西部农村60～75岁老年女性对生殖健康相关疾病就诊意愿分析

Analysis of willingness to visit for reproductive tract-related diseases among the aged women from western rural areas of China

目的分析我国西部农村老年女性对生殖健康相关疾病的就诊意识现状及其影响因素。方法通过分层整群抽样方法抽取云南、青海和四川部分农村地区60～75岁老年女性，采用自制调查表收集其对生殖健康相关疾病就诊意愿及其他相关的信息；采用SPSS13．0软件，在描述性分析和单因素分析的基础上，采用多因素Logistic回归对数据进行分析。结果所回收的1557份问卷中1474份相关信息填写完整，完整率94．7％。受调查对象在“下身出现不适”时愿立即就诊的比例为57．5％。经多因素校正后，与四川的受调查老年女性相比，云南和青海的受调查对象在下身出现不适后立即就诊意愿低[分别为OR0．445，95％CI（0．331，0．599），P〈0．001和OR0．247，95％CI（0．183，0．332），P〈0．001]；与忉中及以上者相比，文盲／半文盲者就诊意愿低[oR0．415，95％CI（0．247，0．698），P〈0．001]；与医疗机构距离较远者（步行〉10min或距离〉3km）立即就诊意愿低[OR0．774，95％CI（0．610，0．983），P〈0．05]；个人可支配收入≥5000元者立即就诊意愿高EoR1．617，95％CI（1．199，2．180），P〈0．01]；与子女同住者就诊意愿高[OR1．517，95％CI（1．172，1．964），P〈0．01]。结论改善西部农村老年女性的生殖健康意识应制定充分考虑地区差异的综合性健康促进策略和措施，以低收入老年女性为重点，注重家庭尤其是子女的参与，同时应进一步改善西部农村地区生殖健康医疗服务的可及性。

Objective： To investigate the willingness to visit aged women from the western rural areas of China, and for reproductive tract-related diseases among the explore the potential influence factors. Methods： Stratified cluster sampling method was used to select the aged women at 60-75 years old from some rural areas of Yunnan,Qinghai and Sichuan provinces. The participants＇ information including the willingness to visit for reproductive tract-related diseases and others were collected by the self-made questionnaire. The descriptive statistical analysis method,univariate logistic regression model and multiple Logistic regression model were used to analyze the data with SPSS software 13.0. Results： Among the returned 1 557 questionnaires, 1 474 questionnaires （94.7%） were filled completely. The proportion of the willingness to visit hospital immediately if they felt vaginal discomfort was 57.5% among the participants. After multivariate adjustment, the participants from Yunnan and Qinghai provinces had significant lower willingness to see a doctor compared with those from Sichuan province,and the corresponding OR values ＆ 95% confindence intervals （CIs） were 0. 445（0. 331,0. 599） for Yunnan vs. Scihuan province （P〈0. 001）,0. 247（0. 183,0. 332） for Qinghai vs. Sichuan province （P〈 0. 001）,respectively. The illiterate or semi illiterate participants had significant lower willingness to see a doctor compared with who received at least junior middle school education,and the ORvalue ＆ 95 % CI and Pvalue were 0. 415（0. 247,0. 698）（P〈0. 001）. The participants with a longer distance （〉10 min. by walk or〉3 km） between resident place to medical center had significant lower willingness to see a doctor,and the OR value ＆ 95% CI were 0.774 （0.610,0.983）（P〈0.05）. The participants with ≥5000 RMB of disposable personal income （DPI） had significant higher willingness to see a doctor,and the OR value 95% CIwere 1. 617（1. 199,2. 180） （P〈0. 01）. The participants lived with their children had significant higher willingness to see a doctor,and the OR value ＆ 95% CI were 1. 517（1. 172,1. 964） （P〈0. 01）. Conclusions： In order to improve the aged women＇s reproductive health awareness from the western rural areas in China, the comprehensive health promotion strategies and programs should be made with a full consideration of regional differences. Focusing on the lower-income aged women and emphasizing the involvement of family members especially their children should also be considered in such health promotion strategies and programs. At the same time, it is necessary to develop effective measures to improve the medical service accessibility of reproductive health in western rural areas of China.