Department of Computer System & Technology, Faculty of Computer Science & Information Technology, Universiti Malaya, Malaysia.
University of Malaya eHealth Unit, Faculty of Medicine, Universiti Malaya, Malaysia.
Trop Med Int Health. 2022 Jan;27(1):13-27. doi: 10.1111/tmi.13695. Epub 2021 Oct 27.
Delays in seeking healthcare for dengue are associated with poor health outcomes. Despite this, the factors influencing such delays remain unclear, rendering interventions to improve healthcare seeking for dengue ineffective. This systematic review aimed to synthesise the factors influencing healthcare seeking of patients with dengue and form a comprehensive framework.
This review included both qualitative and quantitative studies. Studies were obtained by searching five databases, contacting field experts and performing backward reference searches. The best-fit meta-synthesis approach was used during data synthesis, where extracted data were fitted into the social-ecological model. Sub-analyses were conducted to identify the commonly reported factors and their level of statistical significance.
Twenty studies were selected for meta-synthesis. Eighteen factors influencing healthcare seeking in dengue were identified and categorised under four domains: individual (11 factors), interpersonal (one factor), organisational (four factors) and community (two factors). The most reported factors were knowledge of dengue, access to healthcare, quality of health service and resource availability. Overall, more barriers to dengue health seeking than facilitators were found. History of dengue infection and having knowledge of dengue were found to be ambiguous as they both facilitated and hindered dengue healthcare seeking. Contrary to common belief, women were less likely to seek help for dengue than men.
The factors affecting dengue healthcare-seeking behaviour are diverse, can be ambiguous and are found across multiple social-ecological levels. Understanding these complexities is essential for the development of effective interventions to improve dengue healthcare-seeking behaviour.
登革热患者就医延迟与不良健康结局相关。尽管如此，影响这些延迟的因素仍不清楚，导致改善登革热就医的干预措施无效。本系统评价旨在综合影响登革热患者就医的因素，并形成一个综合框架。
本研究纳入了定性和定量研究。通过检索五个数据库、联系现场专家和进行回溯参考文献搜索来获取研究。在数据综合过程中采用了最佳拟合元综合方法，将提取的数据拟合到社会生态学模型中。进行了亚分析以确定常见报告的因素及其统计学意义的水平。
选择了 20 项研究进行元综合。确定了影响登革热患者就医的 18 个因素，并将其分为四个领域：个体（11 个因素）、人际（1 个因素）、组织（4 个因素）和社区（2 个因素）。报告最多的因素是登革热知识、获得医疗保健的机会、卫生服务质量和资源可用性。总体而言，发现的阻碍登革热寻求医疗的因素多于促进因素。登革热感染史和对登革热的了解被发现是模糊的，因为它们既促进又阻碍了登革热的医疗寻求。与普遍看法相反，女性寻求登革热帮助的可能性低于男性。
影响登革热就医行为的因素多种多样，可能存在模糊性，并存在于多个社会生态层面。了解这些复杂性对于制定有效的干预措施以改善登革热就医行为至关重要。
