Ndarukwa Pisirai, Chimbari Moses J, Sibanda Elopy N, Madanhire Tafadzwa
University of KwaZulu-Natal, College of Health Sciences, School of Nursing and Public Health, Durban, South Africa.
Asthma, Allergy and Immune Dsyfunction Clinic, 113 Kwame Nkrumah Ave, Harare, Zimbabwe.
Asthma Res Pract. 2020 Aug 12;6:7. doi: 10.1186/s40733-020-00060-y. eCollection 2020.
Although asthma is a serious public health concern in Zimbabwe, there is lack of information regarding the decision to seek for healthcare services among patients. This study aimed to determine the health care seeking behaviour of adult patients with asthma attending Chitungwiza Central Hospital in Zimbabwe.
A cross-sectional study was conducted among 400 patients with asthma. A questionnaire with four thematic areas (i) patients' demographic characteristics, (ii) types of health seeking behaviours (iii) knowledge of asthma treatment and (iv) attitudes on asthma treatment was used.
We determined the sequence of remedial action that people undertake to rectify perceived ill health commonly referred to as health care seeking behaviours in 400 adult patients with asthma. This behaviour was considered good if the patient sought care at the hospital/clinic and or private practitioners. Poor health seeking behaviour was adjudged if patients sought no treatment, self-treated or resorted to traditional or faith healers for care.The majority 261(65.3%) of the study participants were females mainly between ages 29-39 years who lived in the urban setting. Distance to health facility, perception of supportive roles of healthcare providers, perceived good quality of service and knowledge of asthma complications were key determinants for health seeking behaviour. The results showed that majority 290 (72.5%) reported good health seeking behaviour. The correlates of good health seeking behaviour included financial capacity to pay for medical care [OR: 0.50 (CI: 0.31-0.83); = 0.008)] and receiving good quality of asthma treatment [OR: 0.59 (CI: 0.37-0.93); = 0.03)]. The inability to voluntarily seek own asthma treatment [OR: 1.68 (CI: 1.05-2.70); = 0.03) was a significant risk factor (68% more likely) for poor health seeking behaviour.
We concluded that prior to scaling up asthma treatment programmes in Zimbabwe, there is need to address, individual-level, community-level and health service level barriers to health seeking among asthma patients.
尽管哮喘在津巴布韦是一个严重的公共卫生问题，但关于患者寻求医疗服务决策方面的信息却很匮乏。本研究旨在确定津巴布韦奇通圭扎中心医院成年哮喘患者的就医行为。
对400名哮喘患者进行了一项横断面研究。使用了一份包含四个主题领域的问卷：（i）患者的人口统计学特征，（ii）就医行为类型，（iii）哮喘治疗知识，以及（iv）对哮喘治疗的态度。
我们确定了400名成年哮喘患者为纠正所感知到的健康不佳而采取的补救行动顺序，这通常被称为就医行为。如果患者在医院/诊所和/或私人执业医生处寻求治疗，这种行为被认为是良好的。如果患者不寻求治疗、自行治疗或求助于传统或信仰治疗师进行护理，则判定为不良就医行为。研究参与者中的大多数261人（65.3%）为女性，主要年龄在29 - 39岁之间，居住在城市地区。到医疗机构的距离、对医疗服务提供者支持作用的认知、对服务质量的感知以及对哮喘并发症的了解是就医行为的关键决定因素。结果显示，大多数290人（72.5%）报告有良好的就医行为。良好就医行为的相关因素包括支付医疗费用的经济能力[比值比：0.50（置信区间：0.31 - 0.83）；P = 0.008]以及接受高质量的哮喘治疗[比值比：0.59（置信区间：0.37 - 0.93）；P = 0.03]。无法自主寻求哮喘治疗[比值比：1.68（置信区间：1.05 - 2.70）；P = 0.03]是不良就医行为的一个显著风险因素（可能性高出68%）。
我们得出结论，在津巴布韦扩大哮喘治疗项目之前，有必要解决哮喘患者在个人层面、社区层面和卫生服务层面寻求医疗的障碍。
