膝关节骨性关节炎患者卫生服务利用现状及其影响因素分析

Health service utilization status and influencing factors in patients with knee osteoarthritis

目的 调查膝关节骨性关节炎(KOA)患者卫生服务利用现状,并分析其影响因素。方法 2022年2-12月,使用便利抽样法,采用自行设计的KOA患者就医行为调查问卷进行横断面调查,并应用logistic回归分析KOA患者卫生服务利用的影响因素。结果 该调查共纳入390例患者,160例(41%)处于低就医水平,回归分析结果显示,就医水平受年龄、居住地、居住情况、疾病认知、就诊花费路程、个人月收入、慢性病共病、西安大略及麦克马斯特大学骨关节炎指数评分量表(WOMAC)评分等是卫生服务利用现状的影响因素(P<0.05)。结论 KOA患者的卫生服务利用现状堪忧,高龄、独居、农村、疾病认知缺乏、就诊路程长、个人收入低、共病、躯体功能症状轻的患者就医水平较差,护士应该增加对该类人群的关注,根据不同的就医水平制订适当的方案,促进其行为改变,优化患者卫生服务利用率。

Objective To investigate the current status of healthcare service utilization among patients with knee osteoarthritis(KOA)and analyze its influencing factors.Methods From February to December 2022,a cross-sectional study was conducted by using a convenience sampling method,employing a self-designed questionnaire on healthcare-seeking behavior among KOA patients,and logistic regression analysis was utilized to analyze the influencing factors associated with healthcare service utilization of KOA patients.Results A total of 390 patients were included in this survey,with 160 patients(41%)classified as having low healthcare utilization levels.The regression analysis results indicated that levels of healthcare utilization were influenced by factors such as age,place of residence,living conditions,disease awareness,travel distance for medical visits,personal monthly income,comorbidity of chronic diseases,and Western Ontario and Mcmaster university osteoarthritis index(WOMAC)score(P<0.05).Conclusion The current status of healthcare service utilization among KOA patients is worrying.Elderly individuals,those living alone,residing in rural areas,lacking disease awareness,having long travel distances for medical visits,low personal income,comorbidities,and mild physical functional symptoms tend to exhibit lower levels of healthcare utilization.Nurses shall focus on this group of individuals,and formulate appropriate interventions based on different levels of medical treatment to promote behavioral changes and optimize patients'healthcare service utilization rates.