本文選題：瘧疾 + 求醫(yī)行為��； 參考：《昆明醫(yī)科大學(xué)》2013年碩士論文

【摘要】：研究目的通過對中緬邊境瘧疾流行程度較嚴(yán)重的緬甸克欽邦拉咱市和云南省德宏州盈江縣那邦鎮(zhèn)瘧疾患者的求醫(yī)行為現(xiàn)狀及其影響因素的研究,為中緬邊境地區(qū)有關(guān)部門加強(qiáng)對瘧疾的監(jiān)管,提高中緬居民求醫(yī)的意識和矯正行為,為制訂相關(guān)政策、有針對性地開展健康教育和干預(yù)項(xiàng)目提供實(shí)證依據(jù)。 研究對象與方法本研究為橫斷面現(xiàn)況研究。采取整群抽樣抽取云南省盈江縣那邦鎮(zhèn)3個村以及緬甸拉咱市3個村,調(diào)查對象為過去一年內(nèi)確診的瘧疾患者及疑似瘧疾患者。采用入戶問卷調(diào)查方式收集他們的求醫(yī)行為及可能的影響因素。采用的統(tǒng)計(jì)分析方法包括卡方檢驗(yàn)、秩和檢驗(yàn)、主成分分析及非條件Logistic逐步回歸模型分析求醫(yī)行為的影響因素。研究結(jié)果 (1)調(diào)查對象基本情況：本次調(diào)查共350人,其中男性174人,占49.7%；女性176人,占50.3%。景頗族占74.9%；其他民族25.1%。農(nóng)民占43.4%,其他職業(yè)占56.6%。研究對象年齡15-24歲組、25-34歲組、35-44歲組、55歲以上組分別占總調(diào)查人數(shù)的16.9%、27.7%、32.0%、17.1%、6.3%。文化程度以小學(xué)和初中居多,大學(xué)�？萍耙陨纤急壤畹�。用主成分分析形成調(diào)查對象的社會經(jīng)濟(jì)狀況綜合得分,把調(diào)查家庭分為較富裕、普通和較貧窮三等分。家庭經(jīng)濟(jì)貧困者33.7%,家庭經(jīng)濟(jì)普通者占33.4%,家庭經(jīng)濟(jì)富裕者32.9%。 (2)調(diào)查對象的瘧疾知識、態(tài)度、行為狀況：知識得分平均為6.6±1.2分,態(tài)度得分平均為5.2±1.0分,行為得分平均為4.3土0.8分,KAP總分平均為16.09±1.92分。 (3)調(diào)查對象的醫(yī)療服務(wù)可及性：從自家到就診醫(yī)療機(jī)構(gòu)的距離為不足500米,500-1000米和1000米以上者分別16.3%、33.4%和50.3%。去就診醫(yī)療機(jī)構(gòu)途中所花時間為不足半小時、半小時和1小時以上者分別占59.4%、33.4%和7.2%。生活居住地有瘧疾知識宣傳的占90.6%,沒有宣傳的占9.4%。 (4)調(diào)查對象的求醫(yī)行為：98.6%的調(diào)查對象在出現(xiàn)瘧疾相關(guān)癥狀或患瘧疾后采取相應(yīng)的措施,其中52.6%的選擇去醫(yī)院,46.0%去藥店買藥,僅有1.4%的調(diào)查對象不做任何處理。去醫(yī)院就診患者中,41.9%選擇去村醫(yī)務(wù)室,55.5%選擇去鄉(xiāng)鎮(zhèn)衛(wèi)生院,2.6%去縣級及以上的醫(yī)院。在到醫(yī)院就診的患者中,15.1%的人認(rèn)為醫(yī)療費(fèi)用太貴,40%的人認(rèn)為能接受,還有44.9%的人認(rèn)為比較便宜。 (5)中緬居民對比分析：僅不同年齡、民族、文化程度及家庭經(jīng)濟(jì)收入情況存在差異(P0.05),而中緬兩地瘧疾患者在求醫(yī)行為方面沒有統(tǒng)計(jì)學(xué)差異。 (6)求醫(yī)行為的影響因素分析：以是否到醫(yī)療機(jī)構(gòu)就診為因變量,單因素分析顯示,僅有戶主的性別對求醫(yī)與否有影響,采用非條件Logistic回歸對求醫(yī)行為的影響因素進(jìn)行分析,結(jié)果顯示國籍、社區(qū)宣傳、經(jīng)濟(jì)指標(biāo)也對求醫(yī)行為有影響。 結(jié)論和建議在調(diào)查的中緬邊境地區(qū)瘧疾患者中,小學(xué)文化程度及35-44歲組年齡段居多。求醫(yī)方式在不同性別中有影響(x2=4.159,P0.05),而在不同國籍、年齡、職業(yè)、民族、婚姻狀況、文化程度、醫(yī)療保險、KAP等因素間沒有統(tǒng)計(jì)學(xué)差異。Logistic逐步回歸模型分析顯示,國籍、社區(qū)宣傳、經(jīng)濟(jì)指標(biāo)是求醫(yī)行為的正向影響因素；緬甸患者求醫(yī)行為發(fā)生的機(jī)會低于中國患者,經(jīng)濟(jì)狀況比中國差,而有社區(qū)瘧疾宣傳的求醫(yī)行為高于無社區(qū)宣傳。應(yīng)加強(qiáng)瘧疾相關(guān)知識的宣傳、提供有效的醫(yī)療服務(wù)來增強(qiáng)其感染瘧疾的警覺性,從而激發(fā)采取保護(hù)措施的動機(jī)。
[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.

【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R531.3

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