Drinking Patterns, Gender and Health III: Avoiding vs. Seeking Healthcare.
Drinking Patterns, Gender and Health III: Avoiding vs. Seeking Healthcare.
复制标题
DOI：
10.3109/16066350903398502
复制
发表时间：
2010-01-01
影响因子：
2.9
通讯作者：
Perrin NA
中科院分区：
文献类型：
--
作者：
Green CA;Polen MR;Leo MC;Janoff SL;Anderson BM;Weisner CM;Perrin NA
无法利用人口统计和健康状况预测大多数保健服务的使用和费用，这表明其他因素影响使用，包括影响健康和求医意愿的态度和做法。酒精消费引起了人们的兴趣，因为长期大量饮酒会对健康产生不利影响，急性饮酒会增加伤害，适度饮酒与更好的健康有关，而危险饮酒和酒精相关问题则被视为耻辱，并可能影响寻求治疗的意愿。对健康计划成员进行分层随机抽样，完成邮件调查，共有7884名受访者（男性2995名，女性4889名）。我们将调查数据与24个月的健康计划记录联系起来，以检查酒精使用、性别、与健康有关的态度、实践、健康和服务使用之间的关系。对150名分层受访者的深度访谈探讨了个人寻求或避免护理的原因。定量结果表明，与健康有关的做法和态度可预测随后的服务使用情况。治疗的一致预测因素是戒酒、目前有风险的消费、吸烟、较高的身体质量指数、不喜欢看医生、强烈的宗教/精神信仰。定性分析表明，尴尬和羞耻是避免护理的强烈动机。虽然模型包括许多健康、功能状态、态度和行为预测因素，但解释的方差与以前的报告相似，表明关系比预期的更复杂。定性分析表明，在服务使用研究中通常没有测量到几个潜在的预测因素：尴尬和羞耻、恐惧、相信身体会愈合、对患重病可能性的预期、不喜欢护理过程、了解健康问题的需要，以及对健康相关功能限制的自我评估的影响。
Inability to predict most health services use and costs using demographics and health status suggests that other factors affect use, including attitudes and practices that influence health and willingness to seek care. Alcohol consumption has generated interest because heavy, chronic consumption causes adverse health consequences, acute consumption increases injury, and moderate drinking is linked to better health while hazardous drinking and alcohol-related problems are stigmatized and may affect willingness to seek care. A stratified random sample of health-plan members completed a mail survey, yielding 7884 respondents (2995 male/4889 female). We linked survey data to 24 months of health-plan records to examine relationships between alcohol use, gender, health-related attitudes, practices, health, and service use. In-depth interviews with a stratified 150-respondent subsample explored individuals’ reasons for seeking or avoiding care. Quantitative results suggest health-related practices and attitudes predict subsequent service use. Consistent predictors of care were having quit drinking, current at-risk consumption, cigarette smoking, higher BMI, disliking visiting doctors, and strong religious/spiritual beliefs. Qualitative analyses suggest embarrassment and shame are strong motivators for avoiding care. Although models included numerous health, functional status, attitudinal and behavioral predictors, variance explained was similar to previous reports, suggesting more complex relationships than expected. Qualitative analyses suggest several potential predictive factors not typically measured in service-use studies: embarrassment and shame, fear, faith that the body will heal, expectations about likelihood of becoming seriously ill, disliking the care process, the need to understand health problems, and the effects of self-assessments of health-related functional limitations.
登录
查看更多内容
影响因子：
6
作者：
Cherpitel, CJ;Bond, J;Giesbrecht, N
通讯作者：
Giesbrecht, N
影响因子：
5.4
作者：
Green, CA;Pope, CR
通讯作者：
Pope, CR
DOI：
10.1093/geronj/43.5.s162
发表时间：
1988-09-01
期刊：
JOURNALS OF GERONTOLOGY
影响因子：
--
作者：
MUTRAN, E;FERRARO, KF
通讯作者：
FERRARO, KF
影响因子：
5
作者：
ANDERSEN, RM
通讯作者：
ANDERSEN, RM
影响因子：
3
作者：
Armstrong, MA;Midanik, LT;Klatsky, AL
通讯作者：
Klatsky, AL