重庆市某医院门诊患者的疼痛就医行为及其相关因素——一项横断面调查研究

Healthcare seeking behavior of pain along with its related factors at outpatient department in a hospital in Chongqing: a cross-sectional survey

目的分析重庆市某三甲教学医院门诊患者的疼痛现状、疼痛就医行为及其相关影响因素。方法采用横断面研究,在72 h内对该院871例门诊患者进行了问卷调查,对患者人口学信息、疼痛（发生率、强度、持续时间）、疼痛对疲劳和睡眠的影响以及疼痛就医行为相关影响因素的记录和分析。结果调查显示,该医疗机构门诊患者疼痛患病率为46.15%,其中外科疼痛患病率为55.64%、内科为47.88%、体检中心为20.00%;女性为49.40%、男性为41.82%;急性疼痛为58.46%、慢性疼痛为29.60%。75.66%的门诊患者一般不使用镇痛药;68.43%的门诊患者在就诊中没有向医生寻求镇痛治疗。在门诊患者对镇痛方式的知晓率上,消炎止痛药镇痛占88.40%,阿片类药物镇痛占46.96%、患者自控镇痛占29.39%、神经阻滞占28.13%、手术治疗占22.62%、放射治疗占19.86%、中医中药治疗占8.96%、射频治疗占6.20%。65.79%的门诊患者存在疲劳,36.05%的门诊患者存在睡眠障碍,疼痛患者更容易发生疲劳和睡眠障碍（P〈0.01）。影响患者疼痛就医行为的人口学因素有年龄、性别、文化程度、婚姻状况以及经济情况（P值为0.000 1~0.022 6）。结论调查发现该医疗机构门诊患者的疼痛患病率高,而对疼痛的关注率以及疼痛相关知识的知晓率低,且患者对疼痛的就医行为欠佳,导致疼痛对其生活质量产生了一定程度的影响。

Objective To analyze the disease burden of pain and healthcare seeking behavior of pain along with its related factors at the outpatient department in a teaching hospital in Chongqing. Methods This study was conducted as a cross-sectional survey. A total of 871 outpatients were investigated by questionnaires within 72 h in this hospital. Pain （chief complaint, incidence, severity and duration）, the impact of pain on fatigue and sleep, healthcare seeking behavior of pain and demographic factors of all patients were recorded and analyzed. Results Among the 871 patient of survey, the pain prevalence rate was 46.15%, wherein that of surgery, internal medicine and medical examination center was 55.64%, 47.88%, and 20.00%, respectively; that of female was 49.40% and that of male was 41.82%; that of acute pain was 58.46% and that of chronic pain was 29.60%. Generally 75.66% of the outpatients did not use analgesics, and 68.43% did not receive pain treatment. The awareness rates of analgesia measures in the outpatients were： anti-inflammatory analgesics 88.40%, opioid 46.96%, patient-controlled analgesia 29.39%, nerve block 28.13%, surgery treatment 22.62%, radiotherapy 19.86%, traditional Chinese medicine treatment 8.96% and from radiofrequency treatment 6.20%. There were 65.79% outpatients suffering from fatigue and 36.05% suffering from sleep disorders, indicating that patients with pain were more likely to have fatigue and sleep disorders （P〈0.01）. Demographic factors influencing healthcare seeking behavior of pain included age, gender, education, marital status and economics （P varied from 0.000 1 to 0.022 6）. Conclusion High prevalence of pain in the outpatient department of this hospital is observed. Pain impacts on the prevalence of fatigue and sleep disorders in the outpatients. These patients exhibit poor healthcare seeking behavior and a lack of awareness of pain, as well as their knowledge of pain. Moreover, the quality of life of these patients is influenced by pain.