Use of conventional and complementary health care during the transition to menopause: longitudinal results from the Study of Women's Health Across the Nation (SWAN)
Use of conventional and complementary health care during the transition to menopause: longitudinal results from the Study of Women's Health Across the Nation (SWAN)
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DOI：
10.1097/00042192-200512010-00008
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发表时间：
2005-01-01
影响因子：
2.7
通讯作者：
Kravitz, RL
中科院分区：
文献类型：
--
作者：
Bair, YA;Gold, EB;Kravitz, RL
目的：开始过渡到更年期的妇女现在可以获得补充和替代疗法(CAM)，这在过去并不普遍可用。关于更年期使用CAM和使用传统医疗保健之间的关联，我们知之甚少。我们在全国妇女健康研究(SWAN)队列阶段登记的大量多种族中年妇女样本中，调查了CAM疗法的使用和传统医疗保健利用之间的纵向关联。设计：我们使用广义估计方程、重复测量建模来检验在两年期间，在相关协变量调整后，CAM疗法的使用和传统医疗保健接触者的年数量之间的关联。结果：与非使用者相比，持续使用CAM的人有更多的传统医疗接触(Beta 0.14，95%CI 0.06，0.21)。偶发事件使用者和零星接触者也分别表现出传统保健接触者(贝塔0.14，可信区间0.06，0.22)和(贝塔0.09，可信区间0.01，0.16)的过量。种族与卫生保健接触者独立相关。与白人女性相比，日本女性接触者较少(Beta-0.18，CI-0.31，-0.05)。结论：尽管日本女性总体上健康、受过良好教育、高收入且有良好的医疗保健可获得性，但与不使用CAM的女性相比，使用CAM的女性使用了更多的传统和替代医疗资源。这些发现对传统卫生保健从业者、专职卫生专业人员和CAM从业者具有实际意义。
Objective: Women beginning the transition to menopause now have access to complementary and alternative therapies (CAM) that were not universally available in the past. Little is known about the association between CAM use and the use of conventional health care during menopause. We investigated the longitudinal association between use of CAM therapies and utilization of conventional health care in a large, multiethnic sample of midlife women who were enrolled in the cohort phase of the Study of Women's Health Across the Nation (SWAN).Design: We used generalized estimating equations, repeated measures modeling to examine the association between CAM use and the yearly number of conventional health-care contacts, adjusting for relevant covariates, during a two-year period. CAM use was evaluated longitudinally as continuous, incident (no CAM use at baseline), sporadic, or no use during the study period.Results: Relative to nonusers, continuous CAM users had more conventional health-care contacts (beta 0.14, 95% CI 0.06, 0.21). Incident users and sporadic users also showed an excess in conventional health-care contacts (beta 0.14, CI 0.06, 0.22) and (beta 0.09, CI 0.01, 0.16), respectively. Ethnicity was independently associated with health-care contacts. Relative to white women, Japanese women had fewer contacts (beta -0.18, CI -0.31, -0.05).Conclusions: Despite being a generally healthy, well-educated and high-income population with good access to health care, CAM users were using more of both conventional and alternative health-care resources than women who did not use CAM. These findings have practical implications for conventional health-care practitioners, allied health professionals and CAM practitioners.