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武汉市居民自我药疗行为现状及影响因素调查
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篇名: 武汉市居民自我药疗行为现状及影响因素调查
TITLE:
摘要: 目的:为制定有效的居民自我药疗干预措施、促进自我药疗合理化提供参考。  方法:基于修改后的Anderson卫生服务利用分析模型设计调查问卷,采用整群抽样法对武汉市4城区居民自我药疗行为现状及影响因素进行调查和分析。结果:共发放问卷204份,回收有效问卷199份,有效回收率为97.5%。受访居民自感不适2周内选择自我药疗的比例为47.7%,高于选择“看医生”的比例。选择自我药疗受访居民中疾病较轻、疾病严重程度一般、疾病严重的分别占50.5%、46.3%、3.2%;患病时间<7 d、患病时间≥7 d的分别占95.8%、4.2%。感冒咳嗽是受访居民进行自我药疗购药费用最高的疾病种类。受访居民选择自我药疗的原因依次为没必要“看医生”(占43.2%)、图省事(占23.1%)、医疗费用高(占14.6%)、没时间看病(占14.6%);基本用药常识54.1%来自过去的经验,25.5%来自别人推荐,其余来自互联网络和报纸杂志。对于过去1年中自我药疗的疗效,75.4%的受访居民认为大多有效。18.6%的受访居民自我药疗曾发生不良反应,阅读说明书者发生不良反应的比例显著低于未阅读说明书者(P<0.05),且教育程度低者阅读说明书的比例显著低于教育程度高者(P<0.05)。单因素分析表明,婚姻状况、教育程度、个人月收入、医疗保险、医疗机构可及性、疾病严重程度、患病时间对受访居民自我药疗的选择有显著影响(P<0.05):已婚者对自我药疗的选择比例显著高于未婚者;教育程度较低者对自我药疗的选择比例显著高于教育程度高者;个人月收入较低者对自我药疗的选择比例显著高于个人月收入高者;具有商业医疗保险和自费人群对自我药疗的选择比例显著高于具有基本医疗保险和公费医疗人群;距离医疗机构较远者对自我药疗的选择比例显著高于距离医疗机构近者;疾病较轻者对自我药疗的选择比例显著高于疾病严重者;患病时间≥7 d者对自我药疗的选择比例显著低于患病时间<7 d者。多因素分析表明,疾病严重程度、患病时间是受访居民选择自我药疗的重要影响因素(P<0.05)。结论:自我药疗行为在武汉市居民中普遍存在,且主要针对常见病和慢性病;居民对药品说明书阅读重视不够,自我药疗存在一定的健康风险;其自我药疗选择受多方面因素影响。
ABSTRACT: OBJECTIVE: To provide reference for developing effective interventions to self-medication and promoting reasonable self-medication. METHODS: Questionnaires were designed based on the modified Anderson’s behavioral model of health services. By using cluster sampling, residents were randomly selected from 4 districts of Wuhan city to analyze the self-medication behavior and its influential factors. RESULTS: Totally 204 questionnaires were sent and 199 were recovered with effective rate of 97.5%. The result showed 47.7% residents who perceived discomfort within 2 weeks medicated themselves, and the rate was higher than “see the doctor”. Among self-medication residents, the rate of mild disease, general and serious disease was separately 50.5%, 46.3% and 3.2%. The length of illness<7 d and the length of illness ≥7 d  accounted for 95.8% and 4.2%, separately. Cold and cough was the highest cost disease for self-medication. The reasons for selecting self-medication were: no need to “see the doctor” (43.2%), trouble-saving (23.1%), high medical costs (14.6%), no time to see the doctor (14.6%). 54.1% residents acquired basic medication knowledge from the past experience, 25.5% from other’s recommendation, and the other from the internet, newspaper and magazines. As for the effect of self-medication in the past one year, 75.4% residents considered most were effective. 18.6% had suffered from ADR due to self-medication; the incidence of ADR in the residents reading the instruction was significantly lower than those not reading the instruction(P<0.05); the ratio of reading the instruction in residents with low education level was significantly lower than that with high education level(P<0.05). Single factor analysis showed that residents’ choice of self-medication were significantly influenced by the marital status, education, monthly income, medicare, accessibility of medical institutions, the severity of disease and duration of illness(P<0.05).  The proportion of self-medication for married group was significantly higher than unmarried group; the proportion of self-medication for low education level group was significantly higher than high education level group; the proportion of self-medication for low monthly income group was significantly higher than high monthly income group; the proportion of self-medication for group with business medical insurance or self payment was significantly higher than group with basic medical insurance and public medical insurance; the proportion of self-medication for group far from medical institutions was significantly higher than that close to medical institutions; the proportion of self-medication for mild disease group was significantly higher than serious disease group; the proportion of self-medication for length of disease≥7 d was significantly lower than length of disease<7 d. Results of multivariate analysis showed that severity of disease and length of disease were the important influential factors for the choice of self-medication(P<0.05).  CONCLUSIONS: Self-medication is common in Wuhan city, and mainly for general and chronic disease. Residents don’t pay enough attention to reading the drug instructions. Self-medication is affected by various factors which has a certain health risks.
期刊: 2017年第28卷第9期
编辑: 雷晓盛,黄明安,王芳,刘朝杰
AUTHORS: LEI Xiaosheng,HUANG Ming’an,WANG Fang,LIU Chaojie
关键字: 武汉市;居民;自我药疗;行为;影响因素;调查
KEYWORDS: Wuhan; Residents; Self-medication; Behavior; Influential factors; Investigattion
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