Marcell Arik V, Halpern-Felsher Bonnie L
Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Maryland School of Medicine, 120 Penn Street, Baltimore, MD 21201, USA.
Prev Med. 2005 Jul;41(1):118-25. doi: 10.1016/j.ypmed.2004.10.016. Epub 2004 Nov 26.
The examination of predictors of adolescents' intentions to use health care for different types of health issues has received little attention. This study examined adolescents' health beliefs and how they relate to intentions to seek physician care across different types of health problems.
Two hundred ten high school students (54% females; 76.6% participation rate) completed a self-administered survey of four separate age- and gender-specific health case scenarios: an adolescent who has symptoms of pneumonia; smokes five cigarettes daily; plans to initiate sex; and has symptoms of depression. For each health scenario, participants rated the seriousness of the health problem, physician effectiveness, and intentions to seek physician care.
Most adolescents believed all health problems were serious except for planning to initiate sex (P < 0.001). Adolescents believed that physicians were most effective in diagnosis and treatment for pneumonia, followed by cigarette use, depression, and sex, respectively (P's < 0.001). Adolescents' intentions to seek physician care were greatest for physical as compared to risk behavior or mental health problems (P < 0.001). Multiple regression analyses revealed that adolescents had greater intentions to seek physician care for cigarette, sex, and depression when they believed physicians were effective and they perceived these as health problems after controlling for age and gender (all P's < 0.001). Health beliefs explained 12% to 49% of the variance in intentions to seek care (all P's < 0.001).
Adolescents' health beliefs are important when understanding intentions to seek physician care. Health care use may be improved by increasing adolescents' beliefs that physicians are effective in areas other than physical health, including risk behaviors and mental health.
对于青少年针对不同类型健康问题使用医疗保健的预测因素的研究很少受到关注。本研究考察了青少年的健康信念以及它们与针对不同类型健康问题寻求医生治疗的意图之间的关系。
210名高中生（54%为女性；参与率76.6%）完成了一项针对四个不同的年龄和性别特异性健康案例场景的自填式调查：一名有肺炎症状的青少年；每天吸五支烟；计划开始性行为；以及有抑郁症状。对于每个健康场景，参与者对健康问题的严重程度、医生的有效性以及寻求医生治疗的意图进行评分。
除了计划开始性行为外，大多数青少年认为所有健康问题都很严重（P<0.001）。青少年认为医生在肺炎的诊断和治疗方面最有效，其次分别是吸烟、抑郁和性行为（P值<0.001）。与风险行为或心理健康问题相比，青少年因身体问题寻求医生治疗的意图最大（P<0.001）。多元回归分析显示，在控制年龄和性别后，当青少年认为医生有效且他们将这些视为健康问题时，他们更倾向于因吸烟、性行为和抑郁问题寻求医生治疗（所有P值<0.001）。健康信念解释了寻求治疗意图中12%至49%的变异（所有P值<0.001）。
在理解青少年寻求医生治疗的意图时，他们的健康信念很重要。通过增强青少年对于医生在身体健康以外领域（包括风险行为和心理健康）有效的信念，可能会改善医疗保健的使用情况。
