摘要
目的调查我国农村地区胃癌和食管癌患者就医及时性及其影响因素。方法 2011年11月—2012年5月,在河南、山东、江苏、安徽4省的10个消化道肿瘤高发县区开展癌症患者就医行为调查。从农村县区肿瘤发病登记系统收集的2011年新发并存活的胃癌和食管癌患者中随机抽取1 018例进行面对面问卷调查,其中胃癌患者741例(72.8%),食管癌患者277例(27.2%)。调查患者的就医及时率、确诊及时率、与医疗机构距离、对癌症早诊的认知度及就医习惯。并采用χ2检验、多因素Logistic回归模型等方法进行统计学分析。结果 1 018例患者从出现症状到首次就医的时间平均为11周,就医及时率为37.5%〔95%CI(34.5%,40.5%)〕;首次就医至确诊的时间平均为6周,确诊及时率为76.5%〔95%CI(73.9%,79.1%)〕。与医疗机构距离<0.5 h者就医及时率高于≥0.5 h者〔50.0%(70/140)与36.2%(308/850),P<0.05〕;每年体检者就医及时率高于从不体检者〔46.7%(63/135)与32.5%(169/520),P<0.05〕;平时身体不适及就医者就医及时率高于不就医者〔57.5%(215/374)与26.6%(163/612),P<0.05〕。Logistic回归分析显示,胃癌和食管癌患者就医不及时的主要危险因素是就医习惯不良〔OR=3.7,95%CI(2.8,4.9)〕,其次是与医疗机构距离≥0.5 h〔OR=1.5,95%CI(1.0,2.3)〕。结论我国农村地区胃癌和食管癌患者就医及时率较低,平时就医习惯及与医疗机构距离是影响患者及时就医的主要因素。
ObjectiveToinvestigatethehospitalizationtimelinessandrelatedinfluencingfactorsinpatientswith stomach and esophagus cancer in rural areas .Methods Patients with stomach and esophagus cancer were selected from 10 high-incidence counties and districts in Henan , Shandong , Jiangsu and Anhui provinces from November 2011 to May 2012 and were surveyed in terms of treatment -seeking behavior.1 018 patients, including 741 cases （72.8%） of stomach cancer and 277 ca-ses （27.2%） of esophagus cancer collected by the registry system of the counties and districts were given face -to-face inter-view.The hospitalization and diagnosis timeliness rate , distance from hospital , awareness of early diagnosis of cancer and treat-ment-seeking habit were investigated .χ2 test and Logistic regression model were used to make statistical analysis .Results A-mong the 1 018 patients, the average time from onset to first treatment -seeking behavior was 11 weeks, and the timeliness rate was 37.5% 〔95%CI （34.5%, 40.5%）〕 .The average time from first treatment -seeking behavior to confirmed diagnosis was 6 weeks, and the diagnosis timeliness was 76.5% 〔95%CI （73.9%, 79.1%）〕 .Patients with distance 〈0.5 h to hospital had higher treatment -seeking timeliness rate than those with distance≥0.5 h 〔50.0% （ 70/140 ） vs.36.2% （ 308/850 ） , P〈0.05〕 .Patients with annual physical examination had higher treatment -seeking timeliness rate than those not 〔46.7% （63/135） vs.32.5% （169/520）, P〈0.05〕 .Patients tending to seek treatment when sick had higher treatment -seeking timeli-ness rate than those didn′t 〔57.5% （215/374） vs.26.6% （163/612）, P〈0.05〕 .Logistic regression analysis showed that the main risk factor for the unsatisfactory treatment -seeking timeliness among patients with stomach and esophagus cancer was bad treatment-seeking habit 〔OR=3.7, 95%CI （2.8, 4.9）〕, and the following factor was the distance to hospital≥0.5 h〔OR=1.5, 95%CI （1.0, 2.3）〕 .Conclusion T
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第21期2486-2489,共4页
Chinese General Practice
关键词
胃肿瘤
食管肿瘤
乡村卫生服务
早期诊断
Stomachneoplasms
Esophagealneoplasms
Ruralhealthservices
Earlydiagnosis
