Hickey T, Akiyama H, Rakowski W
University of Michigan School of Public Health, Ann Arbor.
J Appl Gerontol. 1991 Jun;10(2):169-84. doi: 10.1177/073346489101000204.
Although investigations of health care decision making typically deal with patterns of health service use, increasing attention has focused on lay- and self-care actions in response to illness symptoms. This study examined the health care actions of a community sample of 142 older adults, who recorded illness symptoms and corresponding health care actions in daily health diaries for a 14-day period. Self-treatment and no-action decisions were found to be the most frequent response to illness symptoms. Professional-care decisions were associated with greater health care need, such as multiple symptoms and increased pain. Lay-care decisions were significantly related to symptoms of shorter duration. Women were also more likely than men to self-treat their illness symptoms. Results suggest that older people deal with a greater number of recurrent chronic symptoms than previously thought and that they make most treatment decisions without consulting their doctors or other health care providers. This investigation underscores the importance of a prospective diary methodology for studying the daily complexities of chronic illness experiences and for validating and conducting useful interventions.
尽管对医疗保健决策的研究通常涉及卫生服务利用模式，但人们越来越关注针对疾病症状采取的自我护理和非专业护理行为。本研究调查了142名老年人的社区样本的医疗保健行为，这些老年人在14天的日常健康日记中记录了疾病症状及相应的医疗保健行为。自我治疗和不采取行动的决定被发现是对疾病症状最常见的反应。寻求专业护理的决定与更大的医疗需求相关，比如多种症状和疼痛加剧。非专业护理的决定与持续时间较短的症状显著相关。女性也比男性更有可能自我治疗疾病症状。结果表明，老年人应对的复发性慢性症状比之前认为的更多，并且他们在未咨询医生或其他医疗保健提供者的情况下做出了大多数治疗决定。这项调查强调了前瞻性日记方法对于研究慢性病日常经历的复杂性以及验证和开展有效干预措施的重要性。
