深圳市代谢综合征患者就医行为及影响因素的质性研究

Qualitative Research of Health Seeking Behavior and Influence Factors of Patients with Metabolic Syndrome in Shenzhen

目的了解深圳市代谢综合征(MS)患者的就医行为,并探讨其影响因素。方法于2014年8—9月,采用目的性抽样法在香港大学深圳医院全科/专科门诊、福田社区健康服务中心、西丽社区健康服务中心、碧海云天社区健康服务中心选取MS患者49例进行访谈。采用焦点团体访谈法进行资料收集,采用质性研究中的Colaizzi七步资料分析法进行资料分析,并参照生态学理论将患者就医行为影响因素概括为微观因素、中间因素、外层因素及宏观因素4个层面。结果 MS患者的就医行为是一个动态、变化的过程,多数患者有多家医疗机构反复、多次就诊经历;患者就诊时不仅会选择医疗机构,还会选择医生。MS患者就医行为的影响因素包括:(1)微观因素(健康态度、个人喜好);(2)中间因素(人际关系、网络和媒体);(3)外层因素(医疗技术、人文关怀);(4)宏观因素(医疗保险政策)。结论深圳市MS患者的就医行为并无统一标准,且影响因素复杂多样,建议有针对性地引导患者合理就医。

Objective To understand health seeking behavior of patients with metabolic syndrome（ MS） in Shenzhen and to investigate its influencing factors. Methods 49 MS patients from General Outpatient / Special Outpatient of the University of Hong Kong- Shenzhen Hospital and Health Service Centers of Futian Community, Xili Community and Bihaiyuntian Community were interviewed by purposive sampling method from August to September in 2014. Focus group interviews method was used to collect data,Colaizzi seven- step data analysis of qualitative study was applied to analyze data. According to ecological theory,the influencing factors of patients＇ health seeking behavior were summarized into micro factors,medial factors,outer factors and macro factors. Results The health seeking behavior of MS patients is a dynamic and changing process. Most of the patients had repeated doctor visiting experiences in many medical institutions; patients not only selected medical institutions,but also doctors when seeing a doctor. The influencing factors of MS patients＇ health seeking behavior included the following 4 aspects：（ 1） micro factors（ health attitude,personal preference）;（ 2） medial factor（ interpersonal relationship,network and media）;（ 3） outer factors（ medical technology,humanistic care）;（ 4） macro factors（ medical insurance）. Conclusion There is no uniform standard in health seeking behavior of MS patients in Shenzhen,and the influencing factors of their behaviors are complex and diverse. It is recommended to lead patients to seek reasonable medical advice with clear targets.