Study on the attitude to seeing doctors of elderly hospitalized patients and its influencing factors in a general hospital in Changsha
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摘要:
目的 了解老年住院患者的就医态度及其影响因素，为提高老年患者的健康状况提供科学可靠的依据。 方 法选择2012年5月~2012年12月期间某医院老年科的全部老年住院患者为研究对象，采用自编的调查问卷对老年住院患者进行社会人口学特征、躯体健康情况、近一年内的医疗情况和就医态度及其影响因素进行调查。 结果积极就医态度者占47.3%，消极就医态度者占52.7%。在积极就医的原因中，主要的原因是“担心疾病越来越严重”、“觉得有病就应该尽早去看”、“不能忍受疾病带来的痛苦”、“看病比较方便”、“积极看病才能得到正规的治疗”。消极就医的主要原因有“自己不能去，没人陪同”、“经济困难”、“看病麻烦，时间长”、“看也看不好，索性不去”、“不吃药看病，也会好的”。居住地、医疗费用支付方式和健康体检情况是住院老年患者就医态度的影响因素。 结论老年住院患者消极就医态度者比例较高，我们还需采取进一步的措施提高老年患者的就医积极性。 Abstract:ObjectiveTo study the attitude to seeing doctors of elderly hospitalized patients and its influencing factors through cross- sectional study, in order to provide scientific and reliable basis for improving the health of elderly patients. Methods Select the elderly hospitalized patients from May 2012 to December 2012 in a general hospital as our research object, Investigate the social demographic characteristics, body health, nearly a year of health and the attitude of seeing doctors of the elderly hospitalized patients by the self-made questionnaire. ResultsThe survey shows that in the attitude to seeing doctors, having a positive attitude to seeing doctors accounted for 47.3% , having negative attitude to seeing doctors accounted for 52.7%. In active attitude reasons, there were five main reasons:“worrying about diseases becoming more and more serious”, “should see doctors as soon as possible when feeling no good”,“couldn’t endure the pain of diseases”,“seeing doctors are convenient”, "positive treatment can obtain the formal treatment". In negative attitude reasons, there were four main reasons: economic difficulties, thinking "seeing a doctor is very trouble, spending much time", "with no accompany" (28.4% ), and thinking "seeing a doctor is useless", think " it would also be good if not to see a doctor or take medicine". Residence, payment of medical expenses and physical examination situation were the influence factors of attitude to seeing doctors of elderly hospitalized patients. Conclusions The proportion of negative attitude elderly inpatients was higher in this hospital. We need to take further measures to improve their attitude with medical treatment. -
表 1 调查对象积极就医和消极就医态度的原因
积极就医的原因 例数（n) 应答率(%) 担心疾病越拖越严重 58 32.4 觉得有病就应该尽早治疗 48 26.8 看病比较方便 25 14.0 积极看病才能得到正规的治疗 21 11.7 不能忍受疾病带来的痛苦 27 15.1 消极就医的原因 经济困难 46 26.1 看病太麻烦，时间长 32 20.4 自己不能去，没人陪同 50 28.4 看也看不好，索性不去 28 15.9 不吃药看病，也会好的 16 9.1 
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表 2 Logistic回归分析结果
b Sb Wald χ2 P OR OR的下限 95% C.I 上限 居住地 大中城市（对照） 1.000 城郊 -0. 801 0.646 5.024 0.016 0.449 0.237 0.679 县镇市 -0.587 0.314 8.890 0.000 0.556 0.109 0.781 农村 -0. 871 0.123 4.639 0.024 0.418 0.211 0.648 医疗费用支付方式 全额报销 1.000 社会医疗保险 -0.211 0.110 7.993 0.001 0.809 0.439 0.906 商业医疗保险 -0.534 0.413 3.944 0.046 0.586 0.144 0.763 新农合 -0.391 0.179 7.494 0.003 0.676 0.301 0.866 自费 -0.814 0.975 5.719 0.015 0.443 0.198 0.633 健康体检情况 无 1.000 有 1.502 0.853 7.241 0.005 4.490 4.490 6.744
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