Living environment, social support, and informal caregiving are associated with healthcare seeking behaviour and adherence to medication treatment: A cross-sectional population study
Living environment, social support, and informal caregiving are associated with healthcare seeking behaviour and adherence to medication treatment: A cross-sectional population study
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DOI：
10.1111/hsc.12758
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发表时间：
2019-09-01
影响因子：
2.4
通讯作者：
Westerling, Ragnar
中科院分区：
文献类型：
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作者：
Berglund, Erik;Lytsy, Per;Westerling, Ragnar
尽管当地环境与健康之间的关联众所周知，但很少有研究关注环境和医疗保健利用，例如医疗保健寻求行为或依从性。本研究旨在分析住房类型、基于当地户外安全感知的行为、社会支持、非正式护理、人口统计、社会经济学和长期疾病，以及与人口层面的寻求健康和坚持行为的关联。本研究使用了 2004-2014 年瑞典国家公共卫生调查的数据，这是一项每年重复的、大样本、横断面、基于人群的调查研究。总共邮寄了 100,433 份问卷，回收率为 52.9%（100,433/190,000）。使用描述性统计和多重逻辑回归来调查解释变量与不寻求护理和不依从行为的结果之间的关联。住在出租公寓、寄宿者、宿舍或其他地方与报告不寻求护理（调整后 OR 1.16，95% CI 1.00-1.22）和不依从（调整后 OR 1.22；95% CI 1.13-1.31）有关。由于认为周围环境不安全而避免外出与不寻求护理（调整后 OR 1.59，95% CI 1.51-1.67）和不遵守（调整后 OR 1.26，95% CI 1.17-1.36）相关。社会支持和作为非正式护理人员的地位与不寻求医疗护理和不依从的可能性较高相关。这项研究表明，居住在出租房、由于社区安全问题而避免外出、缺乏社会支持或非正式的护理人员身份与较低的寻求健康行为和不遵守处方药物有关。
Despite the well-known associations between local environment and health, few studies have focused on environment and healthcare utilisation, for instance healthcare seeking behaviour or adherence. This study was aimed at analysing housing type, behaviour based on perceived local outdoor safety, social support, informal caregiving, demographics, socioeconomics, and long-term illness, and associations with health-seeking and adherence behaviours at a population level. This study used data from the Swedish National Public Health Survey 2004-2014, an annually repeated, large sample, cross-sectional, population-based survey study. In all, questionnaires from 100,433 individuals were returned by post, making the response rate 52.9% (100,433/190,000). Descriptive statistics and multiple logistic regressions were used to investigate associations between explanatory variables and the outcomes of refraining from seeking care and non-adherence behaviour. Living in rented apartment, lodger, a dorm or other was associated with reporting refraining from seeking care (adjusted OR 1.16, 95% CI 1.00-1.22), and non-adherence (adjusted OR 1.22; 95% CI 1.13-1.31). Refraining from going out due to a perceived unsafe neighbourhood was associated with refraining from seeking care (adjusted OR 1.59, 95% CI 1.51-1.67) and non-adherence (adjusted OR 1.26, 95% CI 1.17-1.36). Social support and status as an informal caregiver was associated with higher odds of refraining from seeking medical care and non-adherence. This study suggests that living in rental housing, refraining from going out due to neighbourhood safety concerns, lack of social support or informal caregiver status are associated with lower health-seeking behaviour and non-adherence to prescribed medication.