中缅边境地区疟疾患者求医现状及影响因素研究

发布时间：2018-04-19 02:39

本文选题：疟疾 + 求医行为　；参考：《昆明医科大学》2013年硕士论文

【摘要】：研究目的通过对中缅边境疟疾流行程度较严重的缅甸克钦邦拉咱市和云南省德宏州盈江县那邦镇疟疾患者的求医行为现状及其影响因素的研究,为中缅边境地区有关部门加强对疟疾的监管,提高中缅居民求医的意识和矫正行为,为制订相关政策、有针对性地开展健康教育和干预项目提供实证依据。研究对象与方法本研究为横断面现况研究。采取整群抽样抽取云南省盈江县那邦镇3个村以及缅甸拉咱市3个村,调查对象为过去一年内确诊的疟疾患者及疑似疟疾患者。采用入户问卷调查方式收集他们的求医行为及可能的影响因素。采用的统计分析方法包括卡方检验、秩和检验、主成分分析及非条件Logistic逐步回归模型分析求医行为的影响因素。研究结果 (1)调查对象基本情况：本次调查共350人,其中男性174人,占49.7%；女性176人,占50.3%。景颇族占74.9%；其他民族25.1%。农民占43.4%,其他职业占56.6%。研究对象年龄15-24岁组、25-34岁组、35-44岁组、55岁以上组分别占总调查人数的16.9%、27.7%、32.0%、17.1%、6.3%。文化程度以小学和初中居多,大学专科及以上所占比例最低。用主成分分析形成调查对象的社会经济状况综合得分,把调查家庭分为较富裕、普通和较贫穷三等分。家庭经济贫困者33.7%,家庭经济普通者占33.4%,家庭经济富裕者32.9%。 (2)调查对象的疟疾知识、态度、行为状况：知识得分平均为6.6±1.2分,态度得分平均为5.2±1.0分,行为得分平均为4.3土0.8分,KAP总分平均为16.09±1.92分。 (3)调查对象的医疗服务可及性：从自家到就诊医疗机构的距离为不足500米,500-1000米和1000米以上者分别16.3%、33.4%和50.3%。去就诊医疗机构途中所花时间为不足半小时、半小时和1小时以上者分别占59.4%、33.4%和7.2%。生活居住地有疟疾知识宣传的占90.6%,没有宣传的占9.4%。 (4)调查对象的求医行为：98.6%的调查对象在出现疟疾相关症状或患疟疾后采取相应的措施,其中52.6%的选择去医院,46.0%去药店买药,仅有1.4%的调查对象不做任何处理。去医院就诊患者中,41.9%选择去村医务室,55.5%选择去乡镇卫生院,2.6%去县级及以上的医院。在到医院就诊的患者中,15.1%的人认为医疗费用太贵,40%的人认为能接受,还有44.9%的人认为比较便宜。 (5)中缅居民对比分析：仅不同年龄、民族、文化程度及家庭经济收入情况存在差异(P0.05),而中缅两地疟疾患者在求医行为方面没有统计学差异。 (6)求医行为的影响因素分析：以是否到医疗机构就诊为因变量,单因素分析显示,仅有户主的性别对求医与否有影响,采用非条件Logistic回归对求医行为的影响因素进行分析,结果显示国籍、社区宣传、经济指标也对求医行为有影响。结论和建议在调查的中缅边境地区疟疾患者中,小学文化程度及35-44岁组年龄段居多。求医方式在不同性别中有影响(x2=4.159,P0.05),而在不同国籍、年龄、职业、民族、婚姻状况、文化程度、医疗保险、KAP等因素间没有统计学差异。Logistic逐步回归模型分析显示,国籍、社区宣传、经济指标是求医行为的正向影响因素；缅甸患者求医行为发生的机会低于中国患者,经济状况比中国差,而有社区疟疾宣传的求医行为高于无社区宣传。应加强疟疾相关知识的宣传、提供有效的医疗服务来增强其感染疟疾的警觉性,从而激发采取保护措施的动机。
[Abstract]:Objective to study the present situation and its influencing factors on the prevalence of health seeking behavior of the China Burma border malaria more serious in Burma city and Yunnan province. We pull Dehong nabang, Yingjiang County town of malaria patients, the relevant departments to strengthen the China Myanmar border areas of malaria supervision, improve the residents awareness and Burma seeking corrective actions to formulate relevant policies that is to provide an empirical basis for the health education and intervention programs.
Research object and method of this research for cross sectional studies. By cluster sampling nabang Yingjiang County of Yunnan Province town of 3 villages and 3 villages in Burma in Laiza, the survey for patients with malaria in the past year diagnosed and suspected malaria. By questionnaire survey collected their health seeking behavior and factors possible effect. The statistical methods included chi square test, rank sum test, principal component analysis and non conditional Logistic regression analysis on Influencing Factors of health seeking behavior. The results of the study
(1) the basic situation of the survey: the survey of 350 people, including 174 men, women accounted for 49.7%; 176 people, accounting for 50.3%. and Jingpo accounted for 74.9%; other national 25.1%. farmers accounted for 43.4%, accounting for 56.6%. of other occupation target age group of 15-24 years old, 25-34 years old group, 35-44 years old group, 55 years old group. The total number of surveys in 16.9%, 27.7%, 32%, 17.1%, 6.3%. education to primary school and junior high school the majority of college or above the lowest proportion. The comprehensive score analysis of socioeconomic status survey of the formation of principal components, the survey of households into richer and poorer, ordinary family economic poverty three equal parts. 33.7%, ordinary family economy accounted for 33.4%, the family economic well-off 32.9%.
