门诊性病患者不当求医行为及影响因素分析  

Influencing factors and characteristics of improper health seeking behaviors among sexually transmitted diseases outpatients

作　　者：徐刚[1,2] 徐金华[3] 陆小年[3] 杨莉佳[4] 胡晓燕[5] 施榕[2] 蔡泳[2] 徐飚[1] 

机构地区：[1]复旦大学公共卫生学院流行病学教研室-公共卫生安全教育部重点实验室,上海200032 [2]上海交通大学公共卫生学院预防医学教研室,上海200025 [3]复旦大学附属华山医院皮肤科,上海200040 [4]无锡市第二人民医院皮肤科,无锡214002 [5]上海交通大学医学院附属瑞金医院卢湾分院性病专科门诊,上海200025

出　　处：《复旦学报（医学版）》2014年第1期66-73,共8页Fudan University Journal of Medical Sciences

基　　金：上海市公共卫生重点学科建设计划(12GWZX0101)~~

摘　　要：目的了解门诊性病患者存在的不当求医行为的特征,并对其影响因素进行探讨,为相关部门制定引导患者形成正确求医行为的对策提供依据。方法采用横断面研究设计,在上海市和无锡市三家不同规模和类型的医院,运用自行设计的匿名问卷,采用系统抽样方法随机抽取在近半年内经临床和实验室确诊且配合程度较好的门诊性病患者共562人进行调查。共收集了519名患者的一般人口学特征、性病相关知识、诊疗情况和求医经历等信息,分析患者各类不当求医行为的特征及其影响因素。结果门诊性病患者存在着相当比例的不当求医行为,就诊延误率达51.4%,平均首次就诊间隔时间为8天;仅有69.0%的患者通知固定性伴,有34.8%的患者的固定性伴未共同诊治;25.8%的患者有未经诊断而自行用药治疗性病的经历;8.7%的患者去过非正规机构诊治性病;9.2%的患者去过无证药店购买治疗性病的药物。影响患者产生各类不当求医行为的因素包括性别、性病防治知识掌握情况、户籍性质、文化程度、收入水平、自报感染途径、与就诊医院的距离等。结论性病防治知识的普及、提高性病医疗服务的可及性是改善患者就诊延误现象的关键环节;促进性伴通知和固定性伴同治的重点应为男性和文化程度较低的患者。Objective To understand the influencing factors and characteristics of improper health seeking behaviors among sexually transmitted diseases （STD） outpatients, seek targeted intervention strategies and measures for this particular group and to guide them proper health seeking behaviors. Methods By using the cross-sectional study design,a total of 519 STD outpatients from three different types of hospitals in Shanghai and Wuxi were investigated with an self-designed anonymousquestionnaire including socio-demographic information, STD/AIDS-related knowledge, disease diagnosis, health seeking behaviors, etc. The characteristics of improper health seeking behaviors and their influencing factors were analyzed. Results We found that there had been a considerable proportion of improper health-seeking behaviors among STD outpatients, for example, delay rate in seeking medical care accounted for 51.4%, and average initial treatment interval accounted up to 8 days. Only 69. （）~ of the patients notified or would notify their regular sexual partners,34.8% of the patientsr regular sexual partners did not go to seek diagnosis and treatment;25.8 ~ of the patients used drugs by themselves without diagnoses;8.7% of the patients had been to undocumented clinics for diagnosis and treatment of STD;9.2% of the patients had been to undocumented pharmacies to buy drugs for STD treatment. The influencing factors of improper health seeking behaviors included gender, knowledge of STD prevention and treatment, household categories, education levels, income levels,self-reported infection routes, and the distance to visiting hospitals. Conclusions Strengthening the education of STD prevention and treatment knowledge and improving service availability were key links to reduce treatment delays. Promoting partner notification and regular sexual partners＇ diagnosis and treatment should focus on male patients and patients with lower education levels.

关 键 词：门诊性病患者 求医行为 就诊延误 

分 类 号：R512.91[医药卫生—内科学] R183[医药卫生—临床医学]