中国肠易激综合征患者就医行为的预测因素。

Predictors of healthcare-seeking behavior among Chinese patients with irritable bowel syndrome.

机构信息

Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

出版信息

World J Gastroenterol. 2017 Nov 14;23(42):7635-7643. doi: 10.3748/wjg.v23.i42.7635.

DOI:10.3748/wjg.v23.i42.7635

PMID:29204063

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5698256/

Abstract

AIM

To analyze predictors of healthcare-seeking behavior among Chinese patients with irritable bowel syndrome (IBS) and their satisfaction with medical care.

METHODS

Participating patients met IBS Rome III criteria (excluding those with organic diseases) and were enrolled in an IBS database in a tertiary university hospital. Participants completed IBS questionnaires in face-to-face interviews. The questionnaires covered intestinal and extra-intestinal symptoms, medical consultations, colonoscopy, medications, and self-reported response to medications during the whole disease course and in the past year. Univariate associations and multivariate logistic regression were used to identify predictors for frequent healthcare-seeking behavior (≥ 3 times/year), frequent colonoscopies (≥ 2 times/year), long-term medications, and poor satisfaction with medical care.

RESULTS

In total, 516 patients (293 males, 223 females) were included. Participants' average age was 43.2 ± 11.8 years. Before study enrollment, 55.2% had received medical consultations for IBS symptoms. Ordinary abdominal pain/discomfort (non-defecation) was an independent predictor for healthcare-seeking behavior (OR = 2.07, 95%CI: 1.31-3.27). Frequent colonoscopies were reported by 14.7% of patients (3.1 ± 1.4 times per year). Sensation of incomplete evacuation was an independent predictor for frequent colonoscopies (OR = 2.76, 95%CI: 1.35-5.67). During the whole disease course, 89% of patients took medications for IBS symptoms, and 14.7% reported they were satisfied with medical care. Patients with anxiety were more likely to report dissatisfaction with medical care (OR = 2.08, 95%CI: 1.20-3.59). In the past year, patients with severe (OR = 1.74, 95%CI: 1.06-2.82) and persistent (OR = 1.66, 95%CI: 1.01-2.72) IBS symptoms sought medical care more frequently.

CONCLUSION

Chinese patients with IBS present high rates of frequent healthcare-seeking behavior, colonoscopies, and medications, and low satisfaction with medical care. Intestinal symptoms are major predictors for healthcare-seeking behavior.

摘要

目的

分析中国肠易激综合征（IBS）患者的就医行为及其对医疗服务的满意度的预测因素。

方法

参与研究的患者符合 IBS 罗马 III 标准（排除器质性疾病患者），并被纳入一家三级大学医院的 IBS 数据库。参与者通过面对面访谈完成 IBS 问卷。问卷涵盖了肠道和肠道外症状、就诊次数、结肠镜检查、药物治疗以及在整个疾病过程中和过去 1 年中对药物治疗的自我报告反应。采用单因素关联和多因素逻辑回归分析来确定频繁就医行为（≥3 次/年）、频繁结肠镜检查（≥2 次/年）、长期药物治疗和对医疗服务不满意的预测因素。

结果

共纳入 516 名患者（293 名男性，223 名女性），平均年龄为 43.2±11.8 岁。在研究入组前，55.2%的患者曾因 IBS 症状就诊。非排便时的普通腹痛/不适是就医行为的独立预测因素（OR=2.07，95%CI：1.31-3.27）。14.7%的患者报告有频繁的结肠镜检查（每年 3.1±1.4 次）。排便不尽感是频繁结肠镜检查的独立预测因素（OR=2.76，95%CI：1.35-5.67）。在整个疾病过程中，89%的患者因 IBS 症状服用药物，14.7%的患者报告对医疗服务满意。焦虑的患者更有可能对医疗服务不满意（OR=2.08，95%CI：1.20-3.59）。在过去 1 年中，严重（OR=1.74，95%CI：1.06-2.82）和持续（OR=1.66，95%CI：1.01-2.72）IBS 症状的患者更频繁地就医。