农村地区上消化道癌症患者住院就医行为及其影响因素调查

目的 调查分析上消化道癌症患者住院就医行为及其影响因素，为促进农村地区上消化道癌症患者及早住院就医提供参考依据。 方法 2014年在河南、山东、江苏、安徽4省的12个县肿瘤发病登记系统收集的2013年新发并存活的胃癌和食管癌患者中，随机抽取1 235例进行面对面问卷调查。调查内容包括患者的主要人口社会学特征、本人是否知情、就医情况、诊断情况、住院和治疗情况等。用SAS 9.3进行统计学分析。 结果 1 182例基本信息完整患者中，胃癌患者859例(72.7%)，食管癌患者323例(27.3%)，90.3%的患者职业为农民，住院906例，占76.6%，患者本人不知情者占39.4%。47.1%的患者肿瘤出现转移，48.2%的患者病情是晚期，32.3%的患者没有采取任何放化疗或者手术治疗。患者住院影响因素的单因素分析中，文化程度、职业、婚姻状态、本人是否知情、认为癌症可以治愈、肿瘤是否转移、肿瘤分期等因素分析差异具有统计学意义(P＜0.05)；影响因素的多因素Logistic回归分析显示，初中毕业、高中及以上患者住院比例分别是小学及以下患者的2.2倍(95%CI:1.4～3.7)和6.5倍(95%CI:1.5～27.8)，已婚患者住院比例是未婚、离婚或丧偶患者的2.1倍(95%CI:1.5～2.9)，患者本人知情是不知情的1.5倍(95%CI:1.1～2.1)，晚期患者住院比例是早期的0.3倍(95%CI:0.2～0.5)。 结论 文化程度、婚姻状况、本人是否知情、病情进展是影响患者住院就医的主要影响因素。 

Analysis on hospitalization behavior and related influencing factors among upper gastrointestinal cancers patients in rural areas

Objective To analyze the hospitalization behavior and related influencing factors among upper digestive tract cancer patients in rural areas,and provide reference for the promotion of early hospitalization. Methods The total of 1 235 stomach and esophagus cancer cases were randomly selected from cancer registration system of 12 counties in Henan,Shandong,Jiangsu and Anhui Provinces.All of the patients were the new and survival cases in 2013.The face-to-face interview was conducted to collect the information on demographic characteristics,whether knowing his/her illness condition,whether seeking the medical service,and the condition of diagnosis,hospitalization and treatment.The statistical analysis was conducted by using SAS 9.3. Results Among the 1 182 patients with complete basic information,there were 859 stomach cancer cases(72.7%) and 323 esophagus cancer cases (27.3%).The proportion of farmer was 90.3%.There were 906 cases had been hospitalized,accounting for 76.6%.The proportion of patients who did not know the illness condition was 39.4%.There were 47.1% patients having metastasized cancer,48.2% patients being the late stage of cancer,and 32.3% patients having not adapt any radiotherapy,chemoradiotherapy and surgery.The univariate analysis showed that the educational level,occupation,marital status,whether knowing the illness condition,whether having metastasized cancer and tumor staging were statistically related with hospitalization.The multiple logistic regression analysis showed that patients with education levels of middle school[OR=2.2,95%CI(1.4,3.7)] and high school or above[OR=6.5,95%CI(1.5,27.8)] were more likely to be hospitalized compared to those with education level of elementary school or below.Compared with unmarried,divorced and widowed patients,married patients was 2.1[95%CI(1.5,2.9)] times being hospitalized.Compared with patients who did not know the illness condition,patients who knew the condition were 1.5 times[95%CI(1.1,2.1)] being hospitalized.Compared with patients in early stage of cancer,patients in late stage were 0.3 times[95%CI(0.2,0.5)] being hospitalized. Conclusion The educational level,marital status,whether knowing his/her own illness,and stage of the illness were the main factors affecting patients' hospitalization.