重庆市公众急救知识的知晓水平及其影响因素研究

The Study on the Public Emergency Knowledge Awareness Level and Its Influencing Factors in Chongqing

摘要: 目的：了解重庆市公众急救知识掌握水平及其影响因素，为提升公众急救能力、降低院前急救死亡率及推动卫生应急技能提升行动提供科学依据。方法：采用多阶段随机整群抽样法，依据重庆市经济水平与地理位置抽取36个社区/村，对 ≥ 15岁常住居民进行问卷调查。采用均数 ± 标准差描述急救知识总分，利用t检验或方差分析比较不同特征人群得分差异，并构建分层回归模型(依次纳入人口学特征、急救环境与认知、个人培训经历)探讨独立影响因素。结果：公众急救知识平均得分为(9.26 ± 4.58)分。单题正确率最高为大出血的处理措施(85.3%)，最低为自动体外除颤器(AED)使用(36.9%)。单因素分析显示，性别、年龄、文化程度、职业、所在街道/社区培训/宣传开展情况、知道国家有保护施救者的法律规定及个人培训经历均对急救知识水平有显著影响(P < 0.01)。分层回归分析显示：在人口学因素中女性、15~29岁年龄组、高学历是急救知识水平的独立保护因素；在环境因素中所在街道/社区开展过急救培训/宣传(β = 1.99, P < 0.001)和知晓国家有施救者法律保护制度(β = 1.23, P < 0.001)显著提升急救知识水平；在培训经历因素中个人参加过急救培训是急救知识水平的较强预测因子(β = 2.39, P < 0.001)。值得注意的是，职业对急救知识水平的影响在控制培训经历后不存在显著差异，提示其作用主要通过培训机会不均等所介导。最终模型解释率达42.7%。结论：重庆市公众急救知识整体水平有待提高，且存在显著的年龄和学历阶段差异及AED知识短板。个人急救培训是提升知识水平的核心驱动力，而社区支持环境与法律保障认知具有重要促进作用。建议依托社区网格化体系，重点向老年人、低学历及农林从业人员倾斜培训资源，大力普及AED使用技能，并通过立法宣传消除施救顾虑，构建“个人主动参与 + 社会环境支持”的急救科普的新格局。

Abstract: Objective: To assess the public’s knowledge of first aid in Chongqing and its influencing factors, providing a scientific basis for enhancing public emergency response capabilities, reducing pre-hospital mortality, and advancing health emergency skills improvement initiatives. Methods: A multi-stage random cluster sampling method was employed to select 36 communities/villages based on Chongqing’s economic level and geographical location, with questionnaires administered to permanent residents aged ≥ 15. The total score of first aid knowledge was described as mean ± standard deviation. Differences in scores among different demographic groups were compared using t-tests or analysis of variance, and stratified regression models (involving demographic characteristics, first aid environment and cognition, and personal training experience) were constructed to explore independent influencing factors. Results: The average score of public first aid knowledge was (9.26 ± 4.58). The highest correct rate for a single item was in the management of massive hemorrhage (85.3%), while the lowest was in the use of automated external defibrillator (AED) (36.9%). Univariate analysis revealed that gender, age, educational level, occupation, training/promotion activities in the local street/community, awareness of national laws protecting rescuers, and personal training experience significantly influenced first aid knowledge levels (P < 0.01). Stratified regression analysis revealed that among demographic factors, female gender, the 15~29 age group, and higher education were independent protective factors for emergency knowledge levels. Environmental factors showed that having undergone emergency training/community awareness programs (β = 1.99, P < 0.001) and awareness of national rescuer legal protections (β = 1.23, P < 0.001) significantly improved emergency knowledge levels. Training experience demonstrated that personal participation in emergency training was a strong predictor of knowledge levels (β = 2.39, P < 0.001). Notably, occupational differences in emergency knowledge levels showed no significant variation after controlling for training experience, suggesting their role was mediated by unequal training opportunities. The final model explained 42.7% of the variance. Conclusion: Chongqing residents’ overall emergency knowledge levels require improvement, with significant disparities by age, education stage, and AED knowledge gaps. Personal emergency training serves as the core driver for knowledge enhancement, while community support environments and legal protection awareness play crucial roles in promotion. Recommendations include leveraging community grid systems to prioritize training resources for the elderly, low-education groups, and agricultural/forestry workers, vigorously popularizing AED usage skills, eliminating rescue concerns through legislative advocacy, and establishing a new emergency science popularization framework combining “individual proactive participation + social environmental support”.