| Objective:This study is based on the theory of The Theory of Planned Behavior(TPB)and The Common-Sense Model of Self-Regulation(CSM)so as to investigate the situation of medical treatment of hemorrhoids patients,to explore the influencing factors of patient delay,to analysis the correlation between the factors and patient delay,which can provide the basis for promoting the comprehensive intervention strategy on health seeking behavior of hemorrhoid patients in China,consequently improving the situation of medical treatment of hemorrhoids patients.Methods:The study combined the TPB and the CSM theory to propose research hypotheses,and used a cross-sectional survey to facilitate the collection of outpatients and admission patients from a tertiary-level hospital in Changchun from June to September 2017.The survey tools included sociodemographic characteristics,disease-related characteristics,Social Impact Scale,Help-Seeking Attitude questionnaire,Coping Efficacy Scale,and the Chinese version of Brief Illness Perception Questionnaire.The original data was first created using Epidata3.1 software.After the data was entered,it was imported into SPSS23.0 software for statistical analysis.Statistical methods:Using the mean,standard deviation,frequency,percentage,median,and interquartile range to represent the sociodemographic characteristics,the disease-related characteristics,the current status of the patient delay,the perceived social impact,help-seeking attitude,coping efficacy and the illness perceptions;used thec~2 test to compare the sociodemographic and disease-related characteristics of the two delayed group(short and long),and used the Mann-Whitney U test to compare the perceived social impact,help-seeking attitude,coping efficacy and the illness perceptions between the two delay groups(short and long).Spearman correlation analysis was used to investigate the relationship between the delay time and the perceived social impact,help-seeking attitude,coping efficacy,the illness perceptions and scores of each dimension.A multi-factor stepwise logistic regression analysis was used to investigate the influencing factors of patient delay for patients with hemorrhoids.Results:1.The shortest time between the onset of the first disease-related symptoms and the first mention of these symptoms by the patient to a doctor was 2 days,the longest was 20 years,and the median time was 5.5 years.Among them,277(90.52%)patients reported patient delay.The delay rate was high.In addition,the participants held positive help-seeking attitudes,the coping efficacy score was above the middle level.The degree of illness perceptions was lower than the middle-lower level,that is,they thought that the severity of harm caused by disease was moderate.And the level of perceived social impact is lower,that is,they thought that others have little influence on their help-seeking behavior.2.The results of thec~2 test showed that there were significant differences in the age,education level,marital status,family monthly income,previous medical history,and hemorrhoids classification among the patients with varying degrees of patient delay(P<0.05).3.Mann-Whitney U test results showed that the total score of perceived social impact,help-seeking attitudes,coping efficacy of patients in the long patient delay group were significantly higher than those of short group(P<0.05).The score of illness perceptions was significantly lower than those of short group(P<0.05).4.Spearman’s correlation analysis showed that the social rejection dimension in the Social Impact Scale was negatively correlated with the patient delay,and the financial insecurity was the opposite.The total score of coping efficacy,help-seeking attitudes,and the dimension of emotional experience were positively related to the patient delay.The scores of illness perceptions and its various dimensions were related to the patient delay(P<0.05).5.Logistic regression analysis showed that the middle-aged group,perceived social impact,illness perceptions,and coping efficacy entered the regression equation.Among them,middle-aged,coping efficacy,and perceived social impact had OR values>1 as risk factors for patient delay.Illness perception was a protective factor,of which OR values<1.Conclusions:1.The patient delay has become the norm for hemorrhoids patients’seeking medical treatment.Therefore,attention must be paid to improving people’s awareness of early medical treatment.2.The age,education level,marital status,family monthly income,previous medical history,and the classification of hemorrhoids were the main influencing factors for patient delay.Based on the results,the medical staff then proposes a comprehensive intervention strategy to promote hemorrhoids patients’help-seeking behavior,which is beneficial to improve their medical treatment status.3.Logistic regression analysis showed that the middle-aged group,perceived social impact,and coping efficiency positively predicted the time of patient delay,and the illness perceptions played a negative predictive role,which suggested the prompting medical staff and patients themselves to pay attention to the predictive factors so as to eliminate the phenomenon of stagnation in diagnosis and treatment,increase their awareness and improve quality of life. |
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