慢性便秘患者对慢性便秘分级诊疗的认知度及其了解情况的影响因素研究

摘要

目的 探讨上海市杨浦区慢性便秘患者对慢性便秘分级诊疗的认知度及其了解情况的影响因素.方法 本研究采用抽样调查的方法,2016年10月-2017年2月抽取上海市杨浦区社区卫生服务中心2家,三级乙等医院1家,采用自制调查问卷对上海市杨浦区部分慢性便秘患者进行调查,Cronbach′s α系数为0.768.结果 共发放问卷240份,回收有效问卷219份,有效回收率91.25%.完全不了解慢性便秘分级诊疗的患者占48.9%,较了解及了解不多的患者分别占16.9%、34.2%.多因素Logistic回归分析结果显示,患者的年龄(20~60岁)、文化程度、近1年去社区卫生服务中心就医次数为慢性便秘患者慢性便秘分级诊疗了解情况的影响因素(P<0.05).结论 上海市杨浦区慢性便秘患者对分级诊疗认知度低,年龄、文化程度、近1年去社区卫生服务中心就医次数是慢性便秘患者对慢性便秘分级诊疗了解情况的影响因素.社会及医疗机构应加大对慢性便秘分级诊疗的宣传力度,提高患者对社区卫生服务中心的认知度,以慢性便秘社区卫生服务中心首诊为突破口推进慢性便秘分级诊疗制度的落实.%Objective To study the level of awareness of hierarchical diagnosis and treatment for chronic constipation and associated factors in chronic constipation patients in Yangpu District,Shanghai.Methods From October 2016 to February 2017,we conducted a survey in 240 selected chronic constipation patients from Yangpu District,Shanghai who had received treatment from the sampled two community health service centers and one tertiary grade B hospital in Yangpu District,Shanghai by sampling survey with a self-developed questionnaire with a Cronbach′s α of 0.768.Results The survey achieved an effective response rate of 91.25%(219/240).Of the 219 final participants,hierarchical diagnosis and treatment for chronic constipation was completely unknown to 48.9% of them,very familiar to 16.9% of them,moderately familiar to 34.2% of them.Multivariate Logistic regression analysis found that,age(20 to 60 yeas old),educational attainment,frequency of visits to the community health service center within one year before the survey were significantly associated with the level of awareness of the hierarchical diagnosis and treatment for chronic constipation(P<0.05).Conclusion The level of awareness of hierarchical diagnosis and treatment for chronic constipation in chronic constipation patients in Yangpu District,Shanghai is not satisfactory,and it is affected by age and educational attainment.Therefore,it is suggested that the social and medical institutions should strengthen the propaganda of hierarchical diagnosis and treatment for chronic constipation to improve it,which in turn can promote the rate of community-based first contact care for the disease,and by which the implementation of hierarchical diagnosis and treatment system for chronic constipation can be promoted.