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预测一般人群样本就医决策的主要因素的层次结构:析因调查设计。

Hierarchy of the main factors predicting the decision to go to the doctor in a general population sample: A factorial survey design.

机构信息

Department of Basic Psychology, Autonomous University of Barcelona, Spain.

Faculty of Psychology, Autonomous University of San Luis Potosí, Mexico.

出版信息

Patient Educ Couns. 2020 Jul;103(7):1407-1414. doi: 10.1016/j.pec.2020.02.004. Epub 2020 Feb 4.

Abstract

OBJECTIVE

To obtain a hierarchy of the main factors that predict the decision to go to the doctor when symptoms are not yet linked to a specific disease.

METHOD

64 representative vignettes, combinations of nine factors, were presented to 168 adults between 28-60 years of age.

RESULTS

Multilevel multiple regression models were used to rank the main factors predicting urgency to see a doctor in order of importance: the interference of symptoms in daily activities (B = -1.29; p < .001), fear (B = -0.96; p < .001), pain (B = -0.90; p < .001), access to medical care (B = -0.64; p < .001) and confidence in the doctor (B = -0.27; <.05). Moreover, gender (B = 0.56; p < .05) and educational level (B =-0.31; p < .05) explained part of the interindividual variation in the daily symptoms' interference.

CONCLUSION

When a specific disease has not yet been diagnosed, daily symptoms' interference is the factor that most strongly increases the urgency to visit a doctor, especially among men and among people with a higher level of education.

PRACTICE IMPLICATIONS

To reduce delay, generic health prevention campaigns should place more emphasis on possible interference in daily activities than on the meaning of symptoms for health.

摘要

目的

确定预测症状尚未与特定疾病相关联时就医决策的主要因素的层次结构。

方法

向 168 名 28-60 岁的成年人展示了 64 个具有代表性的小插图,这些小插图组合了九个因素。

结果

使用多层次多元回归模型对预测医生就诊紧迫性的主要因素进行了排序,按重要性排列如下:症状对日常生活的干扰(B =-1.29;p <.001)、恐惧(B =-0.96;p <.001)、疼痛(B =-0.90;p <.001)、获得医疗保健(B =-0.64;p <.001)和对医生的信任(B =-0.27;<.05)。此外,性别(B = 0.56;p <.05)和教育程度(B =-0.31;p <.05)解释了个体间日常症状干扰差异的部分原因。

结论

当尚未诊断出特定疾病时,日常症状的干扰是最能增加就诊紧迫性的因素,尤其是在男性和教育程度较高的人群中。

实践意义

为了减少延迟,通用健康预防运动应更加重视日常活动可能受到的干扰,而不是症状对健康的意义。

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