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推动和阻碍因素对孟加拉国黄疸患者偏好传统治疗的影响。

Push and pull factors influencing preference for traditional healing by jaundiced patients in Bangladesh.

机构信息

Department of Public Health, Daffodil International University, Dhaka, Bangladesh.

Department of Gastroenterology, Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, Bangladesh.

出版信息

PLoS One. 2024 Nov 1;19(11):e0312962. doi: 10.1371/journal.pone.0312962. eCollection 2024.

Abstract

BACKGROUND

Jaundice is a significant health issue in Bangladesh. Many patients choose traditional medicine (TM) over conventional medicine (CM) for treating jaundice. This study aimed to identify and analyze the push and pull factors influencing the preferences of jaundiced patients for traditional healing methods in Bangladesh.

METHODS

This cross-sectional study used a mixed-methods approach. Two focus group discussions (FGDs) were conducted with 16 participants (8 per group) who had experience of using traditional medicine for jaundice. In-depth interviews with five traditional healers were carried out to gather qualitative insights from the healers' perspectives. Quantitative data were collected from 400 jaundiced patients at a tertiary-level hospital using a semi-structured questionnaire. Chi-square tests and binary logistic regression were used to analyze associations between sociodemographic factors, push-pull factors, and treatment preferences.

RESULTS

The study found that 62% of participants favored TM for jaundice treatment. The scalp and hand cleansing rituals (46%), herbal remedies (37%), garlanding (23%), and use of talismans or amulets (21%) were the most common practices. Qualitative analysis revealed five push factors, eight pull factors, four intervening obstacles, and five personal factors that influenced jaundiced patients' preference for TM. Patients also emphasized the significance of spiritual and emotional aspects in their decision-making process when choosing TM. Significant associations were observed between treatment preference and age group (p = 0.002), residence (p = 0.018), education level (p<0.001), and religion (p = 0.015). Individuals aged 50 years and above (70.9%), rural residents (68%), and those with no or primary education (72%) were more likely to opt for TM. Key push factors towards TM included high costs of CM (OR: 6.80, 95% CI: 2.10-22.04) and perceived ineffectiveness of CM. Strong pull factors were accessibility of TM (OR: 11.18, 95% CI: 4.03-31.00), perceived effectiveness of TM (OR: 3.45, 95% CI: 1.05-11.37), personal testimonials (OR: 7.55, 95% CI: 2.75-20.69), lower costs of TM (OR: 10.48, 95% CI: 4.30-25.54) and lack of information about conventional treatments for jaundice (OR: 13.82, 95% CI: 4.62-41.33).

CONCLUSION

The study reveals that both push and pull factors influence jaundiced patients in Bangladesh to choose TM over CM, with decisions shaped by personal, socioeconomic, and geographical factors.

摘要

背景

黄疸是孟加拉国的一个重大健康问题。许多患者选择传统医学(TM)而非常规医学(CM)来治疗黄疸。本研究旨在确定并分析影响黄疸患者对孟加拉国传统治疗方法偏好的推动因素和拉动因素。

方法

这是一项使用混合方法的横断面研究。对 16 名(每组 8 名)有黄疸患者使用传统医学治疗经验的参与者进行了两次焦点小组讨论。对五名传统治疗师进行了深入访谈,从治疗师的角度收集定性见解。在一家三级医院对 400 名黄疸患者使用半结构式问卷收集定量数据。使用卡方检验和二元逻辑回归分析社会人口因素、推动因素和拉动因素与治疗偏好之间的关联。

结果

研究发现,62%的参与者倾向于使用 TM 治疗黄疸。最常见的做法包括头皮和手部清洁仪式(46%)、草药疗法(37%)、花环(23%)和使用护身符或符咒(21%)。定性分析揭示了影响黄疸患者选择 TM 的五个推动因素、八个拉动因素、四个干预障碍和五个个人因素。患者在选择 TM 时还强调了精神和情感方面的重要性。治疗偏好与年龄组(p=0.002)、居住地(p=0.018)、教育水平(p<0.001)和宗教信仰(p=0.015)之间存在显著关联。年龄在 50 岁及以上(70.9%)、农村居民(68%)和无或小学教育程度的个体(72%)更有可能选择 TM。推动 TM 的主要因素包括 CM 费用高(OR:6.80,95%CI:2.10-22.04)和 CM 疗效不佳。强有力的拉动因素包括 TM 的可及性(OR:11.18,95%CI:4.03-31.00)、TM 的疗效(OR:3.45,95%CI:1.05-11.37)、个人推荐(OR:7.55,95%CI:2.75-20.69)、TM 费用较低(OR:10.48,95%CI:4.30-25.54)和缺乏 CM 治疗黄疸的信息(OR:13.82,95%CI:4.62-41.33)。

结论

该研究表明,推动因素和拉动因素都影响孟加拉国的黄疸患者选择 TM 而非 CM,决策受到个人、社会经济和地理因素的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7625/11530012/eee4bc961fb7/pone.0312962.g001.jpg

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