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使用健康服务利用行为模型考察 CAM 使用披露情况。

Examining CAM use disclosure using the Behavioral Model of Health Services Use.

机构信息

School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.

出版信息

Complement Ther Med. 2013 Oct;21(5):501-8. doi: 10.1016/j.ctim.2013.08.002. Epub 2013 Aug 17.

Abstract

OBJECTIVES

To improve understanding of factors that may influence disclosure of complementary and alternative medicine (CAM) use in the U.S.

DESIGN

Cross-sectional survey.

METHODS

Data are from the 2001 Health Care Quality Survey (HCQS), a nationally representative study of adults aged 18 and older living in the continental United States. Using the Behavioral Model of Health Services Use, we conducted multivariate logistic regressions to identify factors associated with disclosing CAM use among the sub-sample of recent CAM users (n=1995).

MAIN OUTCOME MEASURE

Disclosure of CAM use.

RESULTS

Most CAM users (71.0%) disclosed their use of CAM to their doctors. Contextual, individual, and health behavior factors were associated with CAM use disclosure. Of particular interest, disclosure was significantly more likely among those who perceived high quality relationships with their providers (AOR=1.59, CI: 1.01, 2.49) and among those who had a regular source of medical care (AOR=1.54, CI: 1.03, 2.29). The odds of disclosure were also higher among those who used practitioner-provided CAM, with (AOR=2.02, CI: 1.34, 3.06) or without (AOR=1.52, CI: 1.05, 2.20) concurrent herbal medicine use, compared to those who used herbal medicines only.

CONCLUSIONS

The Behavioral Model of Health Services Use is a useful framework for examining factors that may influence disclosure of CAM use. Further research should examine these relationships using more comprehensive measures.

摘要

目的

增进对可能影响美国补充与替代医学(CAM)使用披露因素的理解。

设计

横断面调查。

方法

数据来自于 2001 年的医疗保健质量调查(HCQS),这是一项对美国大陆 18 岁及以上成年人的全国代表性研究。利用健康服务利用行为模型,我们对近期使用过 CAM 的亚组(n=1995)进行了多变量逻辑回归,以确定与 CAM 使用披露相关的因素。

主要观察指标

CAM 使用披露情况。

结果

大多数 CAM 用户(71.0%)向医生披露了他们使用 CAM 的情况。背景、个体和健康行为因素与 CAM 使用披露相关。特别值得注意的是,那些认为与提供者之间存在高质量关系的患者(AOR=1.59,CI:1.01,2.49)和有固定医疗来源的患者(AOR=1.54,CI:1.03,2.29),其披露的可能性显著更高。那些使用从业者提供的 CAM(AOR=2.02,CI:1.34,3.06)或同时使用(AOR=1.52,CI:1.05,2.20)草药药物而不是仅使用草药药物的患者,其披露的可能性也更高。

结论

健康服务利用行为模型是研究可能影响 CAM 使用披露因素的有用框架。进一步的研究应使用更全面的措施来检验这些关系。

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