School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District, Wuhan, 430030, Hubei, China.
Int J Equity Health. 2020 Mar 12;19(1):32. doi: 10.1186/s12939-020-1148-2.
Self-treatment is a common and widespread behaviour, of which the risks are multiplied in old age. However, the determinants of self-treatment among elders in rural China remain unclear. This study aims to explore the prevalence and associated factors of self-treatment among elders in rural China, trying to discover the vulnerable groups as well as the service gaps among the rural elders.
Based on a multi-stage stratified random sampling method, a cross-sectional household survey was conducted among 30 villages in Sinan County, an impoverished county in western China. Data were collected through a household-individual combined questionnaires. The analysis was restricted to elders who reported illness within the last 2 weeks, and the final sample size was 330 (individuals). Bivariate and multiple logistic regression analysis were performed in the whole sample group and four subgroups to obtain the prevalence ratios regarding the associated factors.
In the present study, 35.2% of the elders with illness within the last 2 weeks reported self-treatment. The variables associated with self-treatment in the whole sample group were health status (OR 6.75, 95%CI 1.93-23.60), recent alcohol consumption (OR 0.42, 95%CI 0.21-0.83) and the utilisation of family practice services (OR 0.59, 95%CI 0.36-0.96); the same predictors were found in the subgroup of elders with chronic diseases. No significant predictors were found in the subgroup of elders without chronic diseases. Empty-nest elders with higher affinity to traditional Chinese medicine (OR 0.39, 95%CI 0.18-0.86) or drinking alcohol recently (OR 0.28, 95%CI 0.09-0.82) were less likely to self-treat, while the non-empty-nest elders who were no less than 75 years old (OR 3.10, 95%CI 1.33, 7.22) or at better health status (OR 9.20, 95%CI 1.73-48.75) were more likely to self-treat.
Self-treatment was prevalent among the elders in rural China. Better health status, no recent alcohol consumption and no utilisation of family practice are associated with self-treatment among rural elders. Older elders in the non-empty nest group were more likely to self-treat, while the empty-nest elders with self-care habits in traditional Chinese medicine were less likely to self-treat. Deeper understanding of the self-treatment behaviour among rural elders may provide insights for identifying the potential service gaps and developing improvement strategies in the health care delivery system for the elderly in China.
自我治疗是一种常见且广泛存在的行为,其风险在老年人群体中会倍增。然而,中国农村老年人自我治疗的决定因素仍不清楚。本研究旨在探讨中国农村老年人自我治疗的流行情况及相关因素,试图发现农村老年人中的脆弱群体和服务缺口。
本研究采用多阶段分层随机抽样方法,对中国西部贫困县思南县的 30 个村庄进行了横断面家庭调查。通过家庭-个体联合问卷收集数据。分析仅限于在过去 2 周内报告患病的老年人,最终样本量为 330 人(个体)。在全样本组和四个亚组中进行了二变量和多变量逻辑回归分析,以获得与相关因素有关的患病率比。
在本研究中,过去 2 周内患病的老年人中有 35.2%报告自我治疗。在全样本组中,与自我治疗相关的变量为健康状况(OR6.75,95%CI1.93-23.60)、近期饮酒(OR0.42,95%CI0.21-0.83)和家庭医疗服务的利用(OR0.59,95%CI0.36-0.96);在患有慢性病的老年人亚组中也发现了相同的预测因素。在没有慢性病的老年人亚组中,没有发现显著的预测因素。对中医药亲和力较高的空巢老人(OR0.39,95%CI0.18-0.86)或近期饮酒(OR0.28,95%CI0.09-0.82)的可能性较小,而非空巢老人年龄在 75 岁以上(OR3.10,95%CI1.33-7.22)或健康状况较好(OR9.20,95%CI1.73-48.75)的可能性较大。
自我治疗在中国农村老年人中很普遍。农村老年人中,较好的健康状况、近期不饮酒和不利用家庭医疗服务与自我治疗有关。非空巢组的老年患者年龄较大者更有可能自我治疗,而有中医药自我保健习惯的空巢老人则不太可能自我治疗。更深入地了解农村老年人的自我治疗行为,可以为确定农村老年人医疗服务中的潜在缺口提供见解,并为中国老年人医疗保健提供改进策略。