金
山东省医药卫生科技发展计划项目(2019WS263);山东省医药卫生科技项目(202412050245)
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    1烟台市疾病预防控制中心结核病防制科,山东 264003
    2海阳市疾病预防控制中心结核病防制科
    3芝罘区疾病预防控制中心结核病防制科

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2种不同金属材料的力学参数
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Percentage of total
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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