卒中入院延迟的社会决定因素分析  

Social determinants of pre-hospital delays after onset of stroke

作　　者：章娟[1] 汪学红[2] 杨华杰[1] 赵景义[3] 方毅[1] 王丽平[1] 汪志宏[4] 卢祖洵[1] 

机构地区：[1]华中科技大学同济医学院 山西医科大学公共卫生学院,武汉430077 [2]武汉体育学院健康科学学院 [3]山西省人民医院病案室 [4]华中科技大学同济医学院 深圳市第二人民医院,武汉430077

出　　处：《中华健康管理学杂志》2014年第1期40-43,共4页Chinese Journal of Health Management

基　　金：国家自然基金面上项目（81172753）;湖北省卫生厅重点科研项目（JX5A08）

摘　　要：目的 了解我国卒中患者院前延迟的现状和社会决定因素,为制定卒中防治策略与措施提供参考.方法 采用自制问卷,对多家三级医院住院部的脑卒中患者进行调查.采用SPSS 18.0进行单因素分析和logistic回归分析.结果 共收回有效问卷778份.决定就医用时,363（47.27％）例患者少于1h,24.35％超过3h;转运用时,62.14％少于2h,21.67％超过3h.入院延迟的患者达到62.60％.logistic回归显示居住在农村的患者决定就医用时和转运用时都较长,入院延迟的发生率高.结论 卒中患者尤其是农村患者,决定就医用时和转运用时仍较长,院前延迟问题仍很严重.Objective To learn current status of pre-hospital delay after onset of stroke and its social determinants. Methods A self-designed questionnaire was used in this multieenter study to collect information of stroke patients admitted to several tertiary hospitals. X2 test, Kruskal-Wallis test and logistic regression were used for data analysis. Results A total of 778 valid questionnaires were received. Forty- seven percent of the patients decided to seek medical help within 1 hour after stroke onset and 24.35% delayed for 3 hours. Sixty-two percent of the patients spent less than 2 hours in transporting and 21.67% more than 3 hours. The rate of pre-hospital delay was 62.60%. In logistic regression, those patients living in rural areas had significantly longer pre-hospital delay for decision making and transportation services. Conclusions The time interval between the onset of symptoms and the decision making to seek medical help are far from the optimal in patients with stroke, especially for those living in rural areas.

关 键 词：卒中 农村卫生 院前延迟 社会决定因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]