Social and health-related factors associated with refraining from seeking dental care: A cross-sectional population study
Social and health-related factors associated with refraining from seeking dental care: A cross-sectional population study
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DOI：
10.1111/cdoe.12284
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发表时间：
2017-06-01
影响因子：
2.3
通讯作者：
Lytsy, Per
中科院分区：
文献类型：
--
作者：
Berglund, Erik;Westerling, Ragnar;Lytsy, Per
背景社会不平等被认为影响了医疗保健的利用，而与不寻求牙科治疗相关的因素却知之甚少。这项研究旨在调查没有社会支持、长期患病、照顾者负担和社会经济地位较低的人是否会避免寻求牙科治疗的比例高于一般瑞典人。方法本研究使用了2004-2013年间重复进行的全国健康调查的横断面问卷数据，共90 845人。问卷包括人口统计特征、社会支持、长期疾病、照顾负担、社会支持和就医行为等问题。采用描述性统计、卡方检验、相关分析和Logistic回归分析自变量与牙科就医行为之间的关系。在调整后的多因素模型中，没有情感社会支持或没有工具性社会支持分别与报告不寻求牙科治疗有关(优势比[OR]1.26，95%可信区间[CI]1.18~1.34，OR：1.89，95%CI：1.67~2.13)。长期患病与在调整后的模型中不寻求牙科治疗有关(调整后的OR：1.43，95%CI：1.35-1.51)。此外，作为非正式的照顾者与避免寻求牙科护理有关(调整后的OR：1.15，95%CI：1.07-1.23)。低SES与更不愿寻求牙科治疗相关；最强的关联是有经济问题(调整后的OR：3.57，95%CI：3.19-4.00)。受教育程度与社会支持状况、社会支持与长期患病及结果之间存在交互作用。结论本研究结果提示，无社会支持、长期患病、非正式照顾者或有经济问题是报告不愿就医的影响因素。
BackgroundSocial inequities are considered to affect healthcare utilization, whereas less is known about the factors associated with refraining from seeking dental care. This study aimed to investigate whether people with no social support, long-term illness, caregiver burden and low socioeconomic status (SES) refrained from seeking dental care in higher proportion than the general Swedish population.MethodsThis study used cross-sectional questionnaire data from repeated nationwide health surveys during 2004-2013 of a total of 90 845 people. The questionnaire included questions on demographic characteristics, social support, long-term illness, caregiving burden, SES and dental care-seeking behaviour. Descriptive statistics, chi-square tests, correlation analyses and logistic regressions were used to investigate associations between independent variables and dental care-seeking behaviour.ResultsIn the total sample, 15.1% of respondents reported refraining from seeking dental care. Having no emotional social support or having no instrumental social support was separately associated with reporting refraining from seeking dental care in adjusted multivariate models (odds ratio [OR] 1.26, 95% confidence interval [CI] 1.18-1.34 and OR: 1.89, 95% CI: 1.67-2.13, respectively). Having a long-term illness was associated with refraining from seeking dental care in adjusted models (adjusted OR: 1.43, 95% CI: 1.35-1.51). Furthermore, being an informal caregiver was associated with refraining from seeking dental care (adjusted OR: 1.15, 95% CI: 1.07-1.23). Low SES was associated with higher refraining from seeking dental care; the strongest association was with having financial problems (adjusted OR: 3.57, 95% CI: 3.19-4.00). Interaction effects were found between education level and SES, and between social support and long-term illness, and the outcome.ConclusionsThe findings in this study imply that having no social support, having long-term illness, being informal caregiver or having financial problems are factors associated with reporting refraining from seeking dental care, on a population basis.