Raglow G J, Luby S P, Nabi N
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
Trop Med Int Health. 2001 Jan;6(1):69-75. doi: 10.1046/j.1365-3156.2001.00653.x.
To investigate the behaviour, knowledge of risks, and attitudes towards injections among patients at a clinic in Karachi.
In March 1995, trained staff administered a structured questionnaire to 198 consecutive new adult patients attending a university clinic in Karachi, Pakistan.
Half (97:49%) of the patients received injections at their last visit to a health care provider. 3.5% had received 10 or more injections in the last year. 64% felt that injections were more powerful and were willing to pay more for them than for pills. 84% preferred pills or advice over injections if told they were equally effective, 83% believed that a used needle could transmit a fatal disease, and 86% believed that it is usually possible to get better without an injection. 91% reported that the doctor always recommends an injection; few patients (9%) ever asked for one. Injections were given without much regard for the chief complaint of the patient. Sonic needles (n = 21) for the injection came from bowls of water: of those from closed packets (n = 116), 68 were 'cleaned' by wiping ot placing them in water. 91% of patients (180) knew at least one risk of reuse of needles. Patients who knew three or more risks of using unclean needles were 0.14 times as likely to have had more than five injections per year in the last 5 years hut only if the patients had s or more years of education.
Patients receive injections from doctors in Pakistan frequently, indiscriminately and often without proper safety precautions. They are aware of both positive and negative aspects of injections but are likely to do what the doctor suggests. Interventions to reduce risky overuse of injections should focus on patients' general education and knowledge of the risks of injections to empower them to choose healthier therapies.
调查卡拉奇一家诊所患者的行为、对风险的认知以及对注射的态度。
1995年3月，经过培训的工作人员向巴基斯坦卡拉奇一家大学诊所连续就诊的198名成年新患者发放了一份结构化问卷。
一半（97名，占49%）的患者在最近一次就诊时接受了注射。3.5%的患者在过去一年接受了10次或更多次注射。64%的患者认为注射效果更强，愿意为注射支付比药片更高的费用。如果被告知药片和注射效果相同，84%的患者更喜欢药片或建议而非注射；83%的患者认为用过的针头可传播致命疾病；86%的患者认为通常不注射也能好转。91%的患者表示医生总是建议注射；很少有患者（9%）主动要求注射。注射时不太考虑患者的主要诉求。部分注射用的针头（n = 21）取自一碗水中：在来自密封包装的针头（n = 116）中，68个是通过擦拭或放入水中“清洁”的。91%的患者（180名）知晓针头重复使用的至少一种风险。知晓使用不清洁针头三种或更多风险的患者在过去5年中每年接受超过5次注射的可能性是其他患者的0.14倍，但前提是这些患者接受过5年或更长时间的教育。
在巴基斯坦，患者频繁、随意地接受医生注射，且往往没有采取适当的安全预防措施。他们知晓注射的利弊，但可能会听从医生的建议。减少注射滥用风险的干预措施应侧重于患者的普遍教育以及对注射风险的认知，使他们能够选择更健康的治疗方法。
