Li Xia, Luo Dan, Qiu Yangyang, Chen Mingliang, Su Juan, Yi Mei
Department of Dermotology, Xiangya Hospital, Central South University, Changsha 410008; School of Public Health, Central South University, Changsha 410078, China.
School of Public Health, Central South University, Changsha 410078, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2016 Jun 28;41(6):612-8. doi: 10.11817/j.issn.1672-7347.2016.06.010.
To explore the characteristics of health seeking behaviors and relevant factors among the outpatients with psoriasis in a general hospital, and to provide scientific evidence to modify the inappropriate health seeking behaviors for psoriasis patients and improve the therapeutic effect.
Using cross-sectional study design, a dermatological clinic in a general hospital was selected for this study. Two hundred psoriasis outpatients from 1st April to 30th September in 2014 were enrolled. A series of questionnaires were used to collect information regarding the social-demographic characteristics, health seeking behaviors, knowledge on psoriasis, and depressive and anxious symptoms.
Among 200 psoriasis outpatients, 141 patients (70.5%) experienced transfer treatment. One hundred and eighty-two patients (91.0%) went to formal hospitals in county for treatment when symptoms were firstly displayed; the other 18 patients (9.0%) went to village or community clinics, or the private clinics. Over 50% patients chose municipal hospital and 35.0% patients went to provincial hospital for medical treatment among the 182 patients. Ninety-one percent of the patients made decision for the first treatment after consulting with their spouses or relatives. According to the definition of the appropriate health seeking behavior in this study, 50 patients (25%) had inappropriate health seeking behaviors. Logistic regression analysis showed inappropriate health seeking behaviors correlated with the family whose income was less than 3 000 yuan per person per month (OR=2.232, 95%CI 1.086 to 4.585), patients who made the decision for the treatment with no discussion with other people when the symptoms appeared (OR=3.016, 95%CI 1.023 to 8.893), and the high score of the International Psoriasis Severity Index (OR=1.043, 95%CI 1.001 to 1.088).
The dermatological practitioner should pay more attention to the factors, such as social-demographical characteristics, especially the low level of family income and their treatment experience. It is necessary for the general hospital to conduct health education for psoriasis outpatients to promote their appropriate health seeking behaviors.
探讨综合医院银屑病门诊患者求医行为特征及相关因素，为纠正银屑病患者不当求医行为、提高治疗效果提供科学依据。
采用横断面研究设计，选取某综合医院皮肤科门诊进行研究。纳入2014年4月1日至9月30日期间的200例银屑病门诊患者。通过一系列问卷收集社会人口学特征、求医行为、银屑病知识以及抑郁和焦虑症状等信息。
200例银屑病门诊患者中，141例（70.5%）曾辗转治疗。症状初发时，182例（91.0%）患者前往县级正规医院就诊，18例（9.0%）患者前往村卫生室、社区诊所或私立诊所。在182例前往正规医院就诊的患者中，超过50%的患者选择市级医院，35.0%的患者选择省级医院。91%的患者在首次治疗决策时与配偶或亲属商量。根据本研究中适当求医行为的定义，50例（25%）患者存在不当求医行为。Logistic回归分析显示，不当求医行为与家庭月人均收入低于3000元（OR=2.232，95%CI 1.086至4.585）、症状出现时未与他人商量自行决定治疗（OR=3.016，95%CI 1.023至8.893）以及银屑病国际严重程度指数高分（OR=1.043，95%CI 1.001至1.088）相关。
皮肤科医生应更加关注社会人口学特征等因素，尤其是家庭收入水平低及治疗经历等。综合医院有必要对银屑病门诊患者进行健康教育，以促进其形成适当的求医行为。
