| Objectives(1)To understand the distribution of symptoms and symptom correlation in primary gastroenterology outpatients.(2)To investigate the factors influencing gastrointestinal symptoms.(3)To understand the current situation of health service utilization of gastrointestinal patients.(4)To analyze the current situation and factors influencing sleep of gastrointestinal patients.(5)To analyze the current situation and factors influencing emotions of gastrointestinal patients.(6)To provide a theoretical basis for future interventions in the management of gastrointestinal diseases.Methods Fuyang and Bozhou,Anhui Province were selected as the survey sites,40 township health centers were randomly selected,and all gastrointestinal patients who came to the internal medicine department of the health center were included in the survey,and the study subjects were observed on site using a self-made structured questionnaire,Pittsburgh Sleep Quality Index Inventory(PSQI),Depression Screening Scale(PHQ-9),Generalized Anxiety Inventory(GAD-7)and Questionnaire survey;SPSS 22.0 software was used to analyze the data of the survey results.The main analysis methods included descriptive analysis,chi-square test,binomial logistic regression analysis,multiple linear regression,and systematic cluster analysis.Results(1)The average age of the 220 gastrointestinal patients investigated in the outpatient clinic was 55.41±17.61 years,slightly more women(55%)than men(45%),77.3% were married,47.7% were farmers by occupation,and 60% had a normal BMI.(2)Patients were more likely to seek medical attention for upper gastrointestinal symptoms than for lower gastrointestinal symptoms,and in general,patients self-reported symptoms most.(3)Binary logistic regression analysis of gastrointestinal symptoms showed that occupation was the influencing factor of abdominal pain,BMI was the influencing factor of poor appetite,depression was the influencing factor of diarrhea,and anxiety was the influencing factor of reflux and acid reflux.Age and anxiety were influencing factors for frequent poor appetite,anxiety and medication history were influencing factors for frequent reflux and acid reflux and frequent bloating,and anxiety was an influencing factor for frequent heartburn.(4)The outpatient consultation rate of patients in the past three months was 34.1%,with an average of 1.6visits.In terms of the level of hospital visited,60.3% of patients chose primary care as the first visit.The hospitalization rate of patients in the past year was 9.1%,with an average of 1.45 hospitalizations,and 65.5% of patients chose to be hospitalized at county or city hospitals.The average number of days of hospitalization for patients was10.3 days,with a decreasing trend of 12.6,10.8 and 8.2 days for provincial,county and municipal,and primary care institutions,respectively.58.2% of patients had a history of taking gastrointestinal drugs.Patients took the most medications for stomach pain,indigestion,gastric distension,diarrhea and control of stomach acid.(5)71.4% of gastrointestinal patients had a PSQI score ≤7 i.e.good sleep quality and 28.6% had a PSQI score >7 i.e.poor sleep quality.Except for the hypnotic medication score,the scores of all dimensions were statistically different from the norm(P<0.05).The overall mean PSQI score was 5.94 ± 3.5,and the mean scores of the seven dimensions of the scale were,in descending order,daytime dysfunction(1.15±1.09),sleep duration(1.15±0.98),sleep disturbance(1.03±0.57),sleep quality(0.93±0.92),time to fall asleep(0.89±0.89),sleep efficiency(0.72 ±1.08),and hypnotic drugs(0.06±0.24).The factors influencing sleep were age,long-term gastrointestinal symptoms,and anxiety.(6)This survey showed that the detection rate of anxiety in gastrointestinal patients was 31.3%,and the detection rate of depression was 42.7%,and the anxiety and depression scores of patients were higher than the domestic and international norm,and the differences were statistically significant.Univariate analysis showed that whether gastrointestinal patients were anxious or not had statistically significant differences in gender,long-term gastrointestinal symptoms,and sleep.Whether depression was statistically significant in body mass index,occupation,and sleep differences.Binary logistic regression analysis showed that poor sleep status and anxiety were risk factors for anxiety in gastrointestinal patients,while occupation was an influential factor for depression in gastrointestinal patients.Conclusions(1)Patients are more likely to seek medical treatment for upper gastrointestinal symptoms than for lower gastrointestinal symptoms,and certain gastrointestinal symptoms are strongly correlated,and the correlation of symptoms should be fully considered in future diagnosis and treatment.(2)The factors affecting the occurrence of different gastrointestinal symptoms are not all the same,suggesting that specific factors should be targeted in late disease intervention.(3)The outpatient consultation rate and hospitalization rate of gastrointestinal patients are low,and the need for health services.(3)Gastrointestinal patients have low outpatient attendance,low hospitalization rates,low medication rates,and the need for health services has not been effectively translated into demand,and patients should increase their awareness of their health.(4)The overall sleep quality of gastrointestinal patients is poor,and there are significant differences with the normal population;in the future,patients’ misconceptions and perceptions should be corrected,interfering factors should be eliminated,and clinical treatment and behavioral.(5)The detection rates of anxiety and depression in gastrointestinal patients are higher than those of the domestic norm,so more attention should be paid to the psychological status of this group in future clinical treatment,and health education and promotion of emotional disorders such as anxiety and depression should be strengthened. |
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