目的:调查体外受精-胚胎移植(in vitro fertilization-embryo transfer，IVF-ET)女性不孕症患者就医延迟(medical treatment delay)现状，分析其影响因素。方法:目的抽样法选取2022年1-12月首次建档并于烟台市烟台山医院生殖医学中心行IVF-ET助孕治疗的203例女性不孕症患者作为研究对象，以确诊不孕至首次就医行IVF-ET助孕间隔时间的中位时间为标准截点将研究对象分为就医延迟组和未就医延迟组。应用一般资料调查表、疾病感知问卷简化版(Brief Illness Perception Questionnaire，BIPQ)、领悟社会支持量表(Perceived Social Support Scale，PSSS)、就医行为感知障碍量表中文版(Perceived Barriers to Health Care-seeking Decision in Chinese patients，PBHSD-C)进行调查，比较2组各指标的差异，并采用Logistic回归分析患者就医延迟的影响因素。结果:203例患者确诊不孕症至首次就医行IVF-ET治疗的间隔时间中位数为18个月，四分位数(P25，P75)为(6，42)个月，其中121例(59。61％)就医延迟，82例未就医延迟。2组患者的夫妻双方文化程度、双方婚史情况、家庭月收入、BIPQ总分、PSSS总分和PBHSD-C总分比较，差异有统计学意义(均P＜0。05)。Logistic回归分析显示，BIPQ总分升高(OR=0。833，P=0。001)、PSSS总分升高(OR=0。887，P=0。002)是就医延迟的保护因素;PBHSD-C总分升高(OR=1。754，P＜0。001)是就医延迟的危险因素。结论:IVF-ET不孕症患者总体就医延迟发生率较高，低疾病感知、低领悟社会支持、高就医行为感知障碍的患者更易发生就医延迟。医护人员应关注就医延迟的高风险人群，通过个性化就医行为指导、普及孕前健康体检，提高患者对疾病的正确认知和理解，提高领悟社会支持水平，降低阻碍就医行为因素，促进及时就医。
Analysis on the Status Quo and Influencing Factors of Medical Treatment Delay in Infertility Patients Undergoing IVF-ET
Objective:To investigate the status quo of medical treatment delay in female infertility patients undergoing in vitro fertilization-embryo transfer(IVF-ET)and analyze the influencing factors.Methods:With the method of objective sampling,203 female infertility patients who received IVF-ET for the first time at the Reproductive Medicine Center of Yantaishan Hospital from January to December 2022 were selected.According to the median time between the diagnosis of infertility and the first visit to IVF-ET,the subjects were divided into two groups:the medical treatment delay group and the non-medical treatment delay group.General information questionnaire,the Brief Illness Perception Questionnaire(BIPQ),the Perceived Social Support Scale(PSSS)and the Perceived Barriers to Health Care-seeking Decision in Chinese patients(PBHSD-C)were used to investigate.The differences of indexes between the two groups were compared,and the influencing factors of medical treatment delay were analyzed by Logistic regression.Results:The median interval between the diagnosis of infertility and the first treatment with IVF-ET in 203 patients was 18 months,and the quartile(P25,P75)was(6,42)months,among which 121 patients(59.61％)were delayed in seeking medical treatment,and 82 patients were not delayed.There were statistically significant differences in the cultural level of couples,marital status of couples,monthly family income,BIPQ total score,PSSS total score,and PBHSD-C total score between two groups(all P＜0.05).Logistic regression analysis showed that an increase in the BIPQ total score(OR=0.833,P=0.001)and PSSS(OR=0.887,P=0.002)was the protective factors for the delay in seeking medical treatment;an increase in the PBHSD-C total score(OR=1.754,P＜0.001)was a risk factor for the delay in seeking medical treatment.Conclusions:The IVF-ET infertility patients generally have a high incidence of delay in seeking medical treatment.Patients with low disease perception,low perceived social support and high perceived disorder of medical treatment behavior are more likely to delay medical treatment.Medical staff should pay attention to the high-risk groups who are delayed in seeking medical treatment,improve their correct cognition and understanding of diseases,improve the level of social support,reduce the behavioral factors that hinder medical treatment,and promote timely medical treatment through the personalized medical treatment behavior guidance and universal pre-pregnancy health examination.
Fertilization in vitroEmbryo transferInfertility,femaleRoot cause analysisMedical treatment delay
国家科技期刊平台
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