Ye Jiali, Shim Ruth, Rust George
Department of Community Health & Preventive Medicine, Morehouse School of Medicine, 720 Westview Dr., Atlanta, GA 30310, USA.
J Health Care Poor Underserved. 2012 Nov;23(4):1620-9. doi: 10.1353/hpu.2012.0189.
Using data of 2007 Health Information National Trends Survey, we investigated the association between individuals' psychological distress and their reported avoidance of medical care and assessed whether people with serious psychological distress (SPD) were more likely to report psychosocial barriers to care. After controlling for demographic and health characteristics, individuals with SPD were more likely than those without SPD to report having avoided visiting a doctor even when they suspected they should (OR=1.64, 95% CI=1.08-2.48). The distressed individuals were also more likely to agree that they avoided a doctor because of fear of having a serious illness (OR=1.99, 95% CI=1.15-3.44) or thinking about dying (OR=2.15, 95% CI=1.12-4.11). Further understanding of the mechanism under which an individuals' mental health status may influence their perceived need for health and their use of medical services would improve the interface between mental health and primary care services.
利用2007年美国国家健康信息趋势调查的数据，我们研究了个体心理困扰与其报告的医疗服务回避行为之间的关联，并评估了患有严重心理困扰（SPD）的人是否更有可能报告存在就医的社会心理障碍。在控制了人口统计学和健康特征后，患有SPD的个体比没有SPD的个体更有可能报告即使怀疑自己应该就医也会回避看医生（比值比=1.64，95%置信区间=1.08 - 2.48）。有心理困扰的个体也更有可能认同他们因为害怕患有严重疾病（比值比=1.99，95%置信区间=1.15 - 3.44）或想到死亡（比值比=2.15，95%置信区间=1.12 - 4.11）而回避看医生。进一步了解个体心理健康状况可能影响其对健康的感知需求及其医疗服务使用的机制，将改善心理健康与初级医疗服务之间的衔接。
