摘要
目的 探讨社会经济、卫生服务、文化背景、症状、行为等因素对农村传染性肺结核患者发现延误的影响。方法 采取横断面调查方法 ,根据不同经济状况在湖南省随机抽取 4个县为研究现场。运用自制的调查问卷 ,在知情同意的前提下对到抽样县结核病防治所诊治、年龄在 15岁及以上的痰涂片阳性的肺结核连续患者逐一面谈。结果 共 318例痰涂片阳性的肺结核患者接受了面谈并完成调查问卷。从症状出现到被确诊为肺结核的平均总延迟时间为 84 6d(中位数 6 5 0d) ;平均就诊延迟和确诊延迟分别为 5 0 8d(中位数 30 0d)和 33 8d(中位数 2 4 0d) ;分别有 187例(5 8 5 % )和 2 0 0例 (6 2 9% )患者存在就诊和确诊延误。导致患者就诊延误的影响因素有 :有无咯血、居住地的距离、有无迷信行为、有无接受民间偏方行为和家庭人均年收入等 ;导致确诊延误的影响因素有 :性别、文化程度、是否接受抗结核治疗的宣传教育、有无迷信行为、有无接受民间偏方行为和患者对结核病的感受等。结论 需采取综合性干预措施 ,包括加强各级医疗机构医务人员有关国家结核病控制规划和相关专业技术的培训 ,合理设置结核病诊治点和广泛开展结核病健康教育等 。
Objective To explore the influences of socio-economic, health services, cultural beliefs, and symptoms on health seeking behavior of tuberculosis patients attending county tuberculosis dispensaries in rural Hunan province of China. Methods A cross-sectional descriptive survey was conducted in 4 counties randomly stratified by economic status from 122 counties, Hunan, China. After informed consent, a consecutive sample of patients, aged 15 years and older, with smear-positive pulmonary tuberculosis were interviewed and completed a pre-tested questionnaire. Results A total of 318 patients with smear-positive pulmonary tuberculosis were interviewed. The median of patient delay, health system delay and total delay were 30, 24 and 65 days, respectively. Logistic regression shows that factors significantly contributed to patient delay were haemoptysis, far distance to health institute, seeking folk therapy, and lower per capita income. Factors significantly associated with health system delay were female, lower level of education, prior health education on tuberculosis, seeking folk therapy and stigma associated with tuberculosis. Conclusion In order to reduce diagnostic delay, integrated measures including extensive training of medical staff in non-tuberculosis health facilities, decentralization of services and more specific and effective health education on tuberculosis should be taken.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2004年第9期617-620,共4页
Chinese Journal of Tuberculosis and Respiratory Diseases
