Disparities in hormone replacement therapy use by socioeconomic status in a primary care population
Disparities in hormone replacement therapy use by socioeconomic status in a primary care population
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DOI：
10.1023/a:1026537114638
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发表时间：
2001-02-01
影响因子：
5.9
通讯作者：
Gay, E
中科院分区：
文献类型：
--
作者：
Finley, C;Gregg, EW;Gay, E
对于许多女性来说，使用激素替代疗法 (HRT) 是一个有争议的决定，但很少有研究评估 HRT 使用的社会人口、心理和行为相关性。这项横断面邮寄调查评估了佛蒙特州 428 名 50-70 岁女性的社会经济地位、预防性健康行为、对 HRT 相关风险和益处的知识和看法与 HRT 使用之间的关系。 HRT 使用的总体流行率为 40%。中高收入女性使用激素替代疗法的可能性是低收入女性的三倍。经医生鼓励使用 HRT 的女性 (58%) 的使用率显着高于那些从医生那里得到矛盾建议的女性 (20%)。在多变量分析中，子宫切除术、高收入、年轻化、定期坚持宫颈癌筛查以及医疗服务提供者的推荐与 HRT 的使用显着相关。根据对心脏病、骨质疏松症或乳腺癌的关注程度，激素替代疗法的使用没有差异。医疗保健提供者的建议是激素替代疗法使用的有力预测指标，但不同社会经济地位的使用存在差异。未来的研究应该探讨为什么低收入女性不太可能使用激素替代疗法，以及这种差异是否是由于医疗保健提供者的建议不一致造成的。
The use of hormone replacement therapy (HRT) is a controversial decision for many women, yet few studies have evaluated the socio-demographic, psychological, and behavioral correlates of HRT use. This cross-sectional, mailed survey evaluated the associations of socioeconomic status, preventive health behaviors, knowledge and perceptions about HRT-related risks and benefits with HRT use among 428 women 50-70 years old in Vermont. The overall prevalence of HRT use was 40%. Women of moderate to high income were three times more likely than those of low income to use HRT. HRT use was significantly higher among women whose physician had encouraged use (58%) than among those who received ambivalent recommendations from their physicians (20%). Hysterectomy, higher income, younger age, regular adherence to cervical cancer screening, and recommendation by a provider were significantly associated with HRT use in multivariate analyses. There were no differences in HRT use according to level of concern about heart disease, osteoporosis, or breast cancer. A recommendation by a health care provider is a powerful predictor of HRT use, but disparities in use exist by socioeconomic status. Future research should examine why lower income women are less likely to use HRT and whether the discrepancy is due to inconsistent recommendations by health care providers.