(2) malaria knowledge, attitude and behavior: the average score of knowledge was 6.6 + 1.2, the average score of attitude was 5.2 + 1, the average score of behavior was 4.3, 0.8 points, and the average score of KAP was 16.09 + 1.92 points.
(3) survey of the accessibility of medical services from medical institutions to their distance is less than 500 meters, 500-1000 meters and 1000 meters respectively 16.3%, 33.4% and 50.3%. to medical institutions on the time spent for less than half an hour, half an hour and 1 hours respectively accounted for 59.4% and 33.4%. 7.2%. residence life malaria knowledge publicity accounted for 90.6%, no promotion accounted for 9.4%.
(4) seeking behaviour survey: 98.6% of respondents take corresponding measures in malaria related symptoms or suffering from malaria, 52.6% of them choose to go to the hospital, 46% go to the pharmacy to buy medicine, only 1.4% of respondents did not receive any treatment. To hospital patients, 41.9% choose to go to the village Clinic, 55.5% choose to go to the township hospitals, 2.6% county level and above hospitals. In hospital patients, 15.1% of people think that health care is too expensive, 40% of people think that can be accepted, and 44.9% of people think that is cheaper.
(5) a comparative analysis of Chinese Burmese residents: there are differences in age, nationality, educational level and family income, but there is no statistical difference in the behavior of malaria among the two places in China and Burma, P0.05.
(6) analysis of influencing factors of health seeking behavior: the dependent variable in whether to medical institutions, the single factor analysis showed that the only head of the sex of the doctor and not affect the non conditional Logistic regression analysis on the influencing factors of health seeking behavior, results showed that nationality, community outreach, economic indicators also have an impact on the doctor behavior.
Conclusions and recommendations in the China Burma border area survey of malaria patients, primary school education and 35-44 years old age groups. Mostly care seeking influence in different gender (x2=4.159, P0.05), and in the different nationality, age, occupation, nationality, marital status, education level, health insurance, KAP and other factors were not statistically the difference of.Logistic regression model analysis showed that the nationality, community outreach, economic indicators are positive factors of health seeking behavior; Burma health care seeking behavior of patients with the chance of less than Chinese patients, economic conditions than China difference, and community health seeking behavior of malaria awareness than those without publicity. The community should strengthen the malaria knowledge propaganda, to provide effective medical services to enhance the malaria awareness, so as to stimulate the motivation to take protective measures.

【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R531.3

【参考文献